A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures

Epstein, Nancy E.

doi:10.4103/2152-7806.130674

Cited by 135 publications

(98 citation statements)

References 18 publications

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“…Screening preoperative blood glucose levels and maintaining tight glucose control after surgery may be especially important in preventing infections in this population [17]. Additional staff may also be needed postoperatively to assist patients with mobilization, as early mobilization is known to lower the risk of wound infection after surgery [18]. Our results suggest that further investigation into infection prevention strategies targeting the obese trauma population is needed.…”

Section: Discussionmentioning

confidence: 92%

Infectious complications in obese patients after trauma

Bell

Bayt

Siedlecki

et al. 2016

Journal of Surgical Research

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Background: Obesity is a public health concern in the U.S. due to its increasing prevalence, especially in younger age groups. Trauma is the most common cause of death for people under 40 years of age. The purpose of this study is to determine the association between obesity and specific infectious complications following traumatic injury. Materials and Methods:A retrospective analysis was conducted using data from the 2012 National Trauma Data Bank (NTDB). The NTDB defined obesity as having a BMI of 30 or greater. Descriptive statistics were calculated and stratified by obesity status. A hierarchical regression model was used to determine the odds of experiencing an infectious complication in patients with obesity while controlling for age, gender, diabetes, number of comorbidities, injury severity, injury mechanism, head injury, and surgical procedure. Results:Patients with a BMI of 30 or greater compared to non-obese patients had increased odds of having an infectious complication (OR=1.59, 1.49-1.69). In addition to obesity, ISS greater than 29, age 40 years or older, diabetes, comorbid conditions, and having a surgical procedure were also predictive of an infectious complication. Conclusions:Our results indicate that trauma patients with obesity are nearly 60% more likely to develop an infectious complication in the hospital. Infection prevention and control measures should be implemented soon after hospital arrival for patients with obesity, particularly those with operative trauma.

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Section: Discussionmentioning

confidence: 92%

Infectious complications in obese patients after trauma

Bell

Bayt

Siedlecki

et al. 2016

Journal of Surgical Research

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“…19 It is therefore critical that adequate pain relief be achieved in order to facilitate early mobilization, which has been shown to decrease the hospital length of stay and improve back functionality in patients having undergone spine surgery. 20 Opioid-based analgesics are known to provide postoperative pain relief but are often associated with serious adverse effects, such as hypotension, altered mental status, respiratory depression, urinary incontinence, and ileus.…”

Section: Discussionmentioning

confidence: 99%

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Brown¹,

Weir²,

Shasti³

et al. 2018

Int J Spine Surg

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Background: Postoperative pain management in spine surgery holds unique challenges. The purpose of this study is to determine if the local anesthetic liposomal bupivacaine (LB) reduces the total opioid requirement in the first 3 days following posterior lumbar decompression and fusion (PLDF) surgery for degenerative spondylosis.Methods: Fifty patients underwent PLDF surgery in a prospective randomized control pilot trial between August 2015 and October 2016 and were equally allocated to either a treatment (LB) or a control (saline) group. Assessments included the 72-hour postoperative opioid requirement normalized to 1 morphine milligram equivalent (MME), visual analog scale (VAS), and hospital length of stay.Results: LB did not significantly alter the 72-hour postoperative opioid requirement compared to saline (11.6 vs. 13.4 MME, P ¼ .40). In a subgroup analysis, there was also no significant difference in opioid consumption among narcotic-naive patients with either LB or saline. Among narcotic tolerant patients, however, opioid consumption was higher with saline than LB (20.6 MME vs. 13.3 MME, P ¼ .048). Additionally, pre-and postoperative VAS scores and hospital length of stay were not significantly different with either LB or saline.Conclusions: In the setting of PLDF surgery, LB injections did not significantly reduce the consumption of opioids in the first 3 postoperative days, nor did the hospital length of stay or VAS pain scores, compared to saline. However, LB could be beneficial in reducing the consumption of opioids in narcotic-tolerant populations.Level of Evidence: 2.

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“…Current literature suggests that rehabilitation and physical therapy initiated on the day of surgery. Early mobilization potentially prevents complications such as venous thromboembolism, atelectasis, urinary tract infection, stroke,…, etc., [45]. Furthermore, it was reported by related studies to reduce length of hospital stay, post-operative morbidity and mortality, improved patient satisfaction, and reduced VTE and its sequelae [45,46].…”

Section: Ambulation and Exercisementioning

confidence: 97%

Fast Track Surgery Program in Knee Replacement

Wang¹,

Chang²,

Chen³

et al. 2018

Primary Total Knee Arthroplasty

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A Fast-track (FT) program, a well-established approach for patients undergoing selective operations, aims at enhanced post-operative recovery. It was first introduced by Professor Henrik Kehlet in 1990s and was applied in colorectal surgery. With the increasing elderly population as well as the increasing incidence of osteoarthritis, the rapid growth of requirement of joint arthroplasties is to be expected. Therefore, many orthopedic teams have applied related principles to their daily practice of total knee arthroplasty to accelerate rehabilitation with lower mortality and morbidity, and to optimize patient satisfaction. The program is a multimodal and multidisciplinary standardized care. Various caring specialties are involved to fulfill the goals of the fast-track program; the basic members include anesthetists, surgeons, pain specialist, physiotherapists, nurses and even medical physicians. In general, the strategy consists of five strands: careful patient selection, improving preoperative care, minimizing perioperative stresses, decreasing postoperative discomfort, and improving postoperative recovery. Through full understanding of these strands and concepts, a comprehensive, perioperative care is thus constructed. This review article gives reader an overall concept of fast track surgery in total knee replacement surgery. A comprehensive search in English literature, including case series, associate randomized controlled trials and systematic reviews were performed using the PubMed databases in 2017 December.

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A review article on the benefits of early mobilization following spinal surgery and other medical/surgical procedures

Cited by 135 publications

References 18 publications

Infectious complications in obese patients after trauma

Infectious complications in obese patients after trauma

The Efficacy of Liposomal Bupivacaine in Lumbar Spine Surgery

Fast Track Surgery Program in Knee Replacement

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