Preoperative Management of Endocrine, Hormonal, and Urologic Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement

Abstract

Perioperative medical management is challenging due to the rising complexity of patients presenting for surgical procedures. A key part of preoperative optimization is appropriate management of long-term medications, yet guidelines and consensus statements for perioperative medication management are lacking. Available resources utilize the recommendations derived from individual studies and do not include a multidisciplinary focus or formal consensus. The Society for Perioperative Assessment and Quality Improvement (SPAQI) identified a lack of authoritative clinical guidance as an opportunity to utilize its multidisciplinary membership to improve evidence-based perioperative care. SPAQI seeks to provide guidance on perioperative medication management that synthesizes available literature with expert consensus. The aim of this Consensus Statement is to provide practical guidance on the preoperative management of endocrine, hormonal, and urologic medications. A panel of experts with anesthesiology, perioperative medicine, hospital medicine, general internal medicine, and medical specialty experience was drawn together and identified the common medications in each of these categories. The authors then utilized a modified Delphi approach to critically review the literature and generate consensus recommendations.

Preoperative Management of Gastrointestinal and Pulmonary Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement

“…d Long-term oral corticosteroid management is covered in another publication within this series, entitled "Preoperative Management of Endocrine, Hormonal, and Urologic Medications: Society for Perioperative Assessment and Quality Improvement (SPAQI) Consensus Statement." 3 Consensus was established for all reviewed medications, and the completed set of recommendations was reviewed and approved by the Executive Committee of SPAQI. Described here are specific recommendations for each medication class.…”

“…Perioperative management of PDE-5 inhibitors prescribed for urologic indications is detailed in another publication within this consensus statement series. 3 Riociguat. Riociguat is an oral PH medication that works by stimulating soluble guanylate cyclase, which induces vasodilation in vascular smooth muscle and assists in reducing elevated pulmonary pressure.…”

“…SPAQI is an international, multidisciplinary society dedicated to the promotion of evidence-based perioperative medicine and has produced a number of recommendation papers and consensus statements in this field. [1][2][3] SPAQI drafted a comprehensive plan for developing consensus recommendations for preoperative medication management using perioperative medicine, anesthesiology, internal medicine, hospital medicine, and medical subspecialty experts. This consensus statement contains the work of a subgroup focused on providing guidance on the preoperative management of gastrointestinal and pulmonary medications.…”

Editorial: New Trends and Approaches in Perioperative Pharmacotherapy: An Update

“…Patients undergoing surgery commonly receive chronic treatment with anti-hypertensives, antiarrhythmic drugs, anticoagulants, chemotherapeutic drugs, and other medications. Many of these drugs have the potential to cause serious drug-drug interactions and perioperative adverse effects (Pai et al, 2017;Pfeifer et al, 2021).…”

“…The Society for Perioperative Assessment and Quality Improvement highlights the importance of evidence-based approach to perioperative care and medication management (Pfeifer et al, 2021).…”