Pub Date : 2025-01-22DOI: 10.1016/j.pcorm.2025.100471
Amy Reed , Alaina Tellson
Purpose
The purpose of this study was to determine if an interactive educational program regarding noise reduction would reduce noise levels in an orthopedic OR setting.
Methods
A quasi-experimental design was used for this study.
Findings
Results from pre-intervention were lower than post intervention. The pre-intervention mean was 73.4 dB where the post-intervention was 74.1 dB. There was no statistically significance between pre- and post- intervention results (t = -1.292, p = 0.099). The results were in alignment with previous studies conducted on noise levels in the OR.
Conclusions
Staff in the OR should work to minimize noise and distraction which they can control, such as music levels and non-patient care conversations. Noise should be kept to an absolute minimum during critical phases of the intraoperative procedure such as time out periods, surgical counts, critical dissections, medication administration/graft preparations, confirming/opening of implant, induction and emergence from anesthesia, and care and handling of specimens.
{"title":"Operating in the Cacophony: A quasi-experimental exploration of noises in the orthopedic surgery setting","authors":"Amy Reed , Alaina Tellson","doi":"10.1016/j.pcorm.2025.100471","DOIUrl":"10.1016/j.pcorm.2025.100471","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to determine if an interactive educational program regarding noise reduction would reduce noise levels in an orthopedic OR setting.</div></div><div><h3>Methods</h3><div>A quasi-experimental design was used for this study.</div></div><div><h3>Findings</h3><div>Results from pre-intervention were lower than post intervention. The pre-intervention mean was 73.4 dB where the post-intervention was 74.1 dB. There was no statistically significance between pre- and post- intervention results (<em>t</em> = -1.292, <em>p</em> = 0.099). The results were in alignment with previous studies conducted on noise levels in the OR.</div></div><div><h3>Conclusions</h3><div>Staff in the OR should work to minimize noise and distraction which they can control, such as music levels and non-patient care conversations. Noise should be kept to an absolute minimum during critical phases of the intraoperative procedure such as time out periods, surgical counts, critical dissections, medication administration/graft preparations, confirming/opening of implant, induction and emergence from anesthesia, and care and handling of specimens.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100471"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138827","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 : 2025-01-22DOI: 10.1016/j.pcorm.2025.100470
Wakjira Lemma Baye , Endala Gedefa Kitessa
Introduction
Preoperative fasting is a time-tested professional practice that is undertaken for physiological and precautionary benefits to patients globally. Adherence to preoperative fasting guidelines is crucial for ensuring patient safety and minimizing complications during surgical procedures.
Objective
This study aimed to assess preoperative fasting times and factors affecting adherence to fasting guidelines among adult patients undergoing elective surgery at St. Paul's Hospital Millennium Medical College.
Methods
A cross-sectional study involving 277 patients who underwent elective surgery at St. Paul Hospital Millennium Medical College was conducted. A stratified sampling technique was used to assign samples for each stratum (type of surgery), and a systematic random sampling technique was used to select participants from each stratum. Data on sociodemographic and clinical characteristics, preoperative fasting instructions, knowledge, and actual fasting times were collected via a structured questionnaire. Descriptive statistics and logistic regression analyses were performed to identify factors associated with adherence to fasting guidelines. Statistical significance of P < 0.25 for bivariate regression and P < 0.05 for multivariate regression were considered.
Results
Most patients fasted considerably longer than recommended, with mean fasting times of 9.76 ± 3.21 h for clear fluids, 10.84 ± 2.92 h for semisolids, and 11.92 ± 2.89 h for solids. Only 10.9 % of patients knew the importance of fasting before surgery, and 92.7 % did not receive information about why avoiding food and fluids was necessary. Factors significantly associated with poor adherence to fasting guidelines included being scheduled second or later for surgery (AOR: 5.199, 95 % CI: 1.412–19.143) and having no previous history of surgery (AOR: 8.746, 95 % CI: 2.462–31.072).
Conclusion
Prolonged preoperative fasting times and poor adherence to fasting guidelines were observed among the study participants. Patient education, standardized protocols, and multidisciplinary collaboration are recommended to improve adherence, enhance patient safety, and promote better anesthesia and surgical outcomes.
{"title":"Preoperative Fasting Time and Factorrs Affecting Adherence to Preoperative Fasting Time Among Adult Patient Undergoing Elective Surgery at Siant Paul's Hospital Millennium Medical College, Adis Ababa Ethiopia","authors":"Wakjira Lemma Baye , Endala Gedefa Kitessa","doi":"10.1016/j.pcorm.2025.100470","DOIUrl":"10.1016/j.pcorm.2025.100470","url":null,"abstract":"<div><h3>Introduction</h3><div>Preoperative fasting is a time-tested professional practice that is undertaken for physiological and precautionary benefits to patients globally. Adherence to preoperative fasting guidelines is crucial for ensuring patient safety and minimizing complications during surgical procedures.</div></div><div><h3>Objective</h3><div>This study aimed to assess preoperative fasting times and factors affecting adherence to fasting guidelines among adult patients undergoing elective surgery at St. Paul's Hospital Millennium Medical College.</div></div><div><h3>Methods</h3><div>A cross-sectional study involving 277 patients who underwent elective surgery at St. Paul Hospital Millennium Medical College was conducted. A stratified sampling technique was used to assign samples for each stratum (type of surgery), and a systematic random sampling technique was used to select participants from each stratum. Data on sociodemographic and clinical characteristics, preoperative fasting instructions, knowledge, and actual fasting times were collected via a structured questionnaire. Descriptive statistics and logistic regression analyses were performed to identify factors associated with adherence to fasting guidelines. Statistical significance of <em>P</em> < 0.25 for bivariate regression and <em>P</em> < 0.05 for multivariate regression were considered.</div></div><div><h3>Results</h3><div>Most patients fasted considerably longer than recommended, with mean fasting times of 9.76 ± 3.21 h for clear fluids, 10.84 ± 2.92 h for semisolids, and 11.92 ± 2.89 h for solids. Only 10.9 % of patients knew the importance of fasting before surgery, and 92.7 % did not receive information about why avoiding food and fluids was necessary. Factors significantly associated with poor adherence to fasting guidelines included being scheduled second or later for surgery (AOR: 5.199, 95 % CI: 1.412–19.143) and having no previous history of surgery (AOR: 8.746, 95 % CI: 2.462–31.072).</div></div><div><h3>Conclusion</h3><div>Prolonged preoperative fasting times and poor adherence to fasting guidelines were observed among the study participants. Patient education, standardized protocols, and multidisciplinary collaboration are recommended to improve adherence, enhance patient safety, and promote better anesthesia and surgical outcomes.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100470"},"PeriodicalIF":0.0,"publicationDate":"2025-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138813","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}
Hip surgeries are one of the common orthopedic surgeries, especially in the geriatricnpopulation following trauma, postoperative pain control and early ambulation are the main concerns for decreasing hospital stay and postoperative complications. We aimed to analyze the ultrasound-guided pericapsular nerve group block (PENG) effect versus fascia iliaca compartment block (FICB) on the time needed for unaided mobilization and postoperative analgesics consumption in hip arthroplasty.
Methods
The study was a randomized, prospective, comparative study carried out at Ain Shams University Hospital where 44 patients subjected to hip arthroplasty were randomized into two equal groups; Group (F) in which patients received FICB under ultrasound guidance and Group (P) in which patients received PENG under ultrasound guidance. Both blocks were performed by injecting 20 mL of 0.25 % bupivacaine immediately after spinal anesthesia. The time needed for unaided mobilization was assessed by the time up and go test (TUG) and postoperative pain was assessed by visual analogue scale (VAS) in the first 24 h postoperatively.
Results
Regarding ambulation data over the first 24 h following surgery, the time needed for unaided mobilization was significantly shorter in the PENG group than FICB group. No statistically significant differences were determined between both groups as regards postoperative complications, total narcotic consumption, and VAS score. Conclusions: The Pericapsular nerve group (PENG) block demonstrated earlier unaided ambulation and delayed first rescue analgesia in hip arthroplasty compared to those who were administered Facia iliaca compartment blocks)FICB(in hip arthroplasty. Both blocks offered efficient postoperative pain control without difference in total opioid requirements.
{"title":"A comparative study between the impact of ultrasound guided Pericapsular Nerve Group Block (PENG) versus Fascia Iliaca Compartment Block (FICB) on the quality of postoperative analgesia and ambulation in hip arthroplasty","authors":"Tamer Nabil Abdelrahman, Moustafa Mahmoud Abdelsattar, Mohamed Abdelmoneim Fouly, Mohsen Abdelghany Bassiouny, Sahar Mohamed Talaat","doi":"10.1016/j.pcorm.2025.100469","DOIUrl":"10.1016/j.pcorm.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>Hip surgeries are one of the common orthopedic surgeries, especially in the geriatricnpopulation following trauma, postoperative pain control and early ambulation are the main concerns for decreasing hospital stay and postoperative complications. We aimed to analyze the ultrasound-guided pericapsular nerve group block (PENG) effect versus fascia iliaca compartment block (FICB) on the time needed for unaided mobilization and postoperative analgesics consumption in hip arthroplasty.</div></div><div><h3>Methods</h3><div>The study was a randomized, prospective, comparative study carried out at Ain Shams University Hospital where 44 patients subjected to hip arthroplasty were randomized into two equal groups; Group (F) in which patients received FICB under ultrasound guidance and Group (P) in which patients received PENG under ultrasound guidance. Both blocks were performed by injecting 20 mL of 0.25 % bupivacaine immediately after spinal anesthesia. The time needed for unaided mobilization was assessed by the time up and go test (TUG) and postoperative pain was assessed by visual analogue scale (VAS) in the first 24 h postoperatively.</div></div><div><h3>Results</h3><div>Regarding ambulation data over the first 24 h following surgery, the time needed for unaided mobilization was significantly shorter in the PENG group than FICB group. No statistically significant differences were determined between both groups as regards postoperative complications, total narcotic consumption, and VAS score. Conclusions: The Pericapsular nerve group (PENG) block demonstrated earlier unaided ambulation and delayed first rescue analgesia in hip arthroplasty compared to those who were administered Facia iliaca compartment blocks)FICB(in hip arthroplasty. Both blocks offered efficient postoperative pain control without difference in total opioid requirements.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100469"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139170","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 : 2025-01-16DOI: 10.1016/j.pcorm.2025.100473
Christy V. Mitchell , Alex R. Anderson , Kenneth Romito , Wesley M. Abadie , Angela K. Phillips
Background
The operating room is a key driver of hospital revenue, making the monitoring of performance metrics crucial for cost reduction. Perioperative leaders often struggle to pinpoint the causes of delays. This article describes how an ambulatory surgical center implemented Lean Six Sigma methodology to identify barriers and implement targeted interventions to improve first-case on-time starts.
Methods
A multidisciplinary committee employed the standard process improvement methodology known as define-measure-analyze-improve-control (DMAIC) to assess workflow, identify the root causes of delays, and implement five targeted interventions to improve workflow.
Results
Data from 888 cases were examined over a 20-month period in the perioperative department, 180 cases before and 708 cases during and after implementation. First case on-time starts increased from 30 % to 79 % 12 months after the interventions were implemented. Additionally, delays in OR minutes decreased by approximately 49 % during this time frame.
Conclusion
A multidisciplinary committee's use of Lean Six Sigma strategies, particularly the DMAIC framework, has effectively identified barriers to on-time first case starts in the OR. This approach established a solid foundation for developing targeted problem-solving interventions. By applying this methodology, the committee improved operational efficiency and reduced delays in the surgical workflow.
{"title":"Employing lean six sigma strategies to improve operating room first case on-time starts: A case report","authors":"Christy V. Mitchell , Alex R. Anderson , Kenneth Romito , Wesley M. Abadie , Angela K. Phillips","doi":"10.1016/j.pcorm.2025.100473","DOIUrl":"10.1016/j.pcorm.2025.100473","url":null,"abstract":"<div><h3>Background</h3><div>The operating room is a key driver of hospital revenue, making the monitoring of performance metrics crucial for cost reduction. Perioperative leaders often struggle to pinpoint the causes of delays. This article describes how an ambulatory surgical center implemented Lean Six Sigma methodology to identify barriers and implement targeted interventions to improve first-case on-time starts.</div></div><div><h3>Methods</h3><div>A multidisciplinary committee employed the standard process improvement methodology known as define-measure-analyze-improve-control (DMAIC) to assess workflow, identify the root causes of delays, and implement five targeted interventions to improve workflow.</div></div><div><h3>Results</h3><div>Data from 888 cases were examined over a 20-month period in the perioperative department, 180 cases before and 708 cases during and after implementation. First case on-time starts increased from 30 % to 79 % 12 months after the interventions were implemented. Additionally, delays in OR minutes decreased by approximately 49 % during this time frame.</div></div><div><h3>Conclusion</h3><div>A multidisciplinary committee's use of Lean Six Sigma strategies, particularly the DMAIC framework, has effectively identified barriers to on-time first case starts in the OR. This approach established a solid foundation for developing targeted problem-solving interventions. By applying this methodology, the committee improved operational efficiency and reduced delays in the surgical workflow.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100473"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138826","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 : 2025-01-16DOI: 10.1016/j.pcorm.2025.100472
Sendhil Kumar, Zareen Fatema, Vikneswaran G, Alben Sigamani, Delitia Manuel
Background
As the global population ages, the vulnerability of older adults (≥50 years) undergoing major non-cardiac surgeries increases significantly, posing greater risks and challenges. This study aims to address the gap in understanding postoperative cardiac complications and associated risk factors in this demographic.
Methods
A retrospective observational study was conducted to identify 100 patients aged 50 or older who underwent major abdominal or vascular surgeries requiring ICU admission for more than 24 h. MACE incidence, including myocardial infarction, unstable angina, heart failure, arrhythmias, stroke, and cardiac death, was assessed. Logistic regression analyzed preoperative risk factors.
Results
Postoperatively, 18 % experienced MACE events, including acute coronary syndrome, unstable angina, and cardiac death. Vascular surgeries correlated with increased mortality risk (p < 0.001). Hypertension emerged as a significant risk factor (OR 10.88, p < 0.02), alongside abnormal echocardiogram findings (p < 0.05).
Discussion
The study highlights the significant association of advanced age, hypertension, and echocardiographic abnormalities with MACE in elderly patients undergoing major abdominal/vascular surgeries requiring ICU care. The findings emphasize the importance of perioperative risk stratification, particularly in high-risk groups, to guide surgical planning and improve outcomes. Developing predictive tools, such as MACE risk calculators, could support clinical decision-making.
Conclusion
Age, hypertension, and echocardiographic findings are key MACE predictors in elderly surgical patients requiring ICU care. Future studies should focus on validating risk calculators and optimizing perioperative strategies to improve patient outcomes.
{"title":"Cardiac monitoring and cardiovascular event incidence in patients over 50 with ICU needs undergoing abdominal/vascular surgery: Insights from a tertiary care facility","authors":"Sendhil Kumar, Zareen Fatema, Vikneswaran G, Alben Sigamani, Delitia Manuel","doi":"10.1016/j.pcorm.2025.100472","DOIUrl":"10.1016/j.pcorm.2025.100472","url":null,"abstract":"<div><h3>Background</h3><div>As the global population ages, the vulnerability of older adults (≥50 years) undergoing major non-cardiac surgeries increases significantly, posing greater risks and challenges. This study aims to address the gap in understanding postoperative cardiac complications and associated risk factors in this demographic.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted to identify 100 patients aged 50 or older who underwent major abdominal or vascular surgeries requiring ICU admission for more than 24 h. MACE incidence, including myocardial infarction, unstable angina, heart failure, arrhythmias, stroke, and cardiac death, was assessed. Logistic regression analyzed preoperative risk factors.</div></div><div><h3>Results</h3><div>Postoperatively, 18 % experienced MACE events, including acute coronary syndrome, unstable angina, and cardiac death. Vascular surgeries correlated with increased mortality risk (<em>p</em> < 0.001). Hypertension emerged as a significant risk factor (OR 10.88, <em>p</em> < 0.02), alongside abnormal echocardiogram findings (<em>p</em> < 0.05).</div></div><div><h3>Discussion</h3><div>The study highlights the significant association of advanced age, hypertension, and echocardiographic abnormalities with MACE in elderly patients undergoing major abdominal/vascular surgeries requiring ICU care. The findings emphasize the importance of perioperative risk stratification, particularly in high-risk groups, to guide surgical planning and improve outcomes. Developing predictive tools, such as MACE risk calculators, could support clinical decision-making.</div></div><div><h3>Conclusion</h3><div>Age, hypertension, and echocardiographic findings are key MACE predictors in elderly surgical patients requiring ICU care. Future studies should focus on validating risk calculators and optimizing perioperative strategies to improve patient outcomes.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100472"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139135","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 : 2025-01-14DOI: 10.1016/j.pcorm.2025.100468
Tugba ALBAYRAM , Sukriye Ilkay GUNER
Background
Patient satisfaction and health status improve with person-centered care. It also reduces hospital stays and medical costs.
Aim
The purpose of this methodological study was to assess the validity and reliability of the "Person-Centered Perioperative Nursing Scale" in Turkey.
Methods
This online study was conducted between March and September 2021, and 185 nurses worked in the operating rooms of fourteen private hospitals, five state hospitals, and one university hospital in Gaziantep, Turkey. Scale validity analysis, language equivalence, content validity, exploratory and confirmatory factor analysis, reliability analysis, internal consistency, item-total correlations, and retest method were used. The STARD checklist organized the study setting.
Results
The scale's item-total correlation values were 0.519–0.804, and the Cronbach's alpha coefficient was 0.939. The scale has a five-factor structure, and according to the confirmatory factor analysis, the fit indices were χ2 (Cmin/df) 2.065; CFI 0.957; IFI: 0.958; Excellent agreement with TLI: 0.944; and RMR: 0.051, RMSEA 0.076; and it was found to be in acceptable agreement with NFI 0.921 and AGFI 0.836 (p = 0.000). The scale's discriminant validity was AVE: 0.59, CR: 0.88, and there were high congruent validity correlations.
Conclusion
The Person-Centered Preoperative Nursing Scale, which can be used to evaluate the quality of perioperative care, has enough validity and reliability indicators to be considered a measurement tool.
{"title":"Turkish validity and reliability study of the person-centered perioperative nursing scale","authors":"Tugba ALBAYRAM , Sukriye Ilkay GUNER","doi":"10.1016/j.pcorm.2025.100468","DOIUrl":"10.1016/j.pcorm.2025.100468","url":null,"abstract":"<div><h3>Background</h3><div>Patient satisfaction and health status improve with person-centered care. It also reduces hospital stays and medical costs.</div></div><div><h3>Aim</h3><div>The purpose of this methodological study was to assess the validity and reliability of the \"Person-Centered Perioperative Nursing Scale\" in Turkey.</div></div><div><h3>Methods</h3><div>This online study was conducted between March and September 2021, and 185 nurses worked in the operating rooms of fourteen private hospitals, five state hospitals, and one university hospital in Gaziantep, Turkey. Scale validity analysis, language equivalence, content validity, exploratory and confirmatory factor analysis, reliability analysis, internal consistency, item-total correlations, and retest method were used. The STARD checklist organized the study setting.</div></div><div><h3>Results</h3><div>The scale's item-total correlation values were 0.519–0.804, and the Cronbach's alpha coefficient was 0.939. The scale has a five-factor structure, and according to the confirmatory factor analysis, the fit indices were χ2 (Cmin/df) 2.065; CFI 0.957; IFI: 0.958; Excellent agreement with TLI: 0.944; and RMR: 0.051, RMSEA 0.076; and it was found to be in acceptable agreement with NFI 0.921 and AGFI 0.836 (<em>p</em> = 0.000). The scale's discriminant validity was AVE: 0.59, CR: 0.88, and there were high congruent validity correlations.</div></div><div><h3>Conclusion</h3><div>The Person-Centered Preoperative Nursing Scale, which can be used to evaluate the quality of perioperative care, has enough validity and reliability indicators to be considered a measurement tool.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100468"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139140","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 : 2025-01-10DOI: 10.1016/j.pcorm.2025.100465
Esra Özkan , Nurten Gülsüm Bayrak
Background
Despite the existence of controlled trials (CTs) and a handful of meta-analyses investigating the effects of massage on postoperative pain and anxiety, recent comprehensive reviews in this area are scarce.
Aim
This study seeks to fill this gap by quantifying the impact of massage therapy on pain and anxiety levels in patients who have undergone cardiac surgery, thereby enriching the existing body of literature.
Design
A systematic review and meta-analysis.
Review methods
The random effect model was applied to estimate the effects since the heterogeneity between results was high.
Data Sources
Five databases (Scopus, Clinical Key, Web of Science, Pubmed, Science-Direct) were searched for CTs from July to October 2023.
Results
The analysis included 19 control trials and showed that massage therapy is effective in reducing postoperative pain (95 % CI, g = 0.899, p < .000) and anxiety (95 % CI, g = 0.705, p < .000). In our study significant variations in effect sizes based on the person applying the massage, and the type of massage used (p < .05 for all), suggesting these factors significantly moderate the effect of massage therapy on pain and anxiety reduction.
Conclusion
The results advocate for the integration of massage therapy into the postoperative recovery plans of patients undergoing cardiac surgery, highlighting its potential to alleviate pain and anxiety effectively. As such, massage therapy represents a valuable complementary approach to traditional care methods.
{"title":"Efficacy of massage therapy in alleviating pain and anxiety post-cardiac surgery: A systematic review and meta-analysis","authors":"Esra Özkan , Nurten Gülsüm Bayrak","doi":"10.1016/j.pcorm.2025.100465","DOIUrl":"10.1016/j.pcorm.2025.100465","url":null,"abstract":"<div><h3>Background</h3><div>Despite the existence of controlled trials (CTs) and a handful of meta-analyses investigating the effects of massage on postoperative pain and anxiety, recent comprehensive reviews in this area are scarce.</div></div><div><h3>Aim</h3><div>This study seeks to fill this gap by quantifying the impact of massage therapy on pain and anxiety levels in patients who have undergone cardiac surgery, thereby enriching the existing body of literature.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Review methods</h3><div>The random effect model was applied to estimate the effects since the heterogeneity between results was high.</div></div><div><h3>Data Sources</h3><div>Five databases (Scopus, Clinical Key, Web of Science, Pubmed, Science-Direct) were searched for CTs from July to October 2023.</div></div><div><h3>Results</h3><div>The analysis included 19 control trials and showed that massage therapy is effective in reducing postoperative pain (95 % CI, <em>g</em> = 0.899, <em>p</em> < .000) and anxiety (95 % CI, <em>g</em> = 0.705, <em>p</em> < .000). In our study significant variations in effect sizes based on the person applying the massage, and the type of massage used (<em>p</em> < .05 for all), suggesting these factors significantly moderate the effect of massage therapy on pain and anxiety reduction.</div></div><div><h3>Conclusion</h3><div>The results advocate for the integration of massage therapy into the postoperative recovery plans of patients undergoing cardiac surgery, highlighting its potential to alleviate pain and anxiety effectively. As such, massage therapy represents a valuable complementary approach to traditional care methods.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100465"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138812","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 : 2025-01-08DOI: 10.1016/j.pcorm.2025.100466
Seham M. Moeen , Shaymaa R. Zarea , Mohamed H. Bakri , Hesham A. Elkady , Mohamed T. Mohamed , Mohamed A. Abdelsalam
Objectives
Optimal analgesia is crucial for promoting early rehabilitation and enhances functional recovery after arthroscopic anterior cruciate ligament reconstruction (ACLR). Our main objective was to compare the analgesic effectiveness of bupivacaine and dexamethasone administered in an adductor canal block (ACB) versus intra-articularly (IA) after ACLR. We hypothesized that the two approaches might have equal efficacy.
Methods
Seventy-two adult patients, ASA I–II, aged 18–65 years, undergoing elective ACLR under spinal anesthesia, were included in this randomized, double-blind, sham-controlled trial. Patients were randomly assigned to receive 18 ml of bupivacaine 0.25 % and 8 mg of dexamethasone either in ACB 30 min before spinal anesthesia or intra-articularly at the end of the surgery. Pain scores, both at rest and during movement, were assessed at 6, 12, 18, and 24 h after surgery. The time until the first analgesic request and the total analgesic consumption were recorded. Quadriceps muscle strength at 6 and 24 h after surgery, patient satisfaction, and any side effects were also recorded.
Results
The pain scores were significantly lower in the IA group at 12, 18, and 24 hrs after surgery, both at rest and during movement, with no patients requiring analgesia up to the first 17 hrs postoperatively. The times to the first ketorolac (1342.5 ± 132.7 versus 1167.5 ± 297.36 min, P= 0.029) and morphine (1412.5 ± 87.94 versus 1278.33 ± 274.04 min, P= 0.025) doses were significantly longer in the IA group compared to the ACB group. Kaplan-Meier curves for times to the first ketorolac and morphine doses showed significant differences (Breslow test) between the groups (P= 0.028 and P= 0.025, respectively). The total analgesic consumption was insignificantly lower in the IA group compared to the ACB group. Both groups had similar quadriceps muscle strength and patient satisfaction post-surgery, with no perioperative side effects observed.
Conclusions
The administration of bupivacaine plus dexamethasone for IA analgesia, compared to ACB, provided superior pain relief for up to 17 h following ACLR, both at rest and during movement.
{"title":"Adductor canal block versus intra-articular analgesia for postoperative pain after arthroscopic anterior cruciate ligament reconstruction: A randomized trial","authors":"Seham M. Moeen , Shaymaa R. Zarea , Mohamed H. Bakri , Hesham A. Elkady , Mohamed T. Mohamed , Mohamed A. Abdelsalam","doi":"10.1016/j.pcorm.2025.100466","DOIUrl":"10.1016/j.pcorm.2025.100466","url":null,"abstract":"<div><h3>Objectives</h3><div>Optimal analgesia is crucial for promoting early rehabilitation and enhances functional recovery after arthroscopic anterior cruciate ligament reconstruction (ACLR). Our main objective was to compare the analgesic effectiveness of bupivacaine and dexamethasone administered in an adductor canal block (ACB) versus intra-articularly (IA) after ACLR. We hypothesized that the two approaches might have equal efficacy.</div></div><div><h3>Methods</h3><div>Seventy-two adult patients, ASA I–II, aged 18–65 years, undergoing elective ACLR under spinal anesthesia, were included in this randomized, double-blind, sham-controlled trial. Patients were randomly assigned to receive 18 ml of bupivacaine 0.25 % and 8 mg of dexamethasone either in ACB 30 min before spinal anesthesia or intra-articularly at the end of the surgery. Pain scores, both at rest and during movement, were assessed at 6, 12, 18, and 24 h after surgery. The time until the first analgesic request and the total analgesic consumption were recorded. Quadriceps muscle strength at 6 and 24 h after surgery, patient satisfaction, and any side effects were also recorded.</div></div><div><h3>Results</h3><div>The pain scores were significantly lower in the IA group at 12, 18, and 24 hrs after surgery, both at rest and during movement, with no patients requiring analgesia up to the first 17 hrs postoperatively. The times to the first ketorolac (1342.5 ± 132.7 versus 1167.5 ± 297.36 min, P= 0.029) and morphine (1412.5 ± 87.94 versus 1278.33 ± 274.04 min, P= 0.025) doses were significantly longer in the IA group compared to the ACB group. Kaplan-Meier curves for times to the first ketorolac and morphine doses showed significant differences (Breslow test) between the groups (P= 0.028 and P= 0.025, respectively). The total analgesic consumption was insignificantly lower in the IA group compared to the ACB group. Both groups had similar quadriceps muscle strength and patient satisfaction post-surgery, with no perioperative side effects observed.</div></div><div><h3>Conclusions</h3><div>The administration of bupivacaine plus dexamethasone for IA analgesia, compared to ACB, provided superior pain relief for up to 17 h following ACLR, both at rest and during movement.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100466"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139138","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 : 2025-01-06DOI: 10.1016/j.pcorm.2025.100462
Maha Sadek El Derh , Sherif Essam Shabaan , Sally Saber AbdelAziz , Reham M. Hashim
Introduction
Fibromyalgia syndrome (FMS) is a disease characterized by chronic, pain associated with impaired physical function and overall quality of life (QOL). Pain can be controlled by IV lidocaine which is considered a topical anesthetic drug. Also, ketamine is used as a potent anesthetic agent reducing the induction of synaptic plasticity and maintenance of chronic pain states.
This study aimed
to assess the efficacy of intravenous (IV) lidocaine versus IV ketamine in pain management and improvement in the QOL in FM patients.
Patients &methods
75 patients were divided equally into 3 groups in which group A received 5 mg/Kg lidocaine, group B received 0.5 mg/Kg ketamine sulphate and group C received a placebo of normal saline. This procedure was done weekly for 3 weeks.
Result
As regards pain perception using VAS group A&B showed a marked reduction in VAS with no difference between them, with no change in group C. Changes in the fibromyalgia impact questionnaire (FIQ) were analyzed and showed the mental part of the health score decreased significantly in all groups while the physical and overall parts of the health score decreased significantly only in the lidocaine and ketamine group and non-significantly changed in the placebo group. Overall QOL significantly improved in groups A&B assessed by Health-related quality of life (HrQOL) SF-12 questionnaire 4 weeks post-procedure.
Conclusion
IV lidocaine and ketamine are efficient not only in pain relief among patients with FM but also in improving physical function and QOL.
{"title":"Potential role of intravenous lidocaine versus intravenous ketamine for pain management in fibromyalgia patients","authors":"Maha Sadek El Derh , Sherif Essam Shabaan , Sally Saber AbdelAziz , Reham M. Hashim","doi":"10.1016/j.pcorm.2025.100462","DOIUrl":"10.1016/j.pcorm.2025.100462","url":null,"abstract":"<div><h3>Introduction</h3><div>Fibromyalgia syndrome (FMS) is a disease characterized by chronic, pain associated with impaired physical function and overall quality of life (QOL). Pain can be controlled by IV lidocaine which is considered a topical anesthetic drug. Also, ketamine is used as a potent anesthetic agent reducing the induction of synaptic plasticity and maintenance of chronic pain states.</div></div><div><h3>This study aimed</h3><div>to assess the efficacy of intravenous (IV) lidocaine versus IV ketamine in pain management and improvement in the QOL in FM patients.</div></div><div><h3>Patients &methods</h3><div>75 patients were divided equally into 3 groups in which group A received 5 mg/Kg lidocaine, group B received 0.5 mg/Kg ketamine sulphate and group C received a placebo of normal saline. This procedure was done weekly for 3 weeks.</div></div><div><h3>Result</h3><div>As regards pain perception using VAS group A&B showed a marked reduction in VAS with no difference between them, with no change in group C. Changes in the fibromyalgia impact questionnaire (FIQ) were analyzed and showed the mental part of the health score decreased significantly in all groups while the physical and overall parts of the health score decreased significantly only in the lidocaine and ketamine group and non-significantly changed in the placebo group. Overall QOL significantly improved in groups A&B assessed by Health-related quality of life (HrQOL) SF-12 questionnaire 4 weeks post-procedure.</div></div><div><h3>Conclusion</h3><div>IV lidocaine and ketamine are efficient not only in pain relief among patients with FM but also in improving physical function and QOL.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100462"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139139","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 : 2025-01-06DOI: 10.1016/j.pcorm.2025.100461
Şeyma Yurtseven , Hamide Şişman
Introduction
Surgical site infections (SSI) are an important health problem that develop after surgical interventions and can have serious negative effects on patient health. Surgical nurses play a critical role in the prevention of these infections.
Objective
This study was conducted to determine the level of knowledge of nurses working in surgical clinics about SSI.
Method
The population of this descriptive and cross-sectional study consisted of 170 nurses working in the surgical units of Çukurova University Faculty of Medicine Balcalı Hospital. The sample of the study consisted of 142 (83 %) nurses who met the inclusion criteria in April-June 2024. The data were collected using a questionnaire form designed to test the socio-demographic characteristics of the participants and their level of knowledge about surgical site infection. In addition to descriptive statistics, ANOVA and Student t-test were used to analyse the data.
Results
Of the nurses who participated in the study, 78.9 % were female and 72.5 % received training on SSI in the institution. The mean number of correct answers given by the nurses to the questions about SSI was 20±2.4 and the mean number of incorrect answers was 8 ± 2.4. It was found that there was a statistically significant relationship between the number of correct answers given by the nurses and gender, age groups, education, working time in surgical units and in the institution, working style, and SSI training status (p < 0.05).
Conclusion
The results of the study suggest that increasing the level of knowledge of surgical nurses about SSI is of great importance in terms of preventing infections and ensuring patient safety. In this context, it is recommended that health institutions should organise continuous education programmes and nurses should actively participate in these programmes. In addition, it is recommended to improve the working conditions of nurses to increase the applicability of infection control measures.
{"title":"Knowledge levels of surgical nurses regarding surgical site infections: A cross-sectional evaluation","authors":"Şeyma Yurtseven , Hamide Şişman","doi":"10.1016/j.pcorm.2025.100461","DOIUrl":"10.1016/j.pcorm.2025.100461","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical site infections (SSI) are an important health problem that develop after surgical interventions and can have serious negative effects on patient health. Surgical nurses play a critical role in the prevention of these infections.</div></div><div><h3>Objective</h3><div>This study was conducted to determine the level of knowledge of nurses working in surgical clinics about SSI.</div></div><div><h3>Method</h3><div>The population of this descriptive and cross-sectional study consisted of 170 nurses working in the surgical units of Çukurova University Faculty of Medicine Balcalı Hospital. The sample of the study consisted of 142 (83 %) nurses who met the inclusion criteria in April-June 2024. The data were collected using a questionnaire form designed to test the socio-demographic characteristics of the participants and their level of knowledge about surgical site infection. In addition to descriptive statistics, ANOVA and Student t-test were used to analyse the data.</div></div><div><h3>Results</h3><div>Of the nurses who participated in the study, 78.9 % were female and 72.5 % received training on SSI in the institution. The mean number of correct answers given by the nurses to the questions about SSI was 20±2.4 and the mean number of incorrect answers was 8 ± 2.4. It was found that there was a statistically significant relationship between the number of correct answers given by the nurses and gender, age groups, education, working time in surgical units and in the institution, working style, and SSI training status (<em>p</em> < 0.05).</div></div><div><h3>Conclusion</h3><div>The results of the study suggest that increasing the level of knowledge of surgical nurses about SSI is of great importance in terms of preventing infections and ensuring patient safety. In this context, it is recommended that health institutions should organise continuous education programmes and nurses should actively participate in these programmes. In addition, it is recommended to improve the working conditions of nurses to increase the applicability of infection control measures.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100461"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138823","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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