Perioperative acute myocardial infarction is a life-threatening event. The aim of preoperative evaluation identifying at-risk patient developing postoperative complications and to undertake risk reduction measures prevent such complications. We report case male with good functional capacity unknown history cardiovascular disease undergoing radical cystectomy who suffered intra-operative cardiac...

This article explores approaches to the perioperative care of pregnant women. Considerations such as the anatomical and physiological changes that occur during pregnancy are addressed, as well as adaptations to perioperative care made necessary by these changes. The potential limitations, constraints and difficulties faced when planning and implementing care are discussed. Social, psychological...

BACKGROUND Perioperative myocardial ischemia occurs in 20-40% of patients at risk for cardiac morbidity and is associated with a ninefold increase in risk of cardiac morbidity. METHODS In a prospective, double-blinded, clinical trial, we studied 190 patients with or at risk for coronary artery disease in two study groups with a 2:1 ratio (clonidine, n = 125 vs. placebo, n = 65) to test the hy...

Children are not just 'small adults'. They have specific physical, psychological and social requirements that must be identified and addressed to optimise their well-being in the perioperative period. The healthcare practitioner should be trained to understand the needs of the paediatric patient in hospital, including the ever increasing need to take into account cultural differences. Hospital ...

PURPOSE The aim of this study was to clarify the efficacy of intravenous milrinone in postoperative care for patients following left ventricular (LV) restoration (LVR). METHODS Fourteen patients who had ischemic cardiomyopathy with an LV ejection fraction (LVEF) of less than 0.30 and an LV end-systolic volume index of more than 100 ml/m2 underwent coronary artery bypass grafting and concomita...

BACKGROUND Our review question was "Does perioperative steroids administration, in comparison with other treatments or placebo, improve either postoperative pain control, length of hospital stay, or return to work in patients undergoing lumbar disc surgery?" METHODS We searched PubMed, CINAHL PLUS, and Cochrane databases for randomized control trials (RCTs) studying the role of steroids for l...

BACKGROUND AND OBJECTIVES Currently, endoscopic medicine is being increasingly used, albeit not without risks. Therefore, this study evaluated the factors associated with perioperative complications in endoscopic surgery with intraoperative irrigation. METHOD A cohort study of six months duration. Patients aged ≥ 18 years undergoing endoscopic surgery with the use of irrigation fluids during ...

Blood coagulation is the process that results in the formation of a blood clot to stop bleeding from a damaged blood vessel. Various pharmacologic agents can affect the coagulation process. The American College of Chest Physicians' evidence-based practice guidelines for perioperative management of antithrombotic therapy provide guidance for anticoagulant or antiplatelet therapy and bridge thera...

BACKGROUND The purpose of this study was to determine the effect of algorithmic physiologic management on patients undergoing head and neck free tissue transfer and reconstruction. METHODS Ninety-four adult patients were randomized to treatment and control groups. The blood pressure of the control group was managed consistent with contemporary standards. The treatment group was managed using ...

Many patients undergo non-invasive testing for the detection of coronary artery disease before non-cardiac surgery. This is despite the low predictive value of positive tests in this population and the lack of any evidence of benefit of coronary revascularisation before non-cardiac surgical procedures. Further, this strategy often triggers a clinical cascade exposing the patient to progressivel...