JMIR Perioperative Medicine
Technology and data science for interdisciplinary innovation to improve care delivery and surgical patient outcomes.
Editor-in-Chief:
Nidhi Rohatgi, MD, MS, SFHM, Clinical Professor of Medicine and (by courtesy) Neurosurgery, Anesthesiology, Perioperative and Pain Medicine, Stanford University School of Medicine, USA
CiteScore 0.5
Recent Articles
![Blood Bonds: Transforming Blood Donation Through Innovation, Inclusion, and Engagement Article Thumbnail](https://asset.jmir.pub/assets/150a1063b981f74208fce32993d88cdb.png 480w,https://asset.jmir.pub/assets/150a1063b981f74208fce32993d88cdb.png 960w,https://asset.jmir.pub/assets/150a1063b981f74208fce32993d88cdb.png 1920w,https://asset.jmir.pub/assets/150a1063b981f74208fce32993d88cdb.png 2500w)
The journey of receiving blood as a patient with transfusion-dependent beta thalassemia has profoundly shaped my understanding of the life-saving power of blood donation. This personal experience underscores the critical importance of blood donors, not just for individual recipients but for the broader community, enhancing public health, productivity, and well-being. There are several challenges to securing a blood donor pool in current health care climate. Solutions that focus on the engagement of donors, clinicians, and patients are key to improving the donor pool and utilizing the blood supply in a judicious manner.
![Use of Biofeedback-Based Virtual Reality in Pediatric Perioperative and Postoperative Settings: Observational Study Article Thumbnail](https://asset.jmir.pub/assets/a84aa4ad9ebad243fe5d2ae7df161cf5.png 480w,https://asset.jmir.pub/assets/a84aa4ad9ebad243fe5d2ae7df161cf5.png 960w,https://asset.jmir.pub/assets/a84aa4ad9ebad243fe5d2ae7df161cf5.png 1920w,https://asset.jmir.pub/assets/a84aa4ad9ebad243fe5d2ae7df161cf5.png 2500w)
Biofeedback-based virtual reality (VR-BF) is a novel, nonpharmacologic method for teaching patients how to control their breathing, which in turn increases heart rate variability (HRV) and may reduce pain. Unlike traditional forms of biofeedback, VR-BF is delivered through a gamified virtual reality environment, increasing the accessibility of biofeedback. This is the first study to systematically integrate VR-BF use in the pediatric perioperative setting, with the ultimate goal of evaluating the efficacy of VR-BF to reduce pain, anxiety, and opioid consumption once feasibility and acceptability have been established.
![Association of a Novel Electronic Form for Preoperative Cardiac Risk Assessment With Reduction in Cardiac Consultations and Testing: Retrospective Cohort Study Article Thumbnail](https://asset.jmir.pub/assets/a27dc674218b35a49b0f12ec4854259e.png 480w,https://asset.jmir.pub/assets/a27dc674218b35a49b0f12ec4854259e.png 960w,https://asset.jmir.pub/assets/a27dc674218b35a49b0f12ec4854259e.png 1920w,https://asset.jmir.pub/assets/a27dc674218b35a49b0f12ec4854259e.png 2500w)
Preoperative cardiac risk assessment is an integral part of preoperative evaluation; however, there is significant variation among providers, leading to inappropriate referrals for cardiology consultation or excessive low-value cardiac testing. We implemented a novel electronic medical record (EMR) form in our preoperative clinics to decrease variation.
![Gamified Mobile App (MobERAS) for Telemonitoring Patients in the Postoperative Period Based on the Enhanced Recovery after Surgery Program: Development and Validation Study Article Thumbnail](https://asset.jmir.pub/assets/bffba4fcd9f92d8542b93e4975f42d2e.png 480w,https://asset.jmir.pub/assets/bffba4fcd9f92d8542b93e4975f42d2e.png 960w,https://asset.jmir.pub/assets/bffba4fcd9f92d8542b93e4975f42d2e.png 1920w,https://asset.jmir.pub/assets/bffba4fcd9f92d8542b93e4975f42d2e.png 2500w)
Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users’ actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results.
![Preoperative Anesthesia Virtual Video Consultations in a Preadmission Clinic: Quality Improvement Study Article Thumbnail](https://asset.jmir.pub/assets/5a37427bdb29406c76a662b554582f58.png 480w,https://asset.jmir.pub/assets/5a37427bdb29406c76a662b554582f58.png 960w,https://asset.jmir.pub/assets/5a37427bdb29406c76a662b554582f58.png 1920w,https://asset.jmir.pub/assets/5a37427bdb29406c76a662b554582f58.png 2500w)
The preadmission clinic (PAC) is crucial in perioperative care, offering evaluations, education, and patient optimization before surgical procedures. During the COVID-19 pandemic, the PAC adapted by implementing telephone visits due to a lack of infrastructure for video consultations. While the pandemic significantly increased the use of virtual care, including video appointments as an alternative to in-person consultations, our PAC had not used video consultations for preoperative assessments.
![Factors Influencing Neuromuscular Blockade Reversal Choice in the United States Before and During the COVID-19 Pandemic: Retrospective Longitudinal Analysis Article Thumbnail](https://asset.jmir.pub/assets/663797ee65c840db2c0a3751564b8fff.png 480w,https://asset.jmir.pub/assets/663797ee65c840db2c0a3751564b8fff.png 960w,https://asset.jmir.pub/assets/663797ee65c840db2c0a3751564b8fff.png 1920w,https://asset.jmir.pub/assets/663797ee65c840db2c0a3751564b8fff.png 2500w)
Neuromuscular blockade (NMB) agents are a critical component of balanced anesthesia. NMB reversal methods can include spontaneous reversal, sugammadex, or neostigmine and the choice of reversal strategy can depend on various factors. Unanticipated changes to clinical practice emerged due to the COVID-19 pandemic, and a better understanding of how NMB reversal trends were affected by the pandemic may help provide insight into how providers view the tradeoffs in the choice of NMB reversal agents.
![Postsurgical Pain Risk Stratification to Enhance Pain Management Workflow in Adult Patients: Design, Implementation, and Pilot Evaluation Article Thumbnail](https://asset.jmir.pub/assets/58b5863406f60a0f3d901eb2fee5b9a3.png 480w,https://asset.jmir.pub/assets/58b5863406f60a0f3d901eb2fee5b9a3.png 960w,https://asset.jmir.pub/assets/58b5863406f60a0f3d901eb2fee5b9a3.png 1920w,https://asset.jmir.pub/assets/58b5863406f60a0f3d901eb2fee5b9a3.png 2500w)
Exposure to opioids after surgery is the initial contact for some people who develop chronic opioid use disorder. Hence, effective postoperative pain management, with less reliance on opioids, is critical. The Perioperative Opioid Quality Improvement (POQI) program developed (1) a digital health platform leveraging patient-survey-reported risk factors and (2) a postsurgical pain risk stratification algorithm to personalize perioperative care by integrating several commercially available digital health solutions into a combined platform. Development was reduced in scope by the COVID-19 pandemic.
![The Effectiveness of Patient Education on Laparoscopic Surgery Postoperative Outcomes to Determine Whether Direct Coaching Is the Best Approach: Systematic Review of Randomized Controlled Trials Article Thumbnail](https://asset.jmir.pub/assets/1e5fb1d786b014e65e069f2da949f8da.png 480w,https://asset.jmir.pub/assets/1e5fb1d786b014e65e069f2da949f8da.png 960w,https://asset.jmir.pub/assets/1e5fb1d786b014e65e069f2da949f8da.png 1920w,https://asset.jmir.pub/assets/1e5fb1d786b014e65e069f2da949f8da.png 2500w)
As of 2022, patient adherence to postoperative guidelines can reduce the risk of complications by up to 52.4% following laparoscopic abdominal surgery. With the availability of various preoperative education interventions (POEIs), understanding which POEI results in improvement in patient outcomes across the procedures is imperative.
![A Novel Digital Health Platform With Health Coaches to Optimize Surgical Patients: Feasibility Study at a Large Academic Health System Article Thumbnail](https://asset.jmir.pub/assets/c58372eb5c895f78abe3e8cb1ebdf6d4.png 480w,https://asset.jmir.pub/assets/c58372eb5c895f78abe3e8cb1ebdf6d4.png 960w,https://asset.jmir.pub/assets/c58372eb5c895f78abe3e8cb1ebdf6d4.png 1920w,https://asset.jmir.pub/assets/c58372eb5c895f78abe3e8cb1ebdf6d4.png 2500w)
![Blood Management: A Current Opportunity in Perioperative Medicine Article Thumbnail](https://asset.jmir.pub/assets/ec3f1a43cccc73cc79645ebe33decb7c.png 480w,https://asset.jmir.pub/assets/ec3f1a43cccc73cc79645ebe33decb7c.png 960w,https://asset.jmir.pub/assets/ec3f1a43cccc73cc79645ebe33decb7c.png 1920w,https://asset.jmir.pub/assets/ec3f1a43cccc73cc79645ebe33decb7c.png 2500w)
The purpose of this viewpoint is to provide awareness of the current opportunities to enhance a high-value care approach to blood product transfusion. It provides a historical context to the evolution of blood management, as well as of the patient safety and high-value care movement. Leveraging current technology for enhanced education, as well as clinical decision support, is also discussed.
![Comparing Anesthesia and Surgery Controlled Time for Primary Total Knee and Hip Arthroplasty Between an Academic Medical Center and a Community Hospital: Retrospective Cohort Study Article Thumbnail](https://asset.jmir.pub/assets/1c6ba80845c04add9f789c84f6ca5183.png 480w,https://asset.jmir.pub/assets/1c6ba80845c04add9f789c84f6ca5183.png 960w,https://asset.jmir.pub/assets/1c6ba80845c04add9f789c84f6ca5183.png 1920w,https://asset.jmir.pub/assets/1c6ba80845c04add9f789c84f6ca5183.png 2500w)
Osteoarthritis is a significant cause of disability, resulting in increased joint replacement surgeries and health care costs. Establishing benchmarks that more accurately predict surgical duration could help to decrease costs, maximize efficiency, and improve patient experience. We compared the anesthesia-controlled time (ACT) and surgery-controlled time (SCT) of primary total knee (TKA) and total hip arthroplasties (THA) between an academic medical center (AMC) and a community hospital (CH) for 2 orthopedic surgeons.
![Survey of the Impact of Decision Support in Preoperative Management of Anemia (i-Anemia): Survey Study Article Thumbnail](https://asset.jmir.pub/assets/287996bf192acd0688b66dc2f8793aa0.png 480w,https://asset.jmir.pub/assets/287996bf192acd0688b66dc2f8793aa0.png 960w,https://asset.jmir.pub/assets/287996bf192acd0688b66dc2f8793aa0.png 1920w,https://asset.jmir.pub/assets/287996bf192acd0688b66dc2f8793aa0.png 2500w)
Major surgery on patients with anemia has demonstrated an increased risk of perioperative blood transfusions and postoperative morbidity and mortality. Recent studies have shown that integrating preoperative anemia treatment as a component of perioperative blood management may reduce blood product utilization and improve outcomes in both cardiac and noncardiac surgery. However, outpatient management of anemia falls outside of daily practice for most anesthesiologists and is probably weakly understood.
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