Excellent anaesthesia needs patient preparation and postoperative support to influence outcome
| Autor: | Carl Waldmann, D. R. Goldhill |
|---|---|
| Rok vydání: | 2006 |
| Předmět: |
medicine.medical_specialty
Myocardial revascularization Colon business.industry Surgical mortality MEDLINE Blood Pressure Perioperative Risk Assessment Outcome (game theory) Perioperative Care Aortic Aneurysm Treatment Outcome Anesthesiology and Pain Medicine Colon surgery Perioperative care Myocardial Revascularization medicine Humans Cardiac Output Risk assessment Intensive care medicine business Needs Assessment |
| Zdroj: | Current Opinion in Anaesthesiology. 19:192-197 |
| ISSN: | 0952-7907 |
| DOI: | 10.1097/01.aco.0000192785.85763.5f |
| Popis: | Studies over many years have demonstrated that preoptimization and attention to appropriate perioperative care is associated with a substantial decrease in surgical mortality. This review discusses ways in which patient preparation and perioperative support can minimize surgical mortality and morbidity.Scoring systems continue to be developed in order to classify categories of surgical risk. Objective physiologically based assessments can also identify high-risk groups of patients. Debate continues over the indications for specific interventions such as beta-blockade or statin therapy. There is continuing interest in perioperative optimization of oxygen delivery. A multimodality approach paying attention to a range of possible interventions appears to be beneficial. Audit, training, experience and a sufficient volume of procedures are all factors associated with surgical mortality.The provision of a high-quality service throughout the perioperative period is vital for a successful outcome. Patients need to be assessed well before major elective surgery to determine if they fall into a high-risk category. Some patients may benefit from a change in management. Postoperatively, critical-care support should be available backed by level 1 (enhanced ward) care with input from outreach or medical emergency teams 24 hours per day, seven days a week. |
| Databáze: | OpenAIRE |
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