Evidence synthesized from various databases reveals that postoperative nausea and vomiting (PONV) are prevalent complications following surgeries with anesthesia, causing significant discomfort. The review identifies intricate neural mechanisms and signaling pathways that contribute to PONV, emphasizing the interaction of multiple pathways rather than independent functions. Key structures such as the nucleus of the solitary tract […]
Category: Perspectives, Opinions and Curiosities
Prospective audit improves antibiotic prescribing compliance
A prospective audit of 655 surgical antibiotic prescriptions revealed that only 49% adhered to guidelines, with significant issues such as inappropriate selections and prolonged usage. Community-acquired infections constituted 89% of treatments. The audit highlighted a low antibiotic guideline compliance rate and identified reasons for non-compliance. Thus, addressing these areas is essential to enhance antibiotic stewardship […]
Gabapentin effectively reduces postoperative pain in abdominal surgery.
A systematic review and meta-analysis of 22 studies involving 1,812 patients revealed gabapentin’s significant efficacy in postoperative pain management for abdominal surgery. It notably decreased pain levels, opioid consumption, and rates of postoperative nausea and vomiting (PONV), positioning gabapentin as a beneficial component of enhanced recovery after surgery (ERAS) protocols. Despite varying results across studies, […]
Opioids can be safely omitted after major surgeries.
A protocol to eliminate routine opioid prescriptions for patients after major intra-abdominal surgery resulted in a significant decrease in post-discharge opioid use. Only 17% of patients in the intervention group received opioids within thirty days compared to 46% in the control group (p
Operative management improves survival among frail patients.
An observational study of 49,169 patients revealed that operative management resulted in lower mortality rates overall (1.3% vs 2.5%, p
Enhanced risk adjustment improves hospital benchmarking accuracy
A new methodology allows for risk adjustments using multiple CPT codes instead of just the principal code in hospital benchmarking. Analysis of 994,332 patient cases revealed that hospitals reporting more CPT codes generally had improved benchmarking outcomes across 13 of 14 measures. In contrast, hospitals using only the principal code had advantages when assessed solely […]
Enhanced supervision improves surgical complication reporting and care
A comprehensive adverse event self-reporting platform significantly improved complication rates and overall quality of surgical care across three hospitals. The study, involving 83,885 surgical cases, found a remarkable 54% and 59% reduction in complication and mortality rates, respectively, at the most rigorously supervised site, compared to lesser reductions at the other locations. There was also […]
AI Advances in Laparoscopic Skill Assessment Show High Accuracy
AI applications in laparoscopic surgery simulation demonstrate significant promise, achieving concordance rates of 42%-100% with human assessments. The study tested AI trained on multiple procedures, revealing 100% accuracy for the appendectomy in the five-class scoring system and also high accuracy in the two-class system across three different procedures. These results suggest that AI can reliably […]
Patients with alcohol-related cirrhosis face significantly higher surgery rates
A nationwide study in Denmark reveals that patients with alcohol-related cirrhosis have a substantially elevated risk of requiring surgery compared to matched individuals from the general population. With a 1-year surgery risk of 42.6% for these patients, versus 13.4% for comparators, the incidence rate ratio for surgeries overall stood at 3.38. Notably, abdominal procedures were […]
Multimodal analgesia research shows rising global interest
A bibliometric analysis of multimodal analgesia (MA) research from 2013 to 2023 revealed a significant increase in publications, particularly post-2020, with 1,939 studies identified. The USA, China, and Canada emerged as leading contributors. Popular themes included non-steroidal anti-inflammatory drugs, enhanced recovery after surgery, and patient-controlled analgesia. Notable journals such as Cureus Journal of Medical Science […]