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October 25, 1985


JAMA. 1985;254(16):2317-2318. doi:10.1001/jama.1985.03360160149042

Reduction of anesthesia morbidity and mortality is a subject of major interest among anesthesiologists, and current research efforts address this problem in a number of ways. Investigators have shown that in high-risk and/or elderly patients, utilization of state-of-the-art preoperative, intraoperative, and postoperative hemodynamic and other physiologic monitoring, plus pharmacologic intervention, results in reduced morbidity and mortality associated with anesthesia and surgery. Rao et al3 examined myocardial reinfarction rates in two groups of patients undergoing noncardiac surgery. The first group was studied retrospectively from 1973 to 1976, and the second prospectively from 1977 through 1982. The latter had the advantages of "newer invasive monitoring in the preoperative period, which guided the titration of pharmacologic therapy to achieve the best possible physical status... and had the benefit of the new cardioactive and vasoactive drugs."

The overall rate of reinfarction fell from 7.7% in the first group (in line with many other