| Chronic medications in the perioperative period. | |
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MedLine Citation:
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PMID: 9563428 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: While most chronic medications can be safely continued in the perioperative period, decisions regarding certain medications remain controversial. METHODS: We mailed a questionnaire to all 150 anesthesiology program directors in the United States, with 113 (75%) responding. Opinions regarding preoperative discontinuance or modification of selected medications were assessed. RESULTS: Antiplatelet agents are typically discontinued preoperatively, although the number of days varies widely. Few respondents discontinue tricyclic antidepressants, oral contraceptives, diuretics, or oral hypoglycemic agents. For a patient on insulin, the most popular regimen is half the patient's usual dose of neutral protamine Hagedorn insulin (50%) or no preoperative insulin (37%), whereas an insulin infusion for tight control was rarely advised. Respondents varied widely in their approach to steroid coverage, their cancellation of elective operations in patients with inadvertent aspirin ingestion, and the length of time before surgery they would discontinue warfarin. In patients with chronic atrial fibrillation, 72% of respondents favored use of a heparin window preoperatively. CONCLUSIONS: Practice variations regarding insulin regimens, steroid coverage, aspirin, and anticoagulants reflect a lack of firm evidence favoring one approach. |
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Authors:
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K Kroenke; D Gooby-Toedt; J L Jackson |
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Publication Detail:
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Type: Comparative Study; Journal Article |
Journal Detail:
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Title: Southern medical journal Volume: 91 ISSN: 0038-4348 ISO Abbreviation: South. Med. J. Publication Date: 1998 Apr |
Date Detail:
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Created Date: 1998-05-06 Completed Date: 1998-05-06 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0404522 Medline TA: South Med J Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 358-64 Citation Subset: AIM; IM |
Affiliation:
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Regenstrief Institute and Department of Medicine, Indiana University School of Medicine, Indianapolis 46202, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anesthesiology* Anticoagulants / administration & dosage Aspirin / administration & dosage Humans Insulin / administration & dosage Intraoperative Care* Middle Aged Patient Care Management Pharmaceutical Preparations / administration & dosage* Physician's Practice Patterns / statistics & numerical data* Platelet Aggregation Inhibitors / administration & dosage Preoperative Care* Questionnaires Steroids / administration & dosage |
| Chemical | |
Reg. No./Substance:
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0/Anticoagulants; 0/Pharmaceutical Preparations; 0/Platelet Aggregation Inhibitors; 0/Steroids; 11061-68-0/Insulin; 50-78-2/Aspirin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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