Pub Date : 2025-06-27DOI: 10.1016/j.pcorm.2025.100519
Franklin Dexter, Bradley J. Hindman, Kokila N. Thenuwara
Background
Annual ongoing professional practice evaluation (i.e., peer review) is mandatory for nurse anesthetists at many hospitals. A work habits instrument is a valid and psychometrically reliable tool for these high-stakes assessments. Our study focuses on item-specific feedback for nurse anesthetists to increase their scores.
Methods
The retrospective cohort study used all 9 complete academic years for which the studied department used the scale, July 2015 through June 2024. There were 59,863 evaluations of 713 nurse anesthetist years provided by 167 rating anesthesiologists, each evaluation with 6 non-Likert scored items from one to five.
Results
The work habits instrument functioned as a binary (5 vs ≤4) multivariate (6-item) correlated (Cronbach alpha 0.96) array. Consequently, the 90 % (53,626/59,863) of evaluations with all 6 items five, or all 6 items scored less than five, provided information about the nurse anesthetists' performance quality but no potentially useful item-specific information for feedback. Cochran Q tests were performed for each of the nurse anesthetist years using the remaining 10 % of evaluations to look for items differing significantly from the other items. There were 4.6 % (33/713) of nurse anesthetist years with adjusted P < 0.05, representing 1.5 % (911/59,863) of evaluations. The 4.6 % did not differ from the nominal Type I error rate of 5 % (P = 0.73).
Conclusions
Providing analyses of individual item scores could benefit, at most, 5 % of nurse anesthetists, likely fewer. Nurse anesthetists with low ongoing professional practice evaluations should have focused evaluation wholistically based on work habits.
{"title":"Evaluation using Cochran’s Q tests of the information content of individual items’ scores in the nurse anesthetist work habits instrument for use in providing feedback","authors":"Franklin Dexter, Bradley J. Hindman, Kokila N. Thenuwara","doi":"10.1016/j.pcorm.2025.100519","DOIUrl":"10.1016/j.pcorm.2025.100519","url":null,"abstract":"<div><h3>Background</h3><div>Annual ongoing professional practice evaluation (i.e., peer review) is mandatory for nurse anesthetists at many hospitals. A work habits instrument is a valid and psychometrically reliable tool for these high-stakes assessments. Our study focuses on item-specific feedback for nurse anesthetists to increase their scores.</div></div><div><h3>Methods</h3><div>The retrospective cohort study used all 9 complete academic years for which the studied department used the scale, July 2015 through June 2024. There were 59,863 evaluations of 713 nurse anesthetist years provided by 167 rating anesthesiologists, each evaluation with 6 non-Likert scored items from one to five.</div></div><div><h3>Results</h3><div>The work habits instrument functioned as a binary (5 vs ≤4) multivariate (6-item) correlated (Cronbach alpha 0.96) array. Consequently, the 90 % (53,626/59,863) of evaluations with all 6 items five, or all 6 items scored less than five, provided information about the nurse anesthetists' performance quality but no potentially useful item-specific information for feedback. Cochran Q tests were performed for each of the nurse anesthetist years using the remaining 10 % of evaluations to look for items differing significantly from the other items. There were 4.6 % (33/713) of nurse anesthetist years with adjusted P < 0.05, representing 1.5 % (911/59,863) of evaluations. The 4.6 % did not differ from the nominal Type I error rate of 5 % (P = 0.73).</div></div><div><h3>Conclusions</h3><div>Providing analyses of individual item scores could benefit, at most, 5 % of nurse anesthetists, likely fewer. Nurse anesthetists with low ongoing professional practice evaluations should have focused evaluation wholistically based on work habits.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100519"},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519187","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}
To study associations between the pre-anesthetic subclavian vein collapsibility index (SCV-CI) during tidal and deep breathing and post induction hypotension (PIH).
Design
Observational cross-sectional study.
Intervention
Pre induction SCV USG.
Measurements
Minimum and maximum diameters of the SCV during tidal and deep breathing were measured and SCV-CI was calculated. Post induction hypotension (PIH) was defined as a fall in MAP>30 % of baseline or MAP <65 mmHg.
Results
Data of 74 patients was analyzed. After induction of GA, 31 patients (41.9 %) developed PIH. The baseline MAP and SCV-CI (deep) were higher in patients who developed PIH as compared to those who did not (p < 0.01, p = 0.03 respectively). The unadjusted odds ratios for predicting PIH suggested that baseline MAP, SCV-CI (deep), and maximum SCV diameter (deep) were significantly higher in patients who developed PIH (p = 0.01, p = 0.03 and p = 0.04)respectively. However, after multivariate logistic regression analysis, only the baseline MAP and SCV-CI (deep) remained significant independent predictors of PIH (p = 0.02 each). An ROC curve using the SCV-CI (deep) for prediction of PIH revealed an AUC of 0.64 (95 % CI: 0.51–0.77). The best cut off using Youden index was 29.44. There was a 61.29 % sensitivity, 67.44 % specificity, a 57.58 % positive predictive value and a 70.73 % negative predictive value.
Conclusion
The baseline MAP and SCV -CI (deep) were identified as significant predictors of PIH. However, ROC curve analysis demonstrated that SCV-CI (deep) had only limited diagnostic accuracy, indicating its poor clinical utility as a standalone predictor of PIH.
{"title":"Association between pre-anesthetic subclavian vein collapsibility index and post induction hypotension in patients undergoing elective surgical procedures; An observational study","authors":"Abhishek Ahirwar, Anju R. Bhalotra, Rahil Singh, Snigdha Singh, Shweta Dhiman","doi":"10.1016/j.pcorm.2025.100512","DOIUrl":"10.1016/j.pcorm.2025.100512","url":null,"abstract":"<div><h3>Study objective</h3><div>To study associations between the pre-anesthetic subclavian vein collapsibility index (SCV-CI) during tidal and deep breathing and post induction hypotension (PIH).</div></div><div><h3>Design</h3><div>Observational cross-sectional study.</div></div><div><h3>Intervention</h3><div>Pre induction SCV USG.</div></div><div><h3>Measurements</h3><div>Minimum and maximum diameters of the SCV during tidal and deep breathing were measured and SCV-CI was calculated. Post induction hypotension (PIH) was defined as a fall in MAP>30 % of baseline or MAP <65 mmHg.</div></div><div><h3>Results</h3><div>Data of 74 patients was analyzed. After induction of GA, 31 patients (41.9 %) developed PIH. The baseline MAP and SCV-CI (deep) were higher in patients who developed PIH as compared to those who did not (<em>p</em> < 0.01, <em>p</em> = 0.03 respectively). The unadjusted odds ratios for predicting PIH suggested that baseline MAP, SCV-CI (deep), and maximum SCV diameter (deep) were significantly higher in patients who developed PIH (<em>p</em> = 0.01, <em>p</em> = 0.03 and <em>p</em> = 0.04)respectively. However, after multivariate logistic regression analysis, only the baseline MAP and SCV-CI (deep) remained significant independent predictors of PIH (<em>p</em> = 0.02 each). An ROC curve using the SCV-CI (deep) for prediction of PIH revealed an AUC of 0.64 (95 % CI: 0.51–0.77). The best cut off using Youden index was 29.44. There was a 61.29 % sensitivity, 67.44 % specificity, a 57.58 % positive predictive value and a 70.73 % negative predictive value.</div></div><div><h3>Conclusion</h3><div>The baseline MAP and SCV -CI (deep) were identified as significant predictors of PIH. However, ROC curve analysis demonstrated that SCV-CI (deep) had only limited diagnostic accuracy, indicating its poor clinical utility as a standalone predictor of PIH.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100512"},"PeriodicalIF":0.0,"publicationDate":"2025-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562941","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}
The COVID-19 pandemic disrupted routine healthcare services, including elective surgeries, and heightened patient fear and anxiety. This study evaluates predictors of COVID-19-related fear among patients undergoing elective surgeries in central India, using the Indian Scale for Fear of COVID-19 (ISF-C19) and the Numerical Anxiety Score (NAS).
Methodology
An observational study of 687 patients was conducted at a multispeciality hospital between October 2021 and May 2022. Data were collected using a semi-structured questionnaire, ISF-C19, and NAS. Patients were stratified into high (≥27) and low (<27) ISF-C19 score groups. Logistic regression was employed to identify predictors of high fear scores.
Results
High ISF-C19 scores correlated significantly with elevated NAS (≥5), comorbidities, and lack of prior COVID-19 infection. NAS emerged as the strongest predictor of fear (p = 0.001), while comorbidities also had a significant impact (p = 0.007). The model demonstrated a sensitivity of 67.40 % and a specificity of 69.21 %.
Conclusion
This study identifies preoperative anxiety (NAS) and comorbidities as key predictors of COVID-19-related fear among surgical patients.
{"title":"Predictors of fear of COVID-19 among patients undergoing elective surgery during the COVID-19 pandemic: An observational study","authors":"Meghna Maheshwari , Anuj Jain , Pankaj Singhai , Swapnil Kumar Barasker","doi":"10.1016/j.pcorm.2025.100516","DOIUrl":"10.1016/j.pcorm.2025.100516","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic disrupted routine healthcare services, including elective surgeries, and heightened patient fear and anxiety. This study evaluates predictors of COVID-19-related fear among patients undergoing elective surgeries in central India, using the Indian Scale for Fear of COVID-19 (ISF-C19) and the Numerical Anxiety Score (NAS).</div></div><div><h3>Methodology</h3><div>An observational study of 687 patients was conducted at a multispeciality hospital between October 2021 and May 2022. Data were collected using a semi-structured questionnaire, ISF-C19, and NAS. Patients were stratified into high (≥27) and low (<27) ISF-C19 score groups. Logistic regression was employed to identify predictors of high fear scores.</div></div><div><h3>Results</h3><div>High ISF-C19 scores correlated significantly with elevated NAS (≥5), comorbidities, and lack of prior COVID-19 infection. NAS emerged as the strongest predictor of fear (<em>p</em> = 0.001), while comorbidities also had a significant impact (<em>p</em> = 0.007). The model demonstrated a sensitivity of 67.40 % and a specificity of 69.21 %.</div></div><div><h3>Conclusion</h3><div>This study identifies preoperative anxiety (NAS) and comorbidities as key predictors of COVID-19-related fear among surgical patients.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100516"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144519186","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}
Pub Date : 2025-06-25DOI: 10.1016/j.pcorm.2025.100515
Naile Akıncı , Kadriye Nilay Genç , Çağla Toprak
Aim
The study was conducted methodologically to evaluate the validity and reliability of the KTUT scale in kidney transplant recipients.
Material and Method
The population of the study consisted of kidney transplant patients at a private hospital group in Istanbul, while the sample comprised patients who met the inclusion criteria and volunteered for the study. Based on ten times the number of scale items, 220 individuals were included in the sample to prevent data loss and to ensure high representativeness. In the study, data collection tools such as the "Patient Information Form" and the "KTUT" scale were employed. The test-retest study was repeated two weeks later with 50 participants. The participants in the retest were not included in other tests of the scale.
Findings
The overall content validity index of the scale (S-CVI/Ave) was found to be 0.93. According to the experts' opinions, the content validity of the scale is high, and the majority of the items have been deemed appropriate for the measurement purpose. The internal consistency reliability coefficient of the scale (Cronbach's Alpha) was calculated as 0.789. This threshold indicates that the scale possesses an acceptable level of reliability for use at the group level. In addition, the results of the study reveal that the scores of the K-TUT scale show a significant difference in the 27 % lower and 27 % upper groups.
Conclusion
As a result of the study, the K-TUT scale has been shown to reliably distinguish knowledge levels and to be an effective measurement tool in the field of kidney transplant.
It is thought that using the Turkish version of the K-TUT to evaluate the knowledge levels of kidney transplant recipients will contribute to evaluation of developed programs and the improvement of patients' treatment processes.
{"title":"Turkish validity and reliability study of the kidney transplant understanding tool (K-TUT) in Kidney transplant recipients","authors":"Naile Akıncı , Kadriye Nilay Genç , Çağla Toprak","doi":"10.1016/j.pcorm.2025.100515","DOIUrl":"10.1016/j.pcorm.2025.100515","url":null,"abstract":"<div><h3>Aim</h3><div>The study was conducted methodologically to evaluate the validity and reliability of the KTUT scale in kidney transplant recipients.</div></div><div><h3>Material and Method</h3><div>The population of the study consisted of kidney transplant patients at a private hospital group in Istanbul, while the sample comprised patients who met the inclusion criteria and volunteered for the study. Based on ten times the number of scale items, 220 individuals were included in the sample to prevent data loss and to ensure high representativeness. In the study, data collection tools such as the \"Patient Information Form\" and the \"KTUT\" scale were employed. The test-retest study was repeated two weeks later with 50 participants. The participants in the retest were not included in other tests of the scale.</div></div><div><h3>Findings</h3><div>The overall content validity index of the scale (S-CVI/Ave) was found to be 0.93. According to the experts' opinions, the content validity of the scale is high, and the majority of the items have been deemed appropriate for the measurement purpose. The internal consistency reliability coefficient of the scale (Cronbach's Alpha) was calculated as 0.789. This threshold indicates that the scale possesses an acceptable level of reliability for use at the group level. In addition, the results of the study reveal that the scores of the K-TUT scale show a significant difference in the 27 % lower and 27 % upper groups.</div></div><div><h3>Conclusion</h3><div>As a result of the study, the K-TUT scale has been shown to reliably distinguish knowledge levels and to be an effective measurement tool in the field of kidney transplant.</div><div>It is thought that using the Turkish version of the K-TUT to evaluate the knowledge levels of kidney transplant recipients will contribute to evaluation of developed programs and the improvement of patients' treatment processes.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100515"},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144557371","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}
Pub Date : 2025-06-24DOI: 10.1016/j.pcorm.2025.100517
Sibhat Teka , Eyayalem Melese , Lidya Haddis
Background
Emergency laparotomy is one of the highest-risk surgical procedures globally, associated with significant morbidity and mortality. The burden is especially severe in low- and middle-income countries, such as Ethiopia, where limited healthcare resources, delayed care, and inadequate postoperative management significantly contribute to these outcomes. Despite global efforts to reduce surgical mortality, a significant knowledge gap persists regarding the specific factors driving high mortality rates in these settings. This study is crucial for improving patient outcomes by identifying factors that contribute to high mortality rates and developing effective mitigation strategies.
Objective
To assess survival status and predictors of mortality among emergency laparotomy patients in selected governmental hospital in Addis Ababa, Ethiopia. from January 1, 2020, to January 1, 2023.
Methods
A retrospective cohort study was conducted in four government hospitals in Addis Ababa, Ethiopia between 2020 and 2023, focusing on emergency laparotomy patients. The study analyzed 374 patient charts using EpiData version 4.6.0.2 and STATA version 17. A Cox proportional hazards regression model was used to correlate independent variables with dependent variables. Bivariate and multiple Cox regression analyses were performed to identify predictors. Kaplan-Meier graphs were used for estimation. The hazard ratio hazard ratio and the 95 % confidence interval were calculated, with factors showing a p-value of <0.05 being strongly correlated with patient mortality.
Results
A total of 374 patients were retrospectively followed from a sample of 379, as data for 5 patients were excluded due to not meeting the criteria because of incomplete information. the median follow-up time was 19 days. The overall mortality rate for patients who underwent emergency laparotomy was 10.43 %. Factors such as pre-existing disease (AHR = 5.43, 95 % CI 1.56, 18.97), preoperative sepsis (AHR = 1.2, 95 % CI 1.03, 3.47), intraoperative use of vasopressors (AHR = 8.49, 95 % CI 1.69, 42.65), and postoperative complications (AHR = 3.73, 95 % CI 1.02, 13.65) were significantly associated with mortality in these patients.
Conclusions
The overall mortality rate among patients who underwent emergency laparotomy was high compared to previous studies. Pre-existing disease, preoperative sepsis, intraoperative use of vasopressors, and postoperative complications were significant factors. Therefore, preoperative optimization and the development of standard operating procedures are essential.
背景急诊剖腹手术是全球风险最高的外科手术之一，与显著的发病率和死亡率相关。在埃塞俄比亚等低收入和中等收入国家，这种负担尤其严重，在这些国家，有限的医疗资源、延迟的护理和不充分的术后管理是导致这些结果的主要原因。尽管全球都在努力降低手术死亡率，但在这些环境中导致高死亡率的具体因素方面，仍然存在重大的知识差距。这项研究通过确定导致高死亡率的因素和制定有效的缓解策略，对改善患者预后至关重要。目的评价埃塞俄比亚首都亚的斯亚贝巴某政府医院急诊剖腹手术患者的生存状况及死亡率预测因素。从2020年1月1日到2023年1月1日。方法对埃塞俄比亚首都亚的斯亚贝巴4家政府医院于2020 - 2023年进行回顾性队列研究，研究对象为急诊剖腹手术患者。该研究使用EpiData版本4.6.0.2和STATA版本17分析了374例患者的图表。采用Cox比例风险回归模型对自变量与因变量进行相关性分析。采用双变量和多重Cox回归分析来确定预测因子。Kaplan-Meier图用于估计。计算风险比风险比和95%置信区间，p值为0.05的因素与患者死亡率密切相关。结果回顾性随访379例患者共374例，其中5例因资料不全不符合标准而被排除。中位随访时间为19天。急诊剖腹手术患者的总死亡率为10.43%。既往疾病（AHR = 5.43, 95% CI 1.56, 18.97）、术前脓毒症（AHR = 1.2, 95% CI 1.03, 3.47）、术中使用血管加压剂（AHR = 8.49, 95% CI 1.69, 42.65）和术后并发症（AHR = 3.73, 95% CI 1.02, 13.65）等因素与这些患者的死亡率显著相关。结论急诊剖腹手术患者的总死亡率高于以往的研究。既往疾病、术前败血症、术中使用血管加压剂和术后并发症是重要因素。因此，术前优化和标准操作程序的制定是至关重要的。
{"title":"Survival status and predictors of mortality among emergency laparotomy patients in a selected governmental hospital in Addis Ababa, Ethiopia; retrospective cohort study (2020 and 2023)","authors":"Sibhat Teka , Eyayalem Melese , Lidya Haddis","doi":"10.1016/j.pcorm.2025.100517","DOIUrl":"10.1016/j.pcorm.2025.100517","url":null,"abstract":"<div><h3>Background</h3><div>Emergency laparotomy is one of the highest-risk surgical procedures globally, associated with significant morbidity and mortality. The burden is especially severe in low- and middle-income countries, such as Ethiopia, where limited healthcare resources, delayed care, and inadequate postoperative management significantly contribute to these outcomes. Despite global efforts to reduce surgical mortality, a significant knowledge gap persists regarding the specific factors driving high mortality rates in these settings. This study is crucial for improving patient outcomes by identifying factors that contribute to high mortality rates and developing effective mitigation strategies.</div></div><div><h3>Objective</h3><div>To assess survival status and predictors of mortality among emergency laparotomy patients in selected governmental hospital in Addis Ababa, Ethiopia. from January 1, 2020, to January 1, 2023.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted in four government hospitals in Addis Ababa, Ethiopia between 2020 and 2023, focusing on emergency laparotomy patients. The study analyzed 374 patient charts using EpiData version 4.6.0.2 and STATA version 17. A Cox proportional hazards regression model was used to correlate independent variables with dependent variables. Bivariate and multiple Cox regression analyses were performed to identify predictors. Kaplan-Meier graphs were used for estimation. The hazard ratio hazard ratio and the 95 % confidence interval were calculated, with factors showing a p-value of <0.05 being strongly correlated with patient mortality.</div></div><div><h3>Results</h3><div>A total of 374 patients were retrospectively followed from a sample of 379, as data for 5 patients were excluded due to not meeting the criteria because of incomplete information. the median follow-up time was 19 days. The overall mortality rate for patients who underwent emergency laparotomy was 10.43 %. Factors such as pre-existing disease (AHR = 5.43, 95 % CI 1.56, 18.97), preoperative sepsis (AHR = 1.2, 95 % CI 1.03, 3.47), intraoperative use of vasopressors (AHR = 8.49, 95 % CI 1.69, 42.65), and postoperative complications (AHR = 3.73, 95 % CI 1.02, 13.65) were significantly associated with mortality in these patients.</div></div><div><h3>Conclusions</h3><div>The overall mortality rate among patients who underwent emergency laparotomy was high compared to previous studies. Pre-existing disease, preoperative sepsis, intraoperative use of vasopressors, and postoperative complications were significant factors. Therefore, preoperative optimization and the development of standard operating procedures are essential.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100517"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535939","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}
Pub Date : 2025-06-24DOI: 10.1016/j.pcorm.2025.100514
C Santhiya, S Sujitha, S Kamaludeen, K Cheran
Introduction
The induction of anaesthesia is a critical phase that ensures a controlled and safe surgical experience. This study evaluates the comparative effects of Propofol-Fentanyl and Dexmedetomidine-Ketamine combinations on haemodynamic stability during laryngeal mask airway (LMA) insertion in adults undergoing elective surgeries.
Methodology
A randomized controlled trial was conducted at the Department of Anaesthesiology, Vinayaka Mission’s Medical College, Karaikal, over two years. ASA I and II patients aged 18-60 years with a BMI of 18.5-29.9 kg/m2 were recruited and randomized into two groups: Group A (Propofol-Fentanyl) and Group B (Dexmedetomidine-Ketamine). Haemodynamic parameters, ease of LMA insertion, and complications such as apnoea, coughing, swallowing reflexes, and laryngospasm were assessed.
Results
The study found no significant difference in demographic variables between the two groups. Heart rate and blood pressure remained stable throughout the procedure, with Group A exhibiting higher heart rates at 15 minutes and post-operatively. Oxygen saturation levels were comparable, and both groups demonstrated similar ease of LMA insertion and incidence of complications.
Conclusion
Both anaesthetic combinations are effective for LMA insertion, but Dexmedetomidine-Ketamine provides superior haemodynamic and respiratory stability, supporting its use in patients requiring tighter perioperative hemodynamic and respiratory control.
{"title":"Effects of propofol-fentanyl and dexmedetomidine-ketamine combinations on haemodynamic status with laryngeal mask airway insertion in adults","authors":"C Santhiya, S Sujitha, S Kamaludeen, K Cheran","doi":"10.1016/j.pcorm.2025.100514","DOIUrl":"10.1016/j.pcorm.2025.100514","url":null,"abstract":"<div><h3>Introduction</h3><div>The induction of anaesthesia is a critical phase that ensures a controlled and safe surgical experience. This study evaluates the comparative effects of Propofol-Fentanyl and Dexmedetomidine-Ketamine combinations on haemodynamic stability during laryngeal mask airway (LMA) insertion in adults undergoing elective surgeries.</div></div><div><h3>Methodology</h3><div>A randomized controlled trial was conducted at the Department of Anaesthesiology, Vinayaka Mission’s Medical College, Karaikal, over two years. ASA I and II patients aged 18-60 years with a BMI of 18.5-29.9 kg/m2 were recruited and randomized into two groups: Group A (Propofol-Fentanyl) and Group B (Dexmedetomidine-Ketamine). Haemodynamic parameters, ease of LMA insertion, and complications such as apnoea, coughing, swallowing reflexes, and laryngospasm were assessed.</div></div><div><h3>Results</h3><div>The study found no significant difference in demographic variables between the two groups. Heart rate and blood pressure remained stable throughout the procedure, with Group A exhibiting higher heart rates at 15 minutes and post-operatively. Oxygen saturation levels were comparable, and both groups demonstrated similar ease of LMA insertion and incidence of complications.</div></div><div><h3>Conclusion</h3><div>Both anaesthetic combinations are effective for LMA insertion, but Dexmedetomidine-Ketamine provides superior haemodynamic and respiratory stability, supporting its use in patients requiring tighter perioperative hemodynamic and respiratory control.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100514"},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144524273","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}
Pub Date : 2025-06-19DOI: 10.1016/j.pcorm.2025.100513
Abida Yousuf , Shahid Ud Din Wani , Suhail Ahmad Mir , Tabassum Ali , Ifat Jan , Sehba Bader , Hadi Mateen , Bilquees Bhat , Basharat Ahad , Ghulam Nabi Bader
Background
Modern medicine relies on general anesthesia. However, due to climate change and geopolitical instability, medicine shortages and supply chain disruptions are having a growing impact on the global healthcare environment. Applying high reliability organization (HRO) principles, healthcare systems must ensure consistent access to key anaesthetic agents. To assess clinical results and implications for sustainable anaesthetic procedures, this study compares thiopentone with propofol as a case study.
Methods
A Prospective, randomised, single-center cohort study. 190 adult patients in the age group of 18–70 years scheduled for different surgical procedures under general anaesthesia were carried out at a tertiary care hospital (Department of Anaesthesiology, SKIMS Medical College and Hospital, Srinagar). Patients were randomly assigned to either propofol or thiopentone to induce anesthesia. Along with qualitative markers such induction smoothness, recovery, and consciousness levels, hemodynamic data such as heart rate, systolic and diastolic blood pressure, and breathing rate were examined.
Results
Both drugs were clinically efficacious and safe. In terms of quicker induction, easier recovery, and general patient satisfaction, propofol performed better (90 % vs. 85 %). It dramatically lowered systolic blood pressure (from 129 ± 11 to 102 ± 9.9 mmHg) and heart rate (from 90 ± 15 to 80 ± 13 beats/min). On the other hand, thiopentone also decreased blood pressure and heart rate, but less significantly. Group differences in respiratory patterns revealed varying physiological reactions.
Conclusion
Although thiopentone and propofol both works well to induce anesthesia, propofol is more patient-acceptable and offers better hemodynamic stability. However, in environments with limited resources, thiopentone is a more practical choice due to its simpler availability and cheaper cost. To improve system resilience—a crucial quality of high reliability organizations functioning under the strains of global supply chain volatility—this case study emphasizes the need of preserving flexibility and redundancy in anesthesia protocols.
Trial registration
The trial was registered prospectively in the Clinical Trial Registry of India (CTRI/2023/02/049,428) registered on 03/02/2023. The first subject was recruited on 05/02/2023.
{"title":"Comparative study of Thiopentone and Propofol for induction of anaesthesia in adult population- a randomized clinical trial","authors":"Abida Yousuf , Shahid Ud Din Wani , Suhail Ahmad Mir , Tabassum Ali , Ifat Jan , Sehba Bader , Hadi Mateen , Bilquees Bhat , Basharat Ahad , Ghulam Nabi Bader","doi":"10.1016/j.pcorm.2025.100513","DOIUrl":"10.1016/j.pcorm.2025.100513","url":null,"abstract":"<div><h3>Background</h3><div>Modern medicine relies on general anesthesia. However, due to climate change and geopolitical instability, medicine shortages and supply chain disruptions are having a growing impact on the global healthcare environment. Applying high reliability organization (HRO) principles, healthcare systems must ensure consistent access to key anaesthetic agents. To assess clinical results and implications for sustainable anaesthetic procedures, this study compares thiopentone with propofol as a case study.</div></div><div><h3>Methods</h3><div>A Prospective, randomised, single-center cohort study. 190 adult patients in the age group of 18–70 years scheduled for different surgical procedures under general anaesthesia were carried out at a tertiary care hospital (Department of Anaesthesiology, SKIMS Medical College and Hospital, Srinagar). Patients were randomly assigned to either propofol or thiopentone to induce anesthesia. Along with qualitative markers such induction smoothness, recovery, and consciousness levels, hemodynamic data such as heart rate, systolic and diastolic blood pressure, and breathing rate were examined.</div></div><div><h3>Results</h3><div>Both drugs were clinically efficacious and safe. In terms of quicker induction, easier recovery, and general patient satisfaction, propofol performed better (90 % vs. 85 %). It dramatically lowered systolic blood pressure (from 129 ± 11 to 102 ± 9.9 mmHg) and heart rate (from 90 ± 15 to 80 ± 13 beats/min). On the other hand, thiopentone also decreased blood pressure and heart rate, but less significantly. Group differences in respiratory patterns revealed varying physiological reactions.</div></div><div><h3>Conclusion</h3><div>Although thiopentone and propofol both works well to induce anesthesia, propofol is more patient-acceptable and offers better hemodynamic stability. However, in environments with limited resources, thiopentone is a more practical choice due to its simpler availability and cheaper cost. To improve system resilience—a crucial quality of high reliability organizations functioning under the strains of global supply chain volatility—this case study emphasizes the need of preserving flexibility and redundancy in anesthesia protocols.</div></div><div><h3>Trial registration</h3><div>The trial was registered prospectively in the Clinical Trial Registry of India (CTRI/2023/02/049,428) registered on 03/02/2023. The first subject was recruited on 05/02/2023.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100513"},"PeriodicalIF":0.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144365531","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}
Pub Date : 2025-06-18DOI: 10.1016/j.pcorm.2025.100509
Sathish Ayyappan , Dr Daideepya Chandra Bhargava , Dr Devendra Jadav , Dr Vikas P Meshram , Dr Tanuj Kanchan
The installation of closed-circuit television (CCTV) in operation theatres (OTs) has not been a popular belief; however, its recent introduction in a few countries has generated intense ethical discussions. While CCTV enhances patient safety, procedural transparency, and accountability, it simultaneously raises concerns about privacy, autonomy, and possible exploitation of recorded data. As patients are in an unconscious state during the operation, they remain unaware of the extent of recording or the storage and utilisation of their data, further complicating informed consent protocols. On the other hand, Surgeons and OT staff often perceive surveillance as an intrusion, potentially fostering a culture of mistrust and inhibiting their professional autonomy. Transparent policies, restricted access, secure data management, and obtaining explicit consent are pivotal in addressing these dilemmas. The ethical challenge lies in balancing the benefits and respecting individual rights. This article critically explores the multifaceted ethical and legal challenges of CCTV in OTs.
{"title":"Ethical conundrum of CCTV in the operation theatre","authors":"Sathish Ayyappan , Dr Daideepya Chandra Bhargava , Dr Devendra Jadav , Dr Vikas P Meshram , Dr Tanuj Kanchan","doi":"10.1016/j.pcorm.2025.100509","DOIUrl":"10.1016/j.pcorm.2025.100509","url":null,"abstract":"<div><div>The installation of closed-circuit television (CCTV) in operation theatres (OTs) has not been a popular belief; however, its recent introduction in a few countries has generated intense ethical discussions. While CCTV enhances patient safety, procedural transparency, and accountability, it simultaneously raises concerns about privacy, autonomy, and possible exploitation of recorded data. As patients are in an unconscious state during the operation, they remain unaware of the extent of recording or the storage and utilisation of their data, further complicating informed consent protocols. On the other hand, Surgeons and OT staff often perceive surveillance as an intrusion, potentially fostering a culture of mistrust and inhibiting their professional autonomy. Transparent policies, restricted access, secure data management, and obtaining explicit consent are pivotal in addressing these dilemmas. The ethical challenge lies in balancing the benefits and respecting individual rights. This article critically explores the multifaceted ethical and legal challenges of CCTV in OTs.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100509"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144470442","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}
Postoperative pulmonary complications including atelectasis are common complications after surgery. However, the incidence of postoperative atelectasis in pediatric surgical population is not yet well delineated.
Methods
Using electronic medical record, we identified pediatric patients who underwent gastrointestinal surgery from January 2016 to September 2019 and determined the presence or absence of postoperative atelectasis by postoperative X-ray read. Risk factor analysis of postoperative atelectasis was performed using logistic regression analysis.
Results
We found that 25.6 % of patients had radiographic evidence of postoperative atelectasis. Univariate and multivariate analyses demonstrated that the risk factors included lower weight, higher ASA class, emergency surgery, the use of higher peak airway pressure, lower lung compliance, and the lack of neuromuscular relaxant reversal agent use. In patients who received muscle relaxants, the lack of neuromuscular relaxant reversal agent use was associated with an increased risk of postoperative atelectasis (odds ratio 0.421, 95 % confidence interval 0.235–0.723, p < 0.001).
Discussion
Postoperative atelectasis was frequently observed in pediatric patients undergoing gastrointestinal surgery. For cases where neuromuscular blockade is used, adequate reversal is critical.
{"title":"The incidence of postoperative atelectasis following gastrointestinal procedures in pediatric population","authors":"Emi Yuki , Sulpicio G. Soriano , Miho Shibamura-Fujiogi , Koichi Yuki","doi":"10.1016/j.pcorm.2025.100510","DOIUrl":"10.1016/j.pcorm.2025.100510","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative pulmonary complications including atelectasis are common complications after surgery. However, the incidence of postoperative atelectasis in pediatric surgical population is not yet well delineated.</div></div><div><h3>Methods</h3><div>Using electronic medical record, we identified pediatric patients who underwent gastrointestinal surgery from January 2016 to September 2019 and determined the presence or absence of postoperative atelectasis by postoperative X-ray read. Risk factor analysis of postoperative atelectasis was performed using logistic regression analysis.</div></div><div><h3>Results</h3><div>We found that 25.6 % of patients had radiographic evidence of postoperative atelectasis. Univariate and multivariate analyses demonstrated that the risk factors included lower weight, higher ASA class, emergency surgery, the use of higher peak airway pressure, lower lung compliance, and the lack of neuromuscular relaxant reversal agent use. In patients who received muscle relaxants, the lack of neuromuscular relaxant reversal agent use was associated with an increased risk of postoperative atelectasis (odds ratio 0.421, 95 % confidence interval 0.235–0.723, <em>p</em> < 0.001).</div></div><div><h3>Discussion</h3><div>Postoperative atelectasis was frequently observed in pediatric patients undergoing gastrointestinal surgery. For cases where neuromuscular blockade is used, adequate reversal is critical.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100510"},"PeriodicalIF":0.0,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144338865","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}
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