Anesthetic management of complex spine surgery in adult patients

Alboog, Abdulrahman; Bae, Sandy J.; Chui, Jason

doi:10.1097/aco.0000000000000765

Cited by 30 publications

(43 citation statements)

References 47 publications

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“…Improved pain control has been proved to be correlated with decreased risks of wound healing and Infectious complications, delirium, delayed mobilization, and prolonged LOS [37,38]. Multimodal analgesia was applied in our ERAS program, and a standardized analgesic strategy was established based on patient-reported pain VAS score.…”

Section: Discussionmentioning

confidence: 99%

Comparative short-term outcomes of enhanced recovery after surgery (ERAS) program and none-ERAS traditional care in elderly patients undergoing lumbar arthrodesis: a retrospective study

Kong

et al. 2021

Preprint

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Background: Enhanced recovery after surgery (ERAS) program is an evidence-based improvement over none-ERAS traditional care. The aim of the present study was to analyze the safety, feasibility, and efficacy of an ERAS program in patients over 70 years undergoing lumbar arthrodesis by comparison with none-ERAS traditional care.Methods: During January 2018 to December 2018, patients enrolled received none-ERAS traditional care, while the ERAS program was implemented from January to December 2019. Demographic characteristics, comorbidities, surgical data and postoperative recovery parameters were collected from all patients. Postoperative pain scores were evaluated by visual analog scales (VAS). The clinical outcomes were length of stay (LOS), postoperative complications and postoperative pain scores. Compliance results were also collected.Result: A total of 127 patients were enrolled, including 67 patients in the none-ERAS traditional care group and 60 patients in the ERAS group. The demographic characteristics and comorbidities of the two groups showed no significant differences. The LOS of patients treated with ERAS program (13.6±4.0 days) was significantly less than that of patients treated with none-ERAS traditional care (15.6±3.9 days) (p = 0.034). Complication rate was 8.3% in the ERAS group versus 20.9% in the none-ERAS traditional care group (p = 0.048). VAS (back) in the ERAS group was significantly lower on postoperative day (POD) 1 and POD2. Postoperative recovery parameters were improved in the ERAS group. The overall compliance with the ERAS program was 94%.Conclusions: Based on our results, ERAS program is safer and more effective for elderly patients over 70 undergoing lumbar arthrodesis than none-ERAS traditional care.

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Section: Discussionmentioning

confidence: 99%

Comparative short-term outcomes of enhanced recovery after surgery (ERAS) program and none-ERAS traditional care in elderly patients undergoing lumbar arthrodesis: a retrospective study

Kong

et al. 2021

Preprint

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“…Improved pain control has been proved to be correlated with decreased risks of wound healing and Infectious complications, delirium, delayed mobilization, and prolonged LOS [29,30]. Preoperative education helps elderly patients gain a clear understanding of the expectations of surgeries and build con dence in perioperative recovery [33].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Study of Enhanced Recovery After Surgery (ERAS) Program and None-ERAS Traditional Care in Elderly Patients Undergoing Lumbar Arthrodesis

Kong

et al. 2020

Preprint

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Background: The aim of the present study was to analyze the safety, feasibility, and efficacy of an ERAS program in patients over 70 years undergoing lumbar arthrodesis by comparison with none-ERAS traditional care.Methods: During January 2018 to December 2018, patients enrolled received none-ERAS traditional care, while the ERAS program was implemented from January to December 2019. Demographic characteristics, comorbidities, surgical data and postoperative recovery parameters were collected from all patients. Postoperative pain scores were evaluated by visual analog scales (VAS). The clinical outcomes were LOS, postoperative complications and postoperative pain scores. Compliance results were also collected.Result: A total of 127 patients were enrolled, including 67 patients in the none-ERAS traditional care group and 60 patients in the ERAS group. The demographic characteristics and comorbidities of the two groups showed no significant differences. The LOS of patients treated with ERAS program (13.6±4.0 days) was significantly less than that of patients treated with none-ERAS traditional care (15.6±3.9 days). Complication rate was 8.3% in the ERAS group versus 20.9% in the none-ERAS traditional care group (p = 0.048). VAS (back) in the ERAS group was significantly lower on postoperative day (POD) 1 and POD2. Postoperative recovery parameters were improved in the ERAS group. The overall compliance with the ERAS program was 94%.Conclusions: Based on our results, ERAS program is safer and more effective for elderly patients over 70 undergoing lumbar arthrodesis than none-ERAS traditional care.Trial registration: ChiCTR, ChiCTR1800020513. Registered 2 January 2018, http:// www.chictr.org.cn/ChiCTR1800020513

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“…Neurosurgery cases are frequently long, positioning is prone, the head of the bed may be rotated away from the anesthesia provider, and the patient’s head may be stabilized with a horseshoe or pins. [ 2 ] These aspects emphasize the importance of securing the endotracheal tube and adequate intravenous (IV) access, typically with an additional IV line (s). Most patients tend to be older and have multiple comorbidities.…”

Section: Neuroanesthesiamentioning

confidence: 99%

A novel checklist for anesthesia in neurosurgical cases

Ghaly¹,

Kushnarev²,

Pirvulescu³

et al. 2021

Surgical Neurology International

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Throughout their training, anesthesiology residents are exposed to a variety of surgical subspecialties, many of which have specific anesthetic considerations. According to the Accreditation Council for Graduate Medical Education requirements, each anesthesiology resident must provide anesthesia for at least twenty intracerebral cases. There are several studies that demonstrate that checklists may reduce deficiencies in pre-induction room setup. We are introducing a novel checklist for neuroanesthesia, which we believe to be helpful for residents during their neuroanesthesiology rotations. Our checklist provides a quick and succinct review of neuroanesthetic challenges prior to case setup by junior residents, covering noteworthy aspects of equipment setup, airway management, induction period, intraoperative concerns, and postoperative considerations. We recommend displaying this checklist on the operating room wall for quick reference.

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Anesthetic management of complex spine surgery in adult patients

Cited by 30 publications

References 47 publications

Comparative short-term outcomes of enhanced recovery after surgery (ERAS) program and none-ERAS traditional care in elderly patients undergoing lumbar arthrodesis: a retrospective study

Comparative short-term outcomes of enhanced recovery after surgery (ERAS) program and none-ERAS traditional care in elderly patients undergoing lumbar arthrodesis: a retrospective study

A Comparative Study of Enhanced Recovery After Surgery (ERAS) Program and None-ERAS Traditional Care in Elderly Patients Undergoing Lumbar Arthrodesis

A novel checklist for anesthesia in neurosurgical cases

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