Department of Medicine, Medical College of Wisconsin, Milwaukee.
Department of Anesthesiology, University of Colorado School of Medicine, Aurora.
Mayo Clin Proc. 2021 Jun;96(6):1655-1669. doi: 10.1016/j.mayocp.2020.10.002. Epub 2021 Mar 10.
Perioperative medical management is challenging due to the rising complexity of patients presenting for surgical procedures. A key part of preoperative optimization is appropriate management of long-term medications, yet guidelines and consensus statements for perioperative medication management are lacking. Available resources utilize the recommendations derived from individual studies and do not include a multidisciplinary focus or formal consensus. The Society for Perioperative Assessment and Quality Improvement (SPAQI) identified a lack of authoritative clinical guidance as an opportunity to utilize its multidisciplinary membership to improve evidence-based perioperative care. SPAQI seeks to provide guidance on perioperative medication management that synthesizes available literature with expert consensus. The aim of this Consensus Statement is to provide practical guidance on the preoperative management of endocrine, hormonal, and urologic medications. A panel of experts with anesthesiology, perioperative medicine, hospital medicine, general internal medicine, and medical specialty experience was drawn together and identified the common medications in each of these categories. The authors then utilized a modified Delphi approach to critically review the literature and generate consensus recommendations.
由于接受手术的患者的复杂性不断增加，围手术期的医疗管理极具挑战性。术前优化的一个关键部分是对长期药物进行适当管理，但围手术期药物管理的指南和共识声明却缺乏。现有的资源利用了从个别研究中得出的建议，并未包括多学科重点或正式共识。围手术期评估和质量改进协会 (SPAQI) 发现，缺乏权威性的临床指导是一个机会，可以利用其多学科成员来改善基于证据的围手术期护理。SPAQI 旨在提供围手术期药物管理方面的指导，将现有文献与专家共识相结合。本共识声明旨在就内分泌、激素和泌尿科药物的术前管理提供实用指南。一个汇集了麻醉学、围手术期医学、医院医学、普通内科和医学专业经验的专家小组被召集在一起，并确定了这些类别中的常见药物。然后，作者使用改良 Delphi 方法对文献进行严格审查，并提出共识建议。
