Resident, Department of Oral & Maxillofacial Surgery, University of Washington, Seattle, WA.
Pre-anesthesia Clinic Medical Director, Harborview Medical Center, Department of Family Medicine, University of Washington, Seattle, WA.
J Oral Maxillofac Surg. 2024 Mar;82(3):364-375. doi: 10.1016/j.joms.2023.11.015. Epub 2023 Nov 28.
The preoperative management guidelines of surgical patients are constantly evolving as newer evidence-based research is published. Oral and maxillofacial surgeons need to be current with the increasingly more complex new drug therapies and updated national association(s) guidelines. This narrative review provides a synopsis with important reference tables for updated preoperative optimization guidelines for anticoagulation, antiplatelet therapy, antihypertensive management, and glycemic control in the preoperative period for the oral and maxillofacial surgery patient. It also includes the most current anesthesia guidelines on glucagon-like peptide receptor agonists.
The search strategy utilized pubmed.gov to identify the most recent national society guidelines and review articles pertinent to perioperative anticoagulation, antiplatelet therapy, antihypertensive management, and glycemic control.
The search identified 75 articles from the American College of Surgeons, American Heart Association, American Society of Anesthesiologists, American College of Cardiologists, in addition to recent reviews discussing the standard of care for optimization of patients in the perioperative period.
Medical optimization prior to surgery is important for safe and efficient surgical practice and has been shown to improve overall mortality. This narrative review provides a summary of the current data with recommendations focusing on four key points.
随着新的循证研究的发表，手术患者的术前管理指南不断发展。口腔颌面外科医生需要了解越来越复杂的新药治疗方法，并更新国家协会的指南。本文综述概述了抗凝、抗血小板治疗、降压管理以及术前血糖控制的最新术前优化指南，为口腔颌面外科患者提供了重要的参考表。它还包括了关于胰高血糖素样肽受体激动剂的最新麻醉指南。
使用 pubmed.gov 搜索策略，以确定与围手术期抗凝、抗血小板治疗、降压管理和血糖控制相关的最新国家学会指南和综述文章。
从美国外科医师学会、美国心脏协会、美国麻醉医师学会、美国心脏病学会中搜索到了 75 篇文章，此外还有最近的综述文章讨论了围手术期患者的最佳治疗标准。
手术前的医疗优化对于安全有效的手术实践很重要，并且已被证明可以降低整体死亡率。本文综述概述了当前的数据，并提出了四项重点建议。
