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Digital Issues

Patients Who Text During Surgery Feel Less Pain

If you've banned mobile electronic devices from your ORs, you might want to reconsider. Researchers have found that patients who text or play games on a smartphone during a minor surgical procedure feel less post-op pain and demand fewer narcotics.

Researchers from Cornell University tracked 4 groups of patients undergoing a minor procedure under local anesthesia: those who received standard perioperative treatment, those that played the Angry Birds game on a mobile phone, those who texted a close friend or family member during the procedure and others who were asked to text a research assistant, whom they had not met.

The study found that those who did not use the mobile phones during surgery were almost twice as likely to receive supplemental pain relief as those playing Angry Birds before and during the procedure. Those who didn't use phones were also 4 times more likely to receive additional analgesics as those texting a companion, and 6 times more likely than those texting a stranger.

"Our findings suggest that text messaging may be a more effective intervention that requires no specialized equipment or involvement from clinicians," the authors write. "Even more importantly, text-based communication may allow for the analgesic-sparing benefits of social support to be introduced to other clinical settings where this type of support is not otherwise available."

Kendal Gapinski

FDA Plans to Scrutinize Healthcare Antiseptic Ingredients

The manufacturers of over-the-counter antiseptics used by healthcare facilities would be required to provide data demonstrating that their ingredients are both safe and effective, according to a proposed rule from the FDA.

The proposal is based on new information and concerns expressed by experts on an FDA advisory committee, but it should not be taken to mean the agency believes the products are ineffective or unsafe, says the agency.

The FDA is particularly focused on the long-term effects of repeated exposure among certain groups, including pregnant and breastfeeding healthcare workers. It plans to review data on absorption, potential hormonal effects and the development of bacterial resistance.

Manufacturers would be required to submit safety and efficacy data on 29 active ingredients, including alcohol, iodine, phenol and hexachlorophene. The products under scrutiny include hand washes and rubs, surgical hand scrubs and rubs, and patient pre-op skin preps, including pre-injection preps. Consumer antiseptics, says the agency, aren't covered by the proposed rule.

Jim Burger

Research Predicts Inflammation Among Joint Replacement Patients

Chronic inflammation inhibits muscles' ability to repair themselves, and can complicate the outcomes of total joint replacement surgeries. A multicenter study suggests a method of determining which patients are more likely to suffer such inflammation and, as a result, require specialized rehabilitation.

For the study, which appeared in the American Journal of Physiology–Endocrinology and Metabolism, researchers measured the levels of inflammation in joint tissue and throughout the bodies of patients undergoing hip replacements due to osteoarthritis and due to fracture, as well as among healthy control subjects. They also measured the presence of a protein that signals muscle impairment and loss. Patients with higher levels of this protein showed more susceptibility to inflammation.

"The results suggest [susceptibility] status at the time of surgery may be a powerful determinant of recovery potential independent of age and BMI," they wrote. "We suspect [the most susceptible] patients may be in need of a rehabilitation program that is more intensive than usual care."

David Bernard

InstaPoll: Can Staff Text in Sick?

Do you let your staff members text in sick, or do you insist that they call? Tell us in this week's InstaPoll. You can also join the discussion and read what your colleagues have to say on the subject on our Second Opinions forum page.

First case of the day late in starting? You can blame it on the surgeon almost all of the time, say 81% of the 406 respondents to last week's poll. The results:

What's the main cause of first-case delays?

  • Surgeon not ready 81%
  • Anesthesia not ready 9%
  • Patient not ready 7%
  • Room not ready 3%

Dan O'Connor

News & Notes

  • Sprayed sealant controls bleeding Raplixa, a biological spray product that can be used to control bleeding from small vessels during surgery, has received FDA approval. The product combines fibrinogen and thrombin, 2 proteins found in plasma, to help coagulate blood in cases where standard surgical techniques are either ineffective or impractical.
  • Corneal implant corrects near vision The KAMRA inlay, a corneal implant designed to correct presbyopia among 45- to 60-year-old patients who have not had cataract surgery, has received pre-market approval from the FDA. The opaque, ring-shaped device is inserted into a laser-cut pocket in the cornea of one eye to improve the eyesight of those who require reading glasses but not corrective lenses for distance vision.
  • Obese patients' plastic surgery complications Obese patients are more likely to suffer complications and visit emergency departments following common plastic surgery procedures, resulting in increased healthcare costs, says a study in the May issue of Plastic and Reconstructive Surgery. A review of nearly 50,000 liposuction, abdominoplasty, breast reduction or blepharoplasty cases found that patients classified as obese were 35% more likely to end up in the ER or hospital within 30 days of surgery, leading to hospital charges of up to $7,500.
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