15Perioperative anaemia and patient blood management
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).
14Enhanced recovery after obstetric surgery
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.
13Alcohol and anaesthesia
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).
12Frailty in perioperative medicine
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.
11The importance of pain management in perioperative outcomes
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.