Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery

Background. Perioperative management of cocaine-abusing patients scheduled for elective surgery varies widely based on individual anecdotes and personal experience. Methods. Chiefs of the anesthesia departments in the Veterans Affairs (VA) health system were surveyed to estimate how often they enco...

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Main Authors: Nabil Elkassabany, Rebecca M. Speck, David Oslin, Mary Hawn, Khan Chaichana, John Sum-Ping, Jorge Sepulveda, Mary Whitley, Yasser Sakawi
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Anesthesiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2013/149892
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author Nabil Elkassabany
Rebecca M. Speck
David Oslin
Mary Hawn
Khan Chaichana
John Sum-Ping
Jorge Sepulveda
Mary Whitley
Yasser Sakawi
author_facet Nabil Elkassabany
Rebecca M. Speck
David Oslin
Mary Hawn
Khan Chaichana
John Sum-Ping
Jorge Sepulveda
Mary Whitley
Yasser Sakawi
author_sort Nabil Elkassabany
collection DOAJ
description Background. Perioperative management of cocaine-abusing patients scheduled for elective surgery varies widely based on individual anecdotes and personal experience. Methods. Chiefs of the anesthesia departments in the Veterans Affairs (VA) health system were surveyed to estimate how often they encounter surgical patients with cocaine use. Respondents were asked about their screening criteria, timing of screening, action resulting from positive screening, and if they have a formal policy for management of these patients. Interest in the development of VA guidelines for the perioperative management of patients with a history of cocaine use was also queried. Results. 172 VA anesthesia departments’ chiefs were surveyed. Response rate was 62%. Over half of the facilities see cocaine-abusing patients at least once a week (52%). Two thirds of respondents canceled or delayed patients with a positive screen regardless of clinical symptoms. Only eleven facilities (10.6%) have a formal policy. The majority of facilities (80%) thought that having formal guidelines for perioperative management of cocaine-abusing patients would be helpful to some extent. Results. 172 VA anesthesia departments’ chiefs were surveyed. Response rate was 62%. Over half of the facilities see cocaine-abusing patients at least once a week (52%). Two thirds of respondents canceled or delayed patients with a positive screen regardless of clinical symptoms. Only eleven facilities (10.6%) have a formal policy. The majority of facilities (80%) thought that having formal guidelines for perioperative management of cocaine-abusing patients would be helpful to some extent. Conclusions. There is a general consensus that formal guidelines would be helpful. Further studies are needed to help formulate evidence-based guidelines for managing patients screening positive for cocaine prior to elective surgery.
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spelling doaj-art-f511237b2bdb4bfaa705b94e9c4ce57b2025-08-20T03:25:22ZengWileyAnesthesiology Research and Practice1687-69621687-69702013-01-01201310.1155/2013/149892149892Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective SurgeryNabil Elkassabany0Rebecca M. Speck1David Oslin2Mary Hawn3Khan Chaichana4John Sum-Ping5Jorge Sepulveda6Mary Whitley7Yasser Sakawi8Department of Anesthesiology, Philadelphia VAMC, 3900 Woodland Avenue, Philadelphia, PA 19104, USADepartment of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USADepartment of Behavioral Health, Philadelphia VAMC, Philadelphia, PA 19104, USADepartment of Surgery, Birmingham VAMC, Birmingham, AL 35249-6810, USADepartment of Anesthesiology and Critical Care, Perelman School of Medicine, University of Pennsylvania, 3400 Spruce Street, Dulles 6, Philadelphia, PA 19104, USADepartment of Anesthesiology, Dallas VA Medical Center, Dallas, TX 75216, USADepartment of Clinical Pathology, Philadelphia VAMC, Philadelphia, PA 19104, USADepartment of Anesthesiology, Birmingham VA Medical Center, USADepartment of Anesthesiology, Birmingham VA Medical Center, USABackground. Perioperative management of cocaine-abusing patients scheduled for elective surgery varies widely based on individual anecdotes and personal experience. Methods. Chiefs of the anesthesia departments in the Veterans Affairs (VA) health system were surveyed to estimate how often they encounter surgical patients with cocaine use. Respondents were asked about their screening criteria, timing of screening, action resulting from positive screening, and if they have a formal policy for management of these patients. Interest in the development of VA guidelines for the perioperative management of patients with a history of cocaine use was also queried. Results. 172 VA anesthesia departments’ chiefs were surveyed. Response rate was 62%. Over half of the facilities see cocaine-abusing patients at least once a week (52%). Two thirds of respondents canceled or delayed patients with a positive screen regardless of clinical symptoms. Only eleven facilities (10.6%) have a formal policy. The majority of facilities (80%) thought that having formal guidelines for perioperative management of cocaine-abusing patients would be helpful to some extent. Results. 172 VA anesthesia departments’ chiefs were surveyed. Response rate was 62%. Over half of the facilities see cocaine-abusing patients at least once a week (52%). Two thirds of respondents canceled or delayed patients with a positive screen regardless of clinical symptoms. Only eleven facilities (10.6%) have a formal policy. The majority of facilities (80%) thought that having formal guidelines for perioperative management of cocaine-abusing patients would be helpful to some extent. Conclusions. There is a general consensus that formal guidelines would be helpful. Further studies are needed to help formulate evidence-based guidelines for managing patients screening positive for cocaine prior to elective surgery.http://dx.doi.org/10.1155/2013/149892
spellingShingle Nabil Elkassabany
Rebecca M. Speck
David Oslin
Mary Hawn
Khan Chaichana
John Sum-Ping
Jorge Sepulveda
Mary Whitley
Yasser Sakawi
Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery
Anesthesiology Research and Practice
title Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery
title_full Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery
title_fullStr Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery
title_full_unstemmed Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery
title_short Preoperative Screening and Case Cancellation in Cocaine-Abusing Veterans Scheduled for Elective Surgery
title_sort preoperative screening and case cancellation in cocaine abusing veterans scheduled for elective surgery
url http://dx.doi.org/10.1155/2013/149892
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