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The United States Centers for Disease Control and Prevention (CDC) has published a new guideline for prescribing opioids for acute, subacute, and chronic pain, updating their 2016 guideline. The guideline is intended for clinicians who prescribe opioids to outpatients ≥18 years of age and does not apply to pain related to sickle cell disease, cancer, palliative care, or end of life care.

The benefit of checking preoperative liver biochemistries in healthy individuals is uncertain because most patients with abnormal biochemistries do not have advanced liver disease. However, emerging data suggested that an elevated FIB-4 score, which consists of age, aminotransferases, and platelet count, may be associated with increased surgical mortality. In a large cohort study of individuals without known liver disease, a preoperative FIB-4 score ≥2.67 (defined as the threshold for advanced fibrosis) was associated with increased risk of intraoperative mortality, mortality during hospitalization, and 30-day mortality. While biochemical markers of liver disease may have a future role for assessing surgical risk, additional studies are needed to confirm these findings.

In a retrospective cohort study of Medicare beneficiaries, the group undergoing cataract surgery had a lower incidence of systemic complications within seven days of surgery than those undergoing other types of elective low-risk outpatient procedures (7.7 versus 13 to 52 percent). An anesthesia provider was present for most cataract procedures, but systemic complications remained low in the six percent that had no anesthesia care (7.4 percent in this group). These data underscore the low risk of systemic complications in patients undergoing cataract surgery, even without anesthesia care.