ASA Monitor February 2024, Vol. 88, 35.
Anesthesiologist offers insights on opioid-sparing surgery
In September, Outpatient Surgery Magazine interviewed Karina Gritsenko, MD, about multimodal anesthesia regimens to help limit the use of opioids before, during, and after surgery. She discussed the need for planning for opioid-sparing surgery and emphasized that pain physicians and anesthesiologists in particular need to always be looking to predict how patients may recover – and communicate that information effectively. “We’re closing the gap between how we treat acute, persistent, and chronic pain. Innovations in enhanced recovery after surgery (ERAS) protocols and regional anesthesia have advanced our capabilities in ways that are invaluable to our patients,” she said.
National coverage of ASA guidance on popular diabetes and weight-loss medications continues
In September, VeryWell Health interviewed then-ASA President Michael W. Champeau, MD, FAAP, FASA, about ASA’s June 2023 guidance to withhold glucagon-like peptide-1 (GLP-1) receptor agonists used for diabetes and weight loss (such as Ozempic and Wegovy) before elective surgery. Dr. Champeau discussed anecdotal reports from ASA members around the country of aspiration risks during surgery from GLP-1 medications. “Out of seemingly nowhere, we started seeing these reports where people’s stomachs were not empty when we expected them to be, and the common factor in all of those stories was that they were taking GLP-1 agonists,” he said. Also in September, MedPage Today interviewed Anesthesia Patient Safety Foundation President Daniel J. Cole, MD, FASA, where he voiced support for ASA’s recommendations and emphasized the need to prioritize patient safety while waiting for additional research.
In November, Becker’s Clinical Leadership interviewed Girish Joshi, MD, FASA, vice chair of ASA’s Committee on Practice Parameters, and Joshua Knight, MD, about ASA’s June 2023 GLP-1 guidance and recommendations from the American Gastroenterological Association (AGA) released in November suggesting that not all patients need to stop GLP-1 agonists prior to elective endoscopy procedures. Delaying surgeries should be the last option available because the disruption can upset patients and result in a longer delay, noted one of the physicians who helped draft AGA’s November 7 statement. “If [halting a surgery] is not possible, that’s OK,” said Dr. Joshi in response. “We are not saying cancel every case where the patient has not stopped the drug.”
KevinMD.com features anesthesiologists discussing sustainable health care, preop patient consultations
In September, Shreya Aggarwal, MD, discussed the impact of the practice of medicine on greenhouse gas emissions and the need for sustainable health care delivery. Dr. Aggarwal also noted that health care’s carbon footprint extends beyond the OR to pharmaceutical waste and supply chain resilience. “As an anesthesiologist, I am acutely aware that my choice of anesthetic impacts my daily carbon footprint,” she wrote.
In November, George Tewfik, MD, FASA, Monica W. Harbell, MD, FASA, Emily Methangkool, MD, and Stephen Rivoli, DO, wrote on how shifting from “clearance” to “evaluation and optimization” of patients during preoperative consultations can help to ensure safe and timely surgery. They emphasized that a poor preoperative consultation can negatively affect patient care and lead to low patient satisfaction if the surgery is delayed or cancelled.
During Pain Awareness Month, ASA raises awareness of cannabis’ impact on surgery patients
In October, 764 news outlets, including the Houston Chronicle and the San Francisco Chronicle, featured an ASA release highlighting that cannabis can interact with anesthesia and increase the risk of complications. The news reached an audience of more than 94.7 million. The release featured potential impacts of cannabis, such as more pain and nausea after surgery and increased need for opioids or other pain relief medications, and emphasized the importance of discussing cannabis use with your doctors before surgery. “While more research is needed, early studies suggest cannabis poses increased risks and side effects during surgery,” said then-ASA President Michael Champeau, MD, FAAP, FASA.
ANESTHESIOLOGY® 2023 research grabs national headlines
Coverage on research presented at ANESTHESIOLOGY 2023 in October has resulted in more than 700 media placements, reaching an estimated audience of more than 585 million.
Newsweek, U.S. News & World Report, and Becker’s Hospital Review were among the outlets covering a study that determined Black and Hispanic patients are more likely to die after surgery than White patients. Newsweek quoted the lead author of the study, Christian Mpody, MD, PhD: “This study represents the first effort to move beyond merely documenting the ongoing disparities in surgical outcomes in the U.S. by quantifying the aggregate human toll of these disparities. We should not become used to reading statistics about people dying.”
Medscape reported on research that found opioid use disorder (OUD) treatment was associated with a decreased risk of overdose after surgery. “For patients who have OUD, it might be really important to get them set up with evidence-based treatment before they’re undergoing surgery,” said study coauthor Anjali Dixit, MD.
Additional media highlights include research showing minority children were less likely to see ear, nose, and throat (ENT) doctors and receive ear tubes for recurring ear infections, which was featured on HealthDay and picked up by more than 200 outlets, including U.S. News & World Report. The story featured a quote from lead study author Yu Shi, MD, who noted: “For the first time, our study found there are significant differences in the rate of ENT office visits for children with ear infections, based on race and ethnicity.”
Healio, HealthDay, and CBS Baltimore all featured research that found women were at much higher risk of depression after a concussion or other traumatic brain injury. “Our study represents the highest quality evidence to date that a patient’s gender influences the risk of depression after traumatic brain injury,” lead study author Isaac Freedman, MD, MPH, told Healio.
In November, an ASA release highlighting three ANESTHESIOLOGY 2023 studies impacting patient care generated more than 1,000 media placements, reaching an audience of 157.5 million. Placements included the Los Angeles Times, Houston Chronicle, San Francisco Chronicle, Seattle Post-Intelligencer, and Wisconsin State Journal. “Over their lifetimes, many Americans may experience traumatic brain injury, endure health care disparities, or experience anxiety when their child is having surgery,” said ASA President Ronald L. Harter, MD, FASA. “This groundbreaking research has real-world implications for patients and their families and aims to improve health care for everyone.”
Epoch Times quotes ASA committee chair on important patient postsurgery activities
In an October article on improving surgical recovery, the Epoch Times quoted Matt Hatch, MD, FASA, chair of the ASA Committee on Communications, about the importance of patients engaging in physical activity after surgery, and that patients who stay in bed longer have longer hospital stays. In November, Dr. Hatch was also quoted in another Epoch Times article discussing postoperative delirium and the need for postsurgical cognitive rehabilitation. “Just as patients who are having orthopedic and other surgeries are guided to get up and move shortly after surgery, there’s evidence that doing crossword puzzles and other cognitive-based activities can help prevent delirium,” Dr. Hatch said.