American Society of Anesthesiologists, Oct. 9-13

The annual meeting of the American Society of Anesthesiologists was held from Oct. 9 to 13 in San Diego and attracted approximately 15,000 participants from around the world, including anesthesiologists and other health care professionals. The conference featured presentations focusing on the latest advances in the relief of pain and total care of surgical patients prior to, during, and after surgery.

In a quality improvement project, Tyler Morrissey, M.D., of the University of Colorado School of Medicine in Aurora, and colleagues increased perioperative influenza vaccination among children by 3,500 percent compared with last year’s flu season, without any process- or vaccine-related complications reported.

The authors offered influenza vaccination to all children undergoing elective general anesthesia from Monday to Friday. When the patient checked in for surgery, a “Best Practice Alert” pop-up would initiate on the intake nurse’s computer screen if the patient did not have documented influenza vaccination for the season. Next, the nurse would determine, using a series of questions, if the patient was eligible for the vaccine and would obtain parental consent. The investigators then tracked the number of vaccines dispensed and given in the perianesthesia environment compared with last year to determine if certain demographics were more or less likely to receive vaccines, as well as to identify other barriers to vaccination.

“If offered, a significant number of pediatric patients and families would jump at the opportunity to be vaccinated under anesthesia. Additional research into anesthesia’s impact on the immune response to vaccination and potential vaccine complications during the postoperative period is warranted,” Morrissey said. “Vaccination under anesthesia remains a controversial topic, but our project demonstrates that general anesthesia may be a ‘teachable moment’ for vaccination for patients and their families.”

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In another study, Gia Pittet, Ph.D., of the University of California in Los Angeles (UCLA), and colleagues found that one in five opioid-naive surgical patients continues to use opioids beyond 90 postoperative days.

The authors developed a novel algorithm to merge the UCLA surgical cohort with the California state narcotics data to create a complete prescription catch approach for narcotic refills beyond the UCLA health system within the state of California. Different statistical modeling methods, including data modeling and algorithmic modeling, were employed, and their performance was compared to find the best performing model. The researchers found that certain risk factors for persistent opioid use were potentially modifiable before surgery, and smoking proved to be a key predictor of new persistent postoperative opioid use.