The Interdisciplinary Synergy of Surgery and Pharmacy: A Narrative Review of Perioperative Pharmacotherapy and Clinical Outcomes
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Abstract
Modern surgical care increasingly relies on complex, high-risk pharmacotherapy to optimize outcomes across the perioperative continuum. This narrative review evaluates the multidisciplinary synergy between surgery and clinical pharmacy, focusing on the specialized contributions of surgical pharmacists in preoperative, intraoperative, and postoperative settings. Preoperatively, pharmacists facilitate medication reconciliation and risk mitigation, particularly regarding high-risk chronic regimens and antithrombotics. Intraoperatively, their expertise supports optimal timing of antimicrobial prophylaxis to prevent surgical site infections, hemodynamic stability, and efficient blood conservation strategies. Postoperatively, clinical pharmacists drive multimodal analgesia protocols to advance opioid stewardship, oversee venous thromboembolism prophylaxis, and manage acute organ dysfunction in surgical intensive care units. Specialized surgical fields, including organ transplantation and oncologic surgery, further underscore the need for targeted therapeutic drug monitoring and specialized dosing regimens. Evidence demonstrates that integrating clinical pharmacists into surgical teams significantly reduces medication errors, adverse drug events, overall length of hospital stay, and healthcare costs. Future directions highlight the expansion of pharmacogenomics and predictive analytics in perioperative drug selection. Ultimately, embedding clinical pharmacy in surgical practice improves patient safety, optimizes clinical efficacy, and enhances the quality of perioperative care.
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