Perioperative Management Center (PERIO) for Neurosurgical Patients

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Author(s)

    • YASUHARA Takao
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • KOBAYASHI Motomu
    • Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine
    • MATSUOKA Yoshikazu
    • Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine
    • SASAKI Toshihiro
    • Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine
    • ASHIWA Takako
    • Perioperative Management Center, Okayama University Hospital
    • ARIOKA Akemi
    • Perioperative Management Center, Okayama University Hospital
    • MISAKI Ayasa
    • Perioperative Management Center, Okayama University Hospital
    • HISHIKAWA Tomohito
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • MORIMATSU Hiroshi
    • Department of Anesthesiology and Resuscitology, Okayama University Graduate School of Medicine
    • DATE Isao
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • AGARI Takashi
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • KUROZUMI Kazuhiko
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • ICHIKAWA Tomotsugu
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • KAMEDA Masahiro
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • SHINKO Aiko
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • ISHIDA Joji
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine
    • HIRAMATSU Masafumi
    • Department of Neurological Surgery, Okayama University Graduate School of Medicine

Abstract

Perioperative management is critical for positive neurosurgical outcomes. In order to maintain safe and authentic perioperative management, a perioperative management center (PERIO) was introduced to patients of our Neurosurgery Department beginning in June 2014. PERIO involves a multidisciplinary team consisting of anesthesiologists, dentists/dental hygienists/technicians, nurses, physical therapists, pharmacists, and nutritionists. After neurosurgeons decide on the course of surgery, a preoperative evaluation consisting of blood sampling, electrocardiogram, chest X-ray, and lung function test was performed. The patients then visited the PERIO clinic 7–14 days before surgery. One or two days before surgery, the patients without particular issues enter the hospital and receive a mouth cleaning one day before surgery. After surgery, postoperative support involving eating/swallowing evaluation, rehabilitation, and pain control is provided. The differences in duration from admission to surgery, cancellation of surgery, and postoperative complications between PERIO and non-PERIO groups were examined. Eighty-five patients were enrolled in the PERIO group and 131 patients in the non-PERIO group. The duration from admission to surgery was significantly decreased in the PERIO group (3.6 ± 0.3 days), compared to that in the non-PERIO group (4.7 ± 0.2 days). There was one cancelled surgery in the PERIO group and six in the non-PERIO group. Postoperative complications and the overall hospital stay did not differ between the two groups. The PERIO system decreased the duration from admission to surgery, and it is useful in providing high-quality medical service, although the system should be improved so as not to increase the burden on medical staff.

Journal

  • Neurologia medico-chirurgica

    Neurologia medico-chirurgica 56(9), 574-579, 2016

    The Japan Neurosurgical Society

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