Perioperative Medicine最新文献

{"title":"Combined epidural-general anesthesia reduces opioid use and improves recovery after laparoscopic hysterectomy: a retrospective cohort study.","authors":"Shufen Jiang, Songquan Kong, Qianqian Fang","doi":"10.1186/s13741-026-00654-9","DOIUrl":"10.1186/s13741-026-00654-9","url":null,"abstract":"<p><p>BACKGROUND: Despite enhanced recovery after surgery (ERAS) pathways, laparoscopic hysterectomy is still associated with substantial acute postoperative pain, opioid exposure, and postoperative nausea and vomiting (PONV). Neuraxial techniques may provide opioid-sparing analgesia, but evidence for combined epidural and general anesthesia in laparoscopic hysterectomy remains limited. METHODS: This single-center retrospective cohort study included consecutive women undergoing elective laparoscopic hysterectomy for benign uterine disease between April 2021 and September 2023. Patients received general anesthesia alone (GA) or combined epidural and general anesthesia (CEA + GA) according to routine practice, and all were managed within an institutional ERAS pathway. Outcomes included intraoperative fentanyl and propofol doses, postoperative 0–24 h opioid use (intravenous morphine equivalents, ME), total perioperative opioid consumption, time to recovery from anesthesia, Visual Analog Scale (VAS) pain scores at 6, 12, 24, and 48 h, time to first ambulation and flatus, length of stay, hemodynamic variables, and anesthesia-related adverse events including PONV. Serum prostaglandin E2, 5-hydroxytryptamine, and substance P were measured from pre-induction to 48 h postoperatively. Multivariable linear regression assessed factors associated with total perioperative opioid dose, and logistic regression evaluated factors associated with PONV. RESULTS: Ninety-eight patients were included (GA, n = 42; CEA + GA, n = 56), with comparable baseline characteristics. Compared with GA, CEA + GA was associated with lower intraoperative fentanyl and propofol requirements, reduced total perioperative opioid consumption, lower VAS scores during the first 24 h, fewer rescue analgesia requirements, shorter time to recovery from anesthesia, earlier ambulation and bowel recovery, and a shorter hospital stay. Hemodynamic parameters were more stable, and intraoperative and early postoperative adverse events, including PONV, were less frequent with CEA + GA. In multivariable analyses, CEA + GA remained independently associated with reduced total perioperative opioid dose, and higher opioid exposure was independently associated with increased odds of PONV. CONCLUSIONS: In women undergoing laparoscopic hysterectomy within an ERAS pathway, combined epidural and general anesthesia was associated with lower opioid exposure, improved early pain control, greater hemodynamic stability, and fewer anesthesia-related adverse events compared with general anesthesia alone. This approach may be a useful opioid-sparing anesthetic option to enhance perioperative recovery after laparoscopic hysterectomy. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative anesthesia management of GLP-1 receptor agonists: a systematic review of potential risks.","authors":"Zachary I Merhavy, Zachary Kowal, Taylor Spencer, Anna Maria Trachuk, Alexander Aldanese, Zulfiqar Ahmed, Camelia Arsene","doi":"10.1186/s13741-026-00662-9","DOIUrl":"10.1186/s13741-026-00662-9","url":null,"abstract":"<p><p>Glucagon-like peptide-1 receptor agonists (GLP-1 RAs) were initially developed for the management of type 2 diabetes, due to their role in enhancing insulin secretion, decreasing glucagon secretion, and delaying gastric emptying. Although these mechanisms have been exploited to facilitate weight loss, these medications have also been indicated for patients with cardiovascular or renal diseases, all of which have caused a recent drastic rise in prescribing GLP-1 RAs. However, the current American Society of Anesthesiologists (ASA) guidelines express concerns of an increased risk of aspiration in the perioperative setting due to the well-documented delayed gastric emptying. This systematic review evaluates the literature on the relationship between GLP-1 RA use and increased regurgitation and aspiration events to contextualize the existing, consensus-based guidelines put forth by the ASA in light of limited comparative evidence. A systematic search was conducted across PubMed, Google Scholar, SCOPUS, MEDLINE, and EMBASE from inception to January 17, 2025, yielding over 1.3 million articles. After a PRISMA analysis was completed on the initial search and articles were screened based on predefined eligibility criteria, 32 articles were selected for review and analysis. Although most of the studies reported an association between GLP-1 RA and increased residual gastric contents, evidence linking these medications to a statistically significant rise in regurgitation or aspiration events remains highly inconsistent. The variability in available studies, potential confounding factors, and the severe heterogeneity of conclusions all emphasize the need for more high-quality evidence-based primary research to optimize perioperative management of patients taking GLP-1 RAs.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13032261/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of perioperative tight glycemic control on prognosis in diabetic abdominal surgery patients: a systematic review and meta-analysis.","authors":"Tianle Zhang, Danni Song, Mingyue Shao, Gang Wang, Zhiwei Jiang","doi":"10.1186/s13741-026-00651-y","DOIUrl":"10.1186/s13741-026-00651-y","url":null,"abstract":"<p><p>BACKGROUND: Asian studies presents conflicting conclusions regarding the prognostic benefits of perioperative tight glycemic control (TGC) versus conventional glycemic control (CGC) in abdominal surgery. This systematic review and meta-analysis synthesizes current evidence to resolve these clinical discrepancies. METHODS: A systematic search across major databases (PubMed, Web of Science, EMBASE, Cochrane, etc.) identified randomized controlled trials assessing perioperative TGC’s impact on abdominal surgery patient prognosis. RESULTS: This meta-analysis, encompassing 30 studies with 2,709 patients, demonstrates that perioperative TGC significantly reduces the incidence of surgical site infections, respiratory tract infections, overall complications, and hypoglycemia in patients undergoing abdominal surgery. While publication bias was noted for overall complications and heterogeneity for hypoglycemia, neither affected the conclusions. TGC’s potential to reduce wound healing time and hospital stay is attenuated by publication bias, while the conclusion on length of stay is further confounded by significant data heterogeneity. No difference was observed in the incidence of urinary tract infections. CONCLUSION: Compared to perioperative CGC, perioperative TGC, which maintains blood glucose levels at 4.44–6.67 mmol/L, can significantly improve the prognosis of patients undergoing abdominal surgery. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13045101/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146227495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"RAPID-CHD pathway improves clinical outcomes in neonates with congenital heart disease.","authors":"Chenyu Li, Zhongyuan Lu, Shilin Wang, Xia Li, Xiaofeng Wang, Qinnan Chen, Xu Wang","doi":"10.1186/s13741-026-00650-z","DOIUrl":"10.1186/s13741-026-00650-z","url":null,"abstract":"<p><strong>Background: </strong>Timely and effective management is crucial for neonates with critical congenital heart disease (CCHD). This study investigated the impact of the RAPID-CHD Pathway, a coordinated referral and transport system, compared with conventional management models.</p><p><strong>Methods: </strong>This retrospective study included neonates (≤ 28 days) with CCHD admitted between January 2019 and December 2024. Group 1 comprised neonates enrolled in the RAPID-CHD Pathway: prenatally diagnosed, delivered in designated maternity hospitals, and transferred via a dedicated fast-track pathway. Group 2 included those referred from other hospitals or self-admitted. Major adverse events (MAEs) were defined as in-hospital death or discharge against medical advice. Logistic regression was used to assess associations between management strategies and MAEs.</p><p><strong>Results: </strong>Among 587 neonates (Group 1: n = 141; Group 2: n = 446), 439 underwent surgery (Group 1: n = 116; Group 2: n = 323). Group 1 had earlier ICU admission (0 vs 6 days, P < 0.001), earlier surgery (7 vs 15 days, P < 0.001), lower rates of low birth weight (< 2.5 kg: 5.7% vs 18.2%, P < 0.001), fewer emergency surgeries (9.5% vs 18.9%, P = 0.028), and higher surgical rates (82.3% vs 72.4%, P = 0.025). MAEs were lower in Group 1 (5.7% vs 12.6%, P = 0.033). Among patients who underwent surgery, the RAPID-CHD pathway remained associated with a trend toward reduced MAEs after adjustment (aOR 0.36; 95% CI, 0.11-1.20).</p><p><strong>Conclusions: </strong>The RAPID-CHD Pathway improves early access to care, surgical opportunities, and outcomes in neonates with CCHD. It supports wider adoption in tertiary pediatric cardiac centers.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13019993/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of intraoperative blood pressure variability on development of postoperative acute kidney injury among Japanese.","authors":"Ryosuke Mimata, Toshitaka Yamanokuchi, Toshiki Maeda, Hisatomi Arima, Kozaburo Akiyoshi","doi":"10.1186/s13741-026-00644-x","DOIUrl":"10.1186/s13741-026-00644-x","url":null,"abstract":"<p><p>BACKGROUND: To investigate the effects of intraoperative blood pressure (BP) variability on development of postoperative acute kidney injury (AKI) in patients undergoing non-cardiac surgery. METHODS: In this retrospective observational study, a total 8504 adult (≥ 20 years) cases who underwent non-cardiac surgery with general anesthesia performed at Fukuoka University Hospital from 2017 to 2019 were included in the present analysis. Standard deviation (SD), coefficient of variation (CV), average real variability (ARV) and minimum value of intraoperative systolic BP based on oscillometric measurement were used as indices of BP variability. Postoperative AKI was defined as an increase serum creatinine level by more than 0.3 mg/dL or 1.5 times from preoperation within 48 h after surgery. RESULTS: A total of 184 (2.16%) cases developed AKI postoperatively. Incidence of AKI increased with elevation of SD, CV and ARV of intraoperative systolic BP. Although the association of SD and CV became non-significant after adjustment for confounding factors including intraoperative hypotension (minimum systolic BP < 80 mm Hg) (both P > 0.05 for trend). However, ARV of intraoperative systolic BP were remained significantly associated with postoperative AKI after adjustment for confounding factors including intraoperative hypotension (P > 0.007 for trend). In contrast, lower minimum systolic BP was associated with increased cumulative incidence of postoperative AKI even after adjustment for other confounding factors (P < 0.001 for trend). CONCLUSIONS: In a large-scale observational study of Japanese who underwent non-cardiac surgery, intraoperative BP variability, which was defined by ARV and minimum value of systolic BP, was associated with higher risks of postoperative AKI. TRIAL REGISTRATION: This study was approved by the Fukuoka University Medical Ethics Committee (No. H19-12-006). </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13014715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146207558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative neurocognitive disorder: migration and crosstalk of inflammation in the peripheral and central nervous system.","authors":"Xinyi Chen, Wanqiu Yu, Zhaoqiong Zhu","doi":"10.1186/s13741-025-00640-7","DOIUrl":"10.1186/s13741-025-00640-7","url":null,"abstract":"<p><p>Postoperative neurocognitive disorder (PNCD) causeschallenges in addition to that resulting from surgery. These adverse effects not only impact patients in the short term but can also lead to long-term consequences, including an increased mortality rate, a higher risk of developing Alzheimer’s disease, and a decline in post-surgical quality of life and longevity. To better prevent and treat PNCD and improve the prognosis of surgical patients, it is essential to enhance the understanding of the pathogenesis of PNCD. According to recent studies, peripheral inflammation and neuroinflammation may collectively contribute to the development of PNCD. This article discusses the sources of peripheral inflammation, the migration and crosstalk of inflammation between the periphery and the central nervous system, and whether this crosstalk could provide new insights into preventing and treating PNCD.</p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13001259/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146197863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of transcutaneous electrical acupoint stimulation for preemptive analgesia on intraoperative opioid dosage in burn patients: a randomized, double-blind, controlled trial.","authors":"Qian Liu, Ziyan Pan, Jingbin Zhang, Haichuan He, Yujia Zhao, Jiangwen Yin, Yan Li","doi":"10.1186/s13741-026-00656-7","DOIUrl":"10.1186/s13741-026-00656-7","url":null,"abstract":"<p><p>BACKGROUND: Burn survivors may be at risk of various opioid-related adverse effects. We aimed to investigate whether transcutaneous electrical acupoint stimulation (TEAS) used for preemptive analgesia in burn patients reduces intraoperative opioid dosage. METHODS: In this trial, 86 burn patients with wound debridement under general anesthesia were randomized to receive thirty minutes of TEAS (TEAS group, n = 43) at acupoints LI4 (Hegu), PC6 (Neiguan), ST36 (Zusanli), and SP6 (Sanyinjiao) before induction of anesthesia or false stimulation (control group, n = 43). The primary outcome was the intraoperative remifentanil dosage. Secondary outcomes included intraoperative propofol dosage, patients’ resting facial-visual analogue scale (F-VAS) scores before stimulation (F1), after stimulation (F2), at 24 h after surgery (F3), and 48 h after surgery (F4), the incidence of opioid-related adverse reactions, and the use of rescue analgesics until the first postoperative day (POD1). RESULTS: The dosage of remifentanil showed a significant difference between the two groups, with 0.65(0.45,1.00) in the TEAS group (T group) and 0.90(0.67,1.23) in the control group (C group) (P < 0.05). Meanwhile, there was no significant difference in the intraoperative propofol dosage between groups. F2 and F3 in the T group were lower than those in the C group (P < 0.05), and no significant differences were observed in F1 and F4 (P > 0.05) between the two groups. Until POD1, the incidence of nausea-vomiting and constipation (P < 0.05) in the T group was lower than that the C group, while there was no significant difference in the incidence of drowsiness and dizziness (P > 0.05). It is worth noting that the use of rescue analgesics between the two groups was comparable (P > 0.05). CONCLUSIONS: The preoperative application of TEAS for preemptive analgesia can reduce intraoperative remifentanil dosage. Meanwhile, it has a positive effect on early postoperative analgesia and gastrointestinal adverse reactions. TRIAL REGISTRATION: This study was registered in the Chinese Clinical Trials Registry (ChiCTR2300078615, date of registration: 14/12/2023, retrospectively registered). </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13005346/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146195246","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early anaemia and prognosis after knee arthroplasty in nonagenarians admitted to ICU post surgery: a multicentre binational cohort study.","authors":"Je Min Suh, Laurence Weinberg, Nattaya Raykateeraroj, Andrew Hardidge, Andrew Ng, Tony Huang, Yao Hui Lim, Sophia Grobler, Jad Jurji, Jae Hyun Lee, David Pilcher, Dong-Kyu Lee","doi":"10.1186/s13741-026-00655-8","DOIUrl":"10.1186/s13741-026-00655-8","url":null,"abstract":"<p><p>INTRODUCTION: Anaemia is one of the most common complications following major surgery, arising from perioperative blood loss, hemodilution, and impaired erythropoiesis. Although preoperative anaemia is a recognised risk factor for adverse outcomes, the prognostic importance of early postoperative anaemia remains underexplored, particularly in very elderly patients. Given the rising prevalence of osteoarthritis and total knee arthroplasty (TKA) in the ≥ 90-year-old population, understanding the implications of anaemia in this high-risk cohort is increasingly relevant. METHODS: We conducted a retrospective binational cohort study using the Australian and New Zealand Intensive Care Society (ANZICS) Adult Patient Database. All patients ≥ 90 years admitted to the ICU following TKA between 2010 and 2024 with haemoglobin (Hb) measured within 24 h were included. Anaemia was defined according to World Health Organization criteria and stratified as non-anaemia, mild, or moderate/severe. The primary outcome was all-cause mortality, examined in short-term (< 365 days) and long-term (≥ 365 days) intervals. Secondary outcomes included ICU and hospital length of stay (LOS), illness severity scores, and postoperative biochemical and physiological parameters. Time-to-event outcomes were assessed with Cox regression, and LOS outcomes with log-transformed linear models. RESULTS: Among 493 patients, 22.3% were non-anaemic, 30.0% had mild anaemia, and 47.7% had moderate/severe anaemia. Severe anaemia was associated with higher illness severity (median APACHE III 57 vs 54; p = 0.013), prolonged ICU stay (18% longer; p = 0.008), and longer hospitalisation (p = 0.037). Anaemia was not associated with short-term mortality. However, beyond 365 days, both mild (HR 2.08; 95% CI 1.05–4.13; p = 0.036) and severe anaemia (HR 1.98; 95% CI 1.05–3.73; p = 0.035) independently predicted higher mortality. DISCUSSION/CONCLUSION: In nonagenarians undergoing TKA, anaemia at ICU admission was highly prevalent and associated with increased illness severity, resource utilisation, and elevated long-term mortality. These findings highlight postoperative Hb as an important prognostic marker in the oldest old and support strategies for early detection, optimisation, and structured follow-up to improve survival and recovery in this vulnerable population. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"16"},"PeriodicalIF":2.5,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12895755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146158119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting deep vein thrombosis risk in patients with knee fractures: a nomogram-based study.","authors":"Ximin Jin, Rui Gong, Cong Wang, Yongkui Zhang","doi":"10.1186/s13741-026-00653-w","DOIUrl":"10.1186/s13741-026-00653-w","url":null,"abstract":"<p><p>OBJECTIVE: This study aims to develop a predictive model based on clinical and laboratory indicators to assess the risk of deep vein thrombosis (DVT) in patients with knee fractures, thereby facilitating early identification of high-risk individuals and guiding personalised interventions. METHOD: Patients with knee fractures were randomly assigned to either a training or validation cohort in a 7:3 ratio. Discrepancy analysis was conducted to compare the variables between the two cohorts. A multiple logistic regression model was employed to identify the independent predictors of lower limb DVT in patients with knee fractures. Receiver operating characteristic (ROC) curves were subsequently utilized to evaluate the diagnostic precision of risk markers, with predictive efficacy assessed through area under the curve calculations. RESULT: Among 923 hospitalised patients meeting the study criteria, we identified six independent factors—age, PTA, FIB, TT, D-dimer, and BMI—for nomogram construction from 21 variables. The area under the ROC curve for predicting lower extremity DVT was 0.75 (95% confidence interval [CI]: 0.71–0.79) in the training set and 0.76 in the validation set. Decision curve analysis confirmed the nomogram’s clinical applicability. CONCLUSION: The nomogram developed in this study shows intense discrimination, calibration, and clinical utility, suggesting promise for predicting lower extremity DVT and functioning as a quantitative instrument in clinical settings. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":""},"PeriodicalIF":2.5,"publicationDate":"2026-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12980941/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Establishing a day case lumbar microdiscectomy service at a University Hospital in Dublin, Ireland.","authors":"Elne Noppe, Oisin Friel, Joseph Fournier, Timothy Martin Murphy, Claire Frith Keyes, Niall Fahey, Emma Leydon, Clare O'Connor","doi":"10.1186/s13741-026-00648-7","DOIUrl":"10.1186/s13741-026-00648-7","url":null,"abstract":"<p><p>BACKGROUND: Day case surgery offers significant patient and economic benefits, with 75% of elective surgeries targeted to be performed as day procedures as set by the Association of Anaesthetists. While advances in surgical and anaesthetic techniques have made more complex surgeries feasible as day cases, concerns remain about the safety of day case spine surgeries due to potential severe complications. OBJECTIVE: This observational study evaluates the feasibility and safety of day case lumbar microdiscectomy (DLM) in an Irish university hospital setting by comparing discharge rates, readmission rates, and patient satisfaction with international data. RESULTS: Of the 26 patients who underwent surgery, 24 (92.3%) were successfully discharged on the same day. No patients required readmission within six weeks postoperatively. High levels of patient satisfaction were noted and similar outcomes to those reported internationally. ANALYSIS: Key factors for success included the development of standardised intraoperative protocols, the use of multimodal analgesia, and strict patient selection criteria. Challenges in implementing take-home analgesia protocols were noted, emphasising the importance of dedicated staff and frequent education to maintain protocol adherence. CONCLUSION: The study concludes that DLM is a viable, safe, and cost-effective option for selected patients, with potential savings of €1660 per patient compared to traditional inpatient procedures. These findings support the feasibility of DLM in Ireland. </p>","PeriodicalId":19764,"journal":{"name":"Perioperative Medicine","volume":" ","pages":"12"},"PeriodicalIF":2.5,"publicationDate":"2026-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12874951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146041134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}