A series of short articles on key topics in perioperative medicine, published in the British Journal of Hospital Medicine

POM in a Nutshell


Perioperative anaemia and patient blood management

Dr Katie Samuel, ST7 Anaesthetist, Southmead Hospital, Bristol

10 Dec 2019

Anaemia is a common condition affecting approximately 30% of surgical patients, with iron deficiency being the leading cause (Musallam et al, 2011). The World Health Organization historically defined anaemia as a haemoglobin concentration of less than 120 g/litre for women and 130 g/litre for men. However, a more recent international consensus statement on management of perioperative anaemia has suggested using 130 g/litre for both men and women (Muñoz et al, 2017).


Enhanced recovery after obstetric surgery

Dr Sarah Ciechanowicz, ST7 anaesthetist, and Dr Nisa Patel, consultant anaesthetist, University College London Hospital

01 Oct 2019

Enhanced recovery is a multimodal package of care intended to expedite recovery following surgery. Many units now having enhanced recovery for obstetric surgery as a standard of practice for elective caesarean deliveries. Early discharge (after 24 hours) for uncomplicated caesarean delivery is in keeping with National Institute for Health and Care Excellence guidance.


Alcohol and anaesthesia

Dr Tom Blincoe, Consultant Anaesthetist, Department of Anaesthetics, Royal Cornwall Hospital, & Dr Duncan Chambler, Consultant in Anaesthesia and Intensive Care, Department of Anaesthetics, Dorset County Hospital

01 Sep 2019

Alcohol is the most commonly consumed recreational drug in the UK – 56% of adults drink alcohol regularly and nearly 10% drink on 5 or more days a week. 1.6 million adults in the UK may have some level of alcohol dependence (Office for National Statistics, 2017).


Frailty in perioperative medicine

Dr Andrew Rogerson, Staff Registrar, Department of General Medicine, Sengkang General Hospital, Singapore 544886 Dr Philip Braude, Consultant Geriatrician, Department of Ageing and Health, Guys and St Thomas’ NHS Foundation Trust, London

01 June 2019

As the proportion of older people in the population increases so too will the prevalence of age-related diseases, many of which are amenable to surgery. This will result in higher numbers of older people considering and undergoing surgical treatment. However, syndromes such as frailty, multimorbidity and functional dependenc render this cohort prone to adverse postoperative outcomes. Identifying frailty early can facilitate timely shared decision making, resource planning and optimization of health to improve outcomes.


The importance of pain management in perioperative outcomes

Dr Ben Morrison, Clinical Fellow, Department of Anaesthesia, Royal Marsden NHS Trust

01 April 2019

Recent focus by leading experts on enhanced recovery after surgery has been on not only a patient-specific but also a procedure-specific approach to analgesia in the perioperative period. Analgesic planning should begin at the earliest possible opportunity, not least to adequately counsel patients about what their anaesthetic will likely entail.

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