Routine pre‐operative focused ultrasonography by anesthesiologists in patients undergoing urgent surgical procedures

Abstract

Focused cardiopulmonary ultrasonography disclosed unexpected pathology in patients undergoing urgent surgical procedures and induced changes in the anesthesia technique or supportive actions. Pre-operative focused ultrasonography seems feasible in patients above 60 year and/or with physical limitations but not in young, healthy individuals.

Impact Assessment of Perioperative Point-of-Care Ultrasound Training on Anesthesiology Residents

“…47,48 On the basis of the assumption that we expected the clinical impact of this curriculum training to be able to detect undiagnosed pathology at an incidence of 20%, we calculated the number of examinations needed to be 142, assuming a power of 0.8 and a level of significance of 0.05. 47,48 On the basis of the assumption that we expected the clinical impact of this curriculum training to be able to detect undiagnosed pathology at an incidence of 20%, we calculated the number of examinations needed to be 142, assuming a power of 0.8 and a level of significance of 0.05.…”

Perioperative medicine: why do we care?

“…For example, outside the OR, echocardiography just prior to emergency non-cardiac surgery was able to detect new cardiopulmonary pathology in 27% of patients, 43% of whom received a change in surgical case management. 22 Recent publications show that ultrasound is an invaluable diagnostic tool for various cardiac, lung, and abdominal pathology. The role of ultrasound for regional nerve blocks is well known, but heart failure and pneumonia can now be diagnosed efficiently and accurately at the bedside with lung ultrasound.…”

“…Par exemple, en dehors de la salle d'opération, une échocardiographie réalisée immédiatement avant une chirurgie non cardiaque urgente a pu détecter une nouvelle pathologie cardiopulmonaire chez 27 % des patients, la gestion du cas chirurgical étant modifiée pour 43 % de ces derniers. 22 Des publications récentes montrent que l'échographie est un outil diagnostique incomparable pour différentes pathologies cardiaques, pulmonaires et abdominales. Le rôle de l'échographie dans les blocs nerveux régionaux est bien connu, mais une défaillance cardiaque et une pneumonie peuvent maintenant être diagnostiquées efficacement et précisément au chevet du patient grâce à l'échographie pulmonaire.…”

POCUS in perioperative medicine: a North American perspective

“…Focused cardiac US [9] has been used in the perioperative assessment of elective [10] and urgent [11] surgical cases and has significantly impacted patient management [12–14]. POCUS may also play key roles in the management of hemodynamic instability and cardiac arrest [15].…”