Searches of PubMed, The Joanna Briggs Institute EBP Database, and the National Guideline Clearinghouse yielded the following practice guideline.
Whitaker Chair, D K, et al. “Immediate post-anaesthesia recovery 2013: Association of Anaesthetists of Great Britain and Ireland.” Anaesthesia 68.3 (2013):288-297.
The abstract states, “The standard of nursing and medical care should be equal to that in the hospital’s critical care units.”
Reviewed 4/8/2014 ldt
A search of Joanna Briggs Institute EBP retrieved this evidence summary:
Surgical Site Infection: Post-anesthesia and Post Operative Management. 2015.
It references a systematic review: Blondet JJ, Beilman GJ. Glycemic control and prevention of perioperative infection. Curr Opin Crit Care. 2007;13(4):421-427.
This review references studies documenting effect of perioperative hyperglycemia on post-surgical infection and mortality.
Additional references
PubMed: hyperglycemi* AND (postoperative OR post-operative OR perioperative) AND (complications OR mortality OR morbidity
Retrieves many references. It is more efficient to begin with the systematic reviews from this search:
hyperglycemi* AND (postoperative OR post-operative OR perioperative) AND (complications OR mortality OR morbidity))systematic[sb]
Some of these reviews will evaluate effect of controling blood glucose in the postoperative period, but they should also address the literature documenting the problem.
Delaney, C P Clinical perspective on postoperative ileus and the effect of opiates. Neurogastroenterology and motility 2004 vol:16 Suppl 2 pg:61 -66
Zutshi, Massarat Randomized controlled trial comparing the controlled rehabilitation with early ambulation and diet pathway versus the controlled rehabilitation with early ambulation and diet with preemptive epidural anesthesia/analgesia after laparotomy and intestinal resection. The American journal of surgery 2005 vol:189 iss:3 pg:268 -272
Delaney, Conor Prospective, randomized, controlled trial between a pathway of controlled rehabilitation with early ambulation and diet and traditional postoperative care after laparotomy and intestinal resection. Diseases of the colon & rectum 2003 vol:46 iss:7 pg:851 -859
van Bree, Sjoerd H W New therapeutic strategies for postoperative ileus. Nature reviews. Gastroenterology & hepatology 2012 vol:9 iss:11 pg:675 -683
Thompson, Melissa Management of postoperative ileus. Orthopedics 2012 vol:35 iss:3 pg:213 -217
Lubawski, James Postoperative ileus: strategies for reduction. Therapeutics and Clinical Risk Management 2008 vol:4 iss:5 pg:913 -917
Reviewed JKN 4/14
Search in PubMed for catheterization AND band AND radial artery identified:
Bottom line: SIRS is a response by the body to some kind of infectious or noninfectious insult. The response includes a profound systemic inflammation that can lead to septic shock and multiple organ failure. Surgey can elicit this systemic inflammation by exposing patient to tissue damage and to possible infection. Signs of SIRS include changes in heart rate, respiratory rate, blood pressure, temperature regulation, and immune cell activation.
Details:
Chapter 4. Fever and hypothermia. In: Textbook of Critical Care, 6th ed., 2011.
Chapter 8. Inflammation, Infection, & Antimicrobial Therapy. In: Current Diagnosis & Treatment: Surgery [AccessSurgery]
These two chapters provide a brief explanation of SIRS. Chapter 4 also includes algorithm for looking for source of infection.
Sepsis in adults. In: DynaMed. Summarizes diagnostic criteria and treatment options. Patient is considered to have SIRS if he/she exhibits more than one of these criteria from the 2001 Society of Critical Care Medicine (SCCM)/The European Society of Intensive Care Medicine (ESICM)/American College of Chest Physicians (ACCP)/American Thoracic Society (ATS)/Surgical Infection Society (SIS) International Sepsis Definitions Conference:
Intensive Care Med 2003 Apr;29(4):530
Chapter 68. Multiple organ failure. In: Trauma [AccessSurgery] explains SIRS in the context of noninfectious causes.
A search of PubMed for “Defibrillators, Implantable”[MAJR] AND (local anesthesia OR sedation) AND (outcome OR complications OR safety OR satisfaction) identified several studies.
Studies comparing local anesthesia/sedation v. general anesthesia
Can we implant cardioverter defibrillator under minimal sedation?
Marquié C, Duchemin A, Klug D, Lamblin N, Mizon F, Cordova H, Boulo M, Lacroix D, Pol A, Kacet S.
Europace. 2007 Jul;9(7):545-50.
Measured patient-reported level of pain.
Electrophysiologist-implanted transvenous cardioverter defibrillators using local versus general anesthesia.
Manolis AS, Maounis T, Vassilikos V, Chiladakis J, Cokkinos DV.
Pacing Clin Electrophysiol. 2000 Jan;23(1):96-105.
Measured rate of post-surgical complications
Local anaesthesia versus general anaesthesia for cardioverter-defibrillator implantation.
Stix G, Anvari A, Podesser B, Pernerstorfer T, Mayer C, Laufer G, Schmidinger H.
Wien Klin Wochenschr. 1999 May 21;111(10):406-9.
Measured rate of post-surgical complications
Intravenous sedation for placement of automatic implantable cardioverter-defibrillators.
Pinosky ML, Reeves ST, Fishman RL, Alpert CC, Dorman BH, Kratz JM.
J Cardiothorac Vasc Anesth. 1996 Oct;10(6):764-6.
Measured length of stay and rate of post-surgical complications
Studies describing outcomes for procedures performed under locatl anesthetic/sedation
Safety and acceptability of implantation of internal cardioverter-defibrillators under local anesthetic and conscious sedation.
Fox DJ, Davidson NC, Royle M, Bennett DH, Clarke B, Garratt CJ, Hall MC, Zaidi AM, Patterson K, Fitzpatrick AP.
Pacing Clin Electrophysiol. 2007 Aug;30(8):992-7. Erratum in: Pacing Clin Electrophysiol. 2007 Nov;30(11):1423
Additional descriptive studies
Reviewed JKN 4/14
Inadvertent Perioperative Hypothermia. In: Joanna Briggs JBI+Connect, Feb 17, 2011.
Evidence summary on effectiveness of various interventions for preventing hypothermia in patients undergoing surgery. Cites evidence-based guideline (National Collaborating Centre for Nursing and Supportive Care. Clinical practice guideline: the management of inadvertent perioperative hypothermia in adults. April 2008) for evidence that suggests warming patients in the preoperative period may reduce risk for inadvertent perioperative hypothermia. See guideline for specific evidence; Fig. 9 (p. 149) summarizes evidence from two observational studies documenting effect of preoperative temperature on incidence of hypothermia.
CINAHL search on preoperative and warming and (postoperative temperature OR hypothermia)
Search results include several quasi-experimental studies evaluating change in post-operative rates of hypothermia after implementing preoperative warming including:
PubMed search: preoperative AND warming identified
Torossian A. Thermal management during anaesthesia and thermoregulation standards for the prevention of inadvertent perioperative hypothermia. Best Pract Res Clin Anaesthesiol. 2008 Dec;22(4):659-68.
Reviews the literature’s findings on all current methods both passive and active and attempts to institute management guidelines for thermal management.
Reviewed by John Nemeth 4/14
Evidence Matters 