Perioperative Management Center (PERIO) for Neurosurgical Patients

  • YASUHARA Takao
    Department of Neurological Surgery, Okayama University Graduate School of Medicine
  • HISHIKAWA Tomohito
    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
  • 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
  • SOGA Yoshihiko
    Division of Hospital Dentistry, Okayama University Hospital
  • YAMANAKA Reiko
    Division of Hospital Dentistry, Okayama University Hospital
  • ASHIWA Takako
    Perioperative Management Center, Okayama University Hospital
  • ARIOKA Akemi
    Perioperative Management Center, Okayama University Hospital
  • HASHIMOTO Yasuko
    Perioperative Management Center, Okayama University Hospital
  • MISAKI Ayasa
    Perioperative Management Center, Okayama University Hospital
  • ISHIHARA Yuriko
    Operation Department, Okayama University Hospital
  • SATO Machiko
    Operation Department, Okayama University Hospital
  • 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

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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.

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