Integrating perioperative medicine with anaesthesia in India: Can the best be achieved? A review

Abstract

Integrating perioperative medicine with anaesthesia is the need of the hour. Evolution of a new superspeciality called perioperative anaesthesia can improve surgical outcomes by quality perioperative care and guarantee imminent escalation of influence and power for anaesthesiologists. All original peer-reviewed manuscripts pertaining to surgery-specific perioperative surgical home models involving preoperative, intraoperative and postoperative initiatives spanning the past 5 years have been reviewed using PubMed and Google Scholar. Whether the perioperative surgical home model is feasible or still a distant dream in the Indian perspective has been analysed.

Predictors of prolonged length of hospital stay and in-hospital mortality among adult patients admitted at the surgical ward of Jimma University medical center, Ethiopia: prospective observational study

“…The reason for this difference was because the later study included older patients (> 80 years unlike that of > 18 years). On the other hand, the mortality rate was reported from 2.3 to 48.5% for patients undergoing a different type of surgery and heterogeneous study population as well as different severity [8,[23][24][25][26]; indeed the death rate is high for low-income countries because of different reason [10,12], for instance, in America, the overall mortality rate was 0.28% [27].…”

“…On the other hand, female gender, emergency admission, presence of Poly-pharmacy, and the presence of sepsis or in-hospital bloodstream infection were found to be independent predictors of in-hospital death at JUMC. Other studies showed that After adjusting for all co-morbidities, female gender [20,28] while in contrast male gender [11,21] and emergency surgery [8,10,11,21], development of in-hospital complications [7,17,18,22], sepsis [25] was an independent predictor for in-hospital mortality [8,28], but, there was no clear reason for the gender-related increase in mortality. The gender-related discrepancy in predicting mortality might be due to the difference in baseline disease or type of operation (general surgery-coronary artery bypass graft surgery-thoracic surgery) respectively.…”

“…Worldwide, 4.8 billion people devoid of access to safe and quality surgical care, due to lack of infrastructure, equipment, and personnel, especially in LMICs [9]. Thus, among patients undergoing surgery, the mortality rates were higher for LMICs [10,11], for instance, the postoperative death was 2times higher than the global deaths in Africa [12].…”

Life after post graduation in anaesthesiology……in search of greener pastures!

“…It has been predicted that the evolution of the speciality of 'Perioperative Medicine' can improve surgical outcomes by provision of quality perioperative care and thus improve our visibility and enhance both the influence and power of anaesthesiologists. [ 27 ]…”

Cloud computing-based remote pre-anaesthetic check-up: An adapted approach during corona pandemic

“…Further, this can also help in integrating perioperative medicine and anaesthesia in an efficient way, which is the need of the hour. [ 5 ]…”