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Anesthesiologists Issue Choosing Wisely Recommendations
List of top 5 unnecessary perioperative medical services in anesthesiology developed

THURSDAY, June 19, 2014 (HealthDay News) -- A list of the top five unnecessary medical services in anesthesiology has been developed as part of the Choosing Wisely campaign, according to a study published online June 16 in JAMA Internal Medicine.

Onyi C. Onuoha, M.D., M.P.H., from the University of Pennsylvania in Philadelphia, and colleagues conducted a multistep survey of anesthesiologists and generated a list of 18 low-value perioperative activities. After further surveying, a list of five items was identified that are of low quality or benefit and high cost, and have poor evidence in support of their use.

The top five low-value activities include two preoperative and three intraoperative practices. The five activities are: (1) avoiding baseline laboratory studies in healthy patients without significant systemic disease and when blood loss is expected to be minimal; (2) avoiding diagnostic cardiac testing or cardiac stress testing in asymptomatic stable patients with known cardiovascular disease; (3) avoiding routine pulmonary arterial catheter use for cardiac surgery in patients at low risk of hemodynamic complications; (4) avoiding administration of packed red blood cells in young healthy patients without ongoing blood loss; and (5) avoiding routine administration of colloid for volume resuscitation without appropriate indications.

"Through a robust and transparent process, we developed a list of five activities in anesthesiology that should be avoided," the authors write.

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October 31, 2014

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