Perioperative Care and Operating Room Management最新文献

{"title":"Violation of the Monro-Kellie doctrine in paediatrics and perioperative anaesthetic concerns","authors":"Amarjeet Kumar, Kunal Singh, Chandni Sinha","doi":"10.1016/j.pcorm.2025.100460","DOIUrl":"10.1016/j.pcorm.2025.100460","url":null,"abstract":"","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100460"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143549776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Operating Room Management in Low-and-Middle Income Countries","authors":"Steven D. Boggs (Retired Chairman)","doi":"10.1016/j.pcorm.2025.100476","DOIUrl":"10.1016/j.pcorm.2025.100476","url":null,"abstract":"","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100476"},"PeriodicalIF":0.0,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143550539","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lidocaine administration techniques for head and limb wound anesthesia: Injection vs. topical application","authors":"Samad Shams Vahdati ,&nbsp;Alireza Ala ,&nbsp;Mohammad Mirza-aghazadeh attari ,&nbsp;Paria Habibollahi ,&nbsp;Arezoo Fathalizadeh ,&nbsp;Behrang Khaffafi ,&nbsp;Saba Mehrtabar","doi":"10.1016/j.pcorm.2025.100483","DOIUrl":"10.1016/j.pcorm.2025.100483","url":null,"abstract":"<div><h3>Purpose</h3><div>Lidocaine is one of the most utilized anesthetics used in different forms and various clinical contexts. Recently there have been controversy about the best method of lidocaine administration and there have been studies comparing subcutaneous and topical lidocaine in different clinical fields. The present study aims to compare the effect of topical and subcutaneous injection of lidocaine in patients presenting with ulcerations in their head and extremities.</div></div><div><h3>Methods</h3><div>This single-center cross-sectional study, conducted from April 2016 to April 2017 at Imam Reza Medical Educational Center, Tabriz, Iran, included patients with extremity lacerations under 3 cm, excluding cases with bites, joint or ear injuries, specific medications, cardiac or neuropathic histories, and epilepsy. Ethical approval and informed consent were obtained. Data were collected via questionnaires by trained interviewers. Patients received either topical or subcutaneous lidocaine as per clinical practice, without randomization. Pain was measured using a 100-mm visual analogue scale (VAS). Data analysis utilized SPSS v22.0, with significance set at <em>p</em> &lt; 0.05 and 80 % study power.</div></div><div><h3>Results</h3><div>In this observational study of 305 patients, 162 received subcutaneous lidocaine and 143 received topical lidocaine. No significant differences in age or gender were found (<em>P</em> = 0.25 and <em>P</em> = 0.86). Patients with topical lidocaine reported higher starting pain, while those receiving subcutaneous lidocaine experienced significantly more pain during administration and suturing (<em>P</em> &lt; 0.05), highlighting the impact of lidocaine application methods on patient pain experiences.</div></div><div><h3>Conclusion</h3><div>The difference in pain during administration between the two methods was statistically and clinically significant, while the difference in pain during suturing was statistically significant but not clinically meaningful. These findings suggest that topical lidocaine offers a less painful alternative to subcutaneous injection, particularly during administration.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100483"},"PeriodicalIF":0.0,"publicationDate":"2025-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143488608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intraperitoneal installation of bupivacaine with either dexmedetomidine or ketamine for postoperative analgesia after laparoscopic sleeve gastrectomy: A randomized controlled study","authors":"Asmaa M. Galal Eldin,&nbsp;Abeer M. Elnakera,&nbsp;Rehab A. Wahdan","doi":"10.1016/j.pcorm.2025.100481","DOIUrl":"10.1016/j.pcorm.2025.100481","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pain management after laparoscopic sleeve gastrectomy is still considered a major challenge. The current study was designed to assess if adding ketamine or dexmedetomidine to intraperitoneal bupivacaine could improve the quality and the duration of postoperative analgesia for morbidly obese patients undergoing laparoscopic sleeve gastrectomy.</div></div><div><h3>Methods</h3><div>Sixty patients scheduled for elective laparoscopic sleeve gastrectomy were randomly assigned to receive intraperitoneal instillation of bupivacaine (0.25 %) alone (group C), bupivacaine (0.25 %)/ketamine 0.5 mg/kg (group K) or bupivacaine (0.25 %)/dexmedetomidine 1µg/kg (group D) after sleeve gastrectomy. The primary outcome measured was the time to first postoperative rescue analgesia. Secondary outcomes included postoperative analgesic requirements, postoperative pain intensity measured by the Visual Analog Scale (VAS) and the incidence of shoulder pain.</div></div><div><h3>Results</h3><div>The time to first rescue analgesia was significantly longer (<strong>&lt; 0.001</strong>) and the total amount of postoperative nalbuphine required was significantly lower in both the K and D groups (<strong>&lt; 0.001</strong>) compared to the C group. Additionally, the time to first rescue analgesia was significantly longer in group D compared to group K. The VAS score was significantly lower in groups K and D compared to group C (<em>P</em> &lt; 0.05) at most measuring points, with no significant difference between groups K and D. The incidence of postoperative shoulder pain was significantly higher in group C compared to groups K and D (<strong>&lt; 0.001</strong>) with no statistically significant difference between groups K and D.</div></div><div><h3>Conclusion</h3><div>Adding either ketamine 0.5 mg/kg or dexmedetomidine 1µg/kg to intraperitoneal bupivacaine 0.25 % can safely improve postoperative analgesia resulting in a longer time to first rescue analgesia, lower VAS for pain values, reduced postoperative rescue analgesic requirements in the first postoperative 24 h and a lower incidence of postoperative shoulder pain.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100481"},"PeriodicalIF":0.0,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143386915","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of the patients’ knowledge undergoing surgery about anesthesiology and anesthesiologists’ roles","authors":"Reza Jouybar ,&nbsp;Mahshad Razaghi ,&nbsp;Mohammad Hossein Eghbal ,&nbsp;Saeed Khademi ,&nbsp;Amirbahador Abbasi ,&nbsp;Naeimehossadat Asmarian ,&nbsp;Mahsa Banifatemi","doi":"10.1016/j.pcorm.2025.100480","DOIUrl":"10.1016/j.pcorm.2025.100480","url":null,"abstract":"<div><h3>Introduction</h3><div>We aim to assess patients' understanding of anesthesia and the anesthesiologist's role in pre-, intra, and post-operative periods. Anesthesiologists' responsibilities have expanded beyond the operating room to include trauma centers, labor analgesia, resuscitation units, etc. This is particularly important as patients in developing countries often have limited knowledge about anesthesia.</div></div><div><h3>Methods</h3><div>This cross-sectional study was conducted on 170 patients from January to February 2021 at Faghihi Hospital, affiliated with Shiraz University of Medical Sciences. Consenting patients were interviewed based on a pre-designed and pre-tested checklist.</div></div><div><h3>Results</h3><div>Out of 170 patients with an age of 46 ± 12 years, 85 % had previous exposure to anesthesia. 93 % of patients thought anesthesia meant to sleep, while only 66 % knew it was a medical specialty, and 24 % were aware of postoperative pain control by an anesthesiologist. Education level was the most important factor influencing patient knowledge, followed by place of residence and previous anesthesia experience. Previous anesthesia experience did not affect opinions about anesthesia (<em>P</em> = 0.15).</div></div><div><h3>Conclusion</h3><div>The study participants generally had poor knowledge about anesthesia and anesthesiologists' responsibilities. To improve this, we must endeavor to educate patients in the field of anesthesia. Also, attention should be focused on finding ways to inform patients about anesthesiology in rural areas and unschooled patients with video/audio instructions, as our findings indicate that a patient's place of residence influences their knowledge about anesthesiology.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100480"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the Flexible Endoscope Disinfection Cycle indicates the Need for Risk Reduction Strategies for Task Complexity and Environmental Stressors","authors":"Abner M.P. Barbosa ,&nbsp;Mark J. Saari ,&nbsp;Peter F. Nichol","doi":"10.1016/j.pcorm.2025.100478","DOIUrl":"10.1016/j.pcorm.2025.100478","url":null,"abstract":"<div><h3>Introduction</h3><div>Endoscopes carry a significant infectious risk if not properly sterilized. We mapped the total tasks required to properly sterilize an endoscope and conducted theoretical risk modeling to define tasks at greatest risk for error in this process.</div></div><div><h3>Methods</h3><div>observations were conducted on a hospital campus in the following spaces: operating room, sterile processing pre-washer side, sterile processing post-washer side, and storage. The total number of tasks and the stress level in each space were determined. Each task was assigned an error rate based on a complexity scale in Smith's textbook <em>Reliability, Maintainability and Risk</em>, 7th Ed. Tasks in low stress spaces were assigned the lowest possible error rate per task type and those in high stress environments were assigned the highest error rate per task type. Risk of error score (RES) for each space and an overall RES was calculated by adding up all the assigned task error rates.</div></div><div><h3>Results</h3><div>observations were conducted on 22 flexible endoscopes. Seventy-five tasks were identified. Each was performed by a human. Fifty-two tasks were performed in sterile processing which had the highest stress score and highest number of complicated, non-routine tasks. The aggregate RES per endoscope. was 3.0832 The majority of risk (94.%) mapped to sterile processing (RES of 2.918).</div></div><div><h3>Conclusions</h3><div>proper sterilization of endoscopes involves 75 tasks. The majority of the RES maps to the high stress SPD environment. Strategies that reduce stress levels and the complexity of tasks in this space would significantly reduce the risk of errors in sterilization.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100478"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139169","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of different doses of ephedrine on the incidence of second episode of hypo-tension during elective cesarean section under subarachnoid block: Time to event analysis; randomized clinical trial","authors":"Ayman Mohamady Eldemrdash ,&nbsp;Mahmoud Fawzy Elsharkawy ,&nbsp;Basma M. Ghoniem ,&nbsp;Wafaa Abdelsalam ,&nbsp;Soudy S. Hammad ,&nbsp;Tarek S. Hemaida ,&nbsp;Ahmed Mohamed Reda Ragheb ,&nbsp;Gamal Hendawy Shams","doi":"10.1016/j.pcorm.2025.100479","DOIUrl":"10.1016/j.pcorm.2025.100479","url":null,"abstract":"<div><h3>Background</h3><div>Hypotension is the most prevalent consequence of spinal anesthesia (SA). Ephedrine is a commonly employed medication that successfully elevates arterial blood pressure while maintaining uteroplacental perfusion, primarily through its cardio-acceleratory effects. The objective of the study was to estimate the incidence of and time to second hypotension by using three different doses.</div></div><div><h3>Methods</h3><div>This randomized double-blinded study was multicentric and carried out on 300 parturients planning to have elective CS under SA. Parturients were randomly divided equally into three groups to receive either a 5 mg (group I),10 mg (group II), or 15 mg (group III) ephedrine IV after the first hypotension. The study time was from spinal anesthesia to delivery, and blood pressure measurements were noninvasive at three-minute intervals. The starting point was the first hypotension and the endpoint of interest was a second episode of hypotension.</div></div><div><h3>Results</h3><div>The incidence of a second episode of hypotension was significantly lower in group II [29 (30.21%)] and III [11(11.34%)] than in group I [41(44.09%)] P&lt;0.05 and lower in group III than II (P&lt;0.001). The time taken until the second episode of hypotension by minutes was significantly delayed in group II (20.6 ± 2.63) and III (26.5± 4.61) than in group I (16.4 ± 2.23), (P&lt;0.001) and in group III than group II, (P&lt;0.001). Meantime free from hypotension by minutes with <strong>95% CI</strong> in group I [24 (22.59 to 25.40)] was less than group II and III, while in group II was 27.16(26.24 to 28.06), less than group III 29.59(29.21 to 29.98) P&lt;0.001. <strong>Hazard ratio with 95%CI</strong> when group III as a reference group, the risk of occurrence of hypotension in group I was 5.17 (2.99 to 8.94) times compared to group III, while in group II was 2.88 (1.72 to 4.80) times in compared to group III.</div></div><div><h3>Conclusions</h3><div>In SA, the higher the dose of ephedrine used significantly the lower the incidence of 2nd hypotension with non-significant adverse effects on the fetus, blood loss, and hemodynamic effect. Moreover, the dose of 15 mg ephedrine is the most effective one compared with the smaller dosages (5 or 10 mg).</div></div><div><h3>Trial registration</h3><div>This study was registered at Aswan University IRP 669/10/2022 and Clinical Trials.gov (registration number: NCT05993182). The registration date for this experiment is 15/08/2023. Enrollment was from August 20, 2023, to January 1, 2024.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100479"},"PeriodicalIF":0.0,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143395065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of mobile device use among healthcare providers in the operating theatres: Perceptions and distractions","authors":"Betül Kocamer Şimşek,&nbsp;Yunus Baydilek,&nbsp;Soner Karadaş,&nbsp;Ahmet Aykut Akyılmaz","doi":"10.1016/j.pcorm.2025.100474","DOIUrl":"10.1016/j.pcorm.2025.100474","url":null,"abstract":"<div><h3>Background</h3><div>Distractions in the operating theatre can significantly impair surgical performance and patient safety. This study investigates the various sources of distractions, particularly focusing on technological and non-technological factors, and their differential impact across various occupational roles within anesthesiology.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted involving 169 anes- thesiology professionals categorized into three groups: residents, technicians, and specialists. Data were collected via structured questionnaires, capturing both quantitative and qualitative aspects of workplace distractions. Statis- tical analysis included ANOVA, Kruskal-Wallis tests, Pearson's chi-square test, and multivariate analysis of covariance, adhering to STROBE guide- lines.</div></div><div><h3>Results</h3><div>The multivariate analysis of covariance revealed significant occupational effects on distraction-related variables (Pillai's Trace = 0.323, F(32, 298) = 1.80, <em>p</em> = 0.007). Significant findings included higher levels of mobile phone use for texting, gaming, and media consumption among specialists compared to other groups. Texting on the phone (F(2, 163) = 6.37, <em>p</em> = 0.002), playing games on phone (F(2, 163) = 8.39, <em>p</em> &lt; 0.001), and watching movies/series on phone (F(2, 163) = 4.15, <em>p</em> = 0.018) were notably higher among specialists.</div></div><div><h3>Conclusion</h3><div>The study highlights the need for comprehensive inter- ventions to mitigate the effects of distractions in surgical environments, in- cluding policy formulation for mobile device usage and strategies to improve team dynamics and environmental conditions. Future research should focus on longitudinal assessments to evaluate the effectiveness of interventions and explore the broader implications across different healthcare settings.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100474"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143350164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of post operative analgesia following intraperitoneal instillation of ropivacaine with or without dexamethasone for patients undergoing laparoscopic surgeries","authors":"Adibur Rahman,&nbsp;Sadia Ummer,&nbsp;Kamaludeen S,&nbsp;Cheran K","doi":"10.1016/j.pcorm.2025.100475","DOIUrl":"10.1016/j.pcorm.2025.100475","url":null,"abstract":"<div><h3>Aim</h3><div>To analyse how combining ropivacaine with dexamethasone in multimodal analgesia amplifies pain management and decreases postoperative discomfort (including nausea, vomiting, and rescue analgesia use) compared to using ropivacaine alone in patients undergoing laparoscopic surgery, with a focus on improving recovery outcomes.</div></div><div><h3>Results</h3><div>The initial patient distribution between groups showed no significant difference, our study highlighted substantial differences in key outcomes. Patients receiving multimodal analgesia (ropivacaine with dexamethasone) had significantly less postoperative nausea, vomiting, lower pain scores (VAS), decreased need for rescue analgesia, and longer intervals before requiring additional pain relief compared to those receiving ropivacaine alone.</div></div><div><h3>Conclusion</h3><div>Combining ropivacaine with dexamethasone for laparoscopic surgery patients gives superior pain relief compared to using ropivacaine alone. This dual approach not only reduces pain more effectively but also reduces nausea, vomiting, and the use of additional pain medication. It aims to enhance postoperative comfort and expedite recovery for patients undergoing these procedures.\"</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100475"},"PeriodicalIF":0.0,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143342843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review on the impact of national guidelines on clinical practice and patient safety in the context of perioperative care","authors":"Gráinne Brady ,&nbsp;Sigrún Eyrúnardóttir Clark ,&nbsp;Duncan Wagstaff ,&nbsp;Cecilia Vindrola-Padros","doi":"10.1016/j.pcorm.2025.100477","DOIUrl":"10.1016/j.pcorm.2025.100477","url":null,"abstract":"<div><div>This systematic review identifies and assesses national guidelines that are used to improve clinical practice and patient safety in perioperative care. The authors searched, MEDLINE, Embase, Cumulative Index of Nursing and Allied Health Literature (CINAHL Plus) and Health Management Information Consortium (HMIC) to identify relevant studies published from January 2014 until May 2024. Two researchers screened a total of 727 studies (which yielded 37 eligible studies), extracted data and rated study quality using the Mixed Methods Appraisal Tool (MMAT). The most common national guidelines identified were the Enhanced Recovery After Surgery (ERAS) and the WHO Surgical Safety Checklist (WHO SSC). 13 studies identified improvements in morbidity, 10 a decrease in length of stay and 1 a decrease in readmission. Strength of evidence was high (18 studies rated as high), with most studies being pre-post evaluations. The evidence leans to suggest that the implementation of national guidelines can improve patient outcomes, however, this conclusion should be considered in light of all the available evidence.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100477"},"PeriodicalIF":0.0,"publicationDate":"2025-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}