Perioperative Care and Operating Room Management最新文献

{"title":"Comparative efficacy of greater occipital nerve radiofrequency approaches for the treatment of combined migraine and cervicogenic headache: Randomized clinical trial","authors":"Ghada Mohammad AboElfadl ,&nbsp;Manal Hassanien ,&nbsp;Ahmed A. Hamed ,&nbsp;Ahmed Mohamed Aboelfadl ,&nbsp;Gehan I. Salem ,&nbsp;Amr Mohamed Ahmed Thabet","doi":"10.1016/j.pcorm.2025.100571","DOIUrl":"10.1016/j.pcorm.2025.100571","url":null,"abstract":"<div><h3>Background</h3><div>we aimed to evaluate the efficacy of ultrasound-guided distal and proximal greater occipital nerve (GON) radiofrequency approaches in patients with combined chronic migraine and cervicogenic headaches.</div></div><div><h3>Methods</h3><div>We studied 60 patients with combined chronic migraine and cervicogenic headache, aged between 18 and 65 years and met the specific diagnostic criteria of the International Classification of Headache Disorders (ICHD). Patients were divided into two groups: proximal (Group A) and distal (Group B). The primary endpoint measured changes in headache frequency per month, while secondary endpoints included pain intensity, changes in the Headache Disability Index (HDI), sleep disturbances, and patient satisfaction.</div></div><div><h3>Results</h3><div>The proximal approach had a lower nocturnal neck and migraine pain intensity compared to the distal approach. Both groups reduced headache episodes and sleep disturbances and improved HDI. However, the proximal approach showed a greater reduction in headache episodes (p = 0.000), fewer sleep disturbances (p = 0.001), more improvement in HDI, and higher patient satisfaction (p = 0.016).</div></div><div><h3>Conclusion</h3><div>The proximal and distal approaches for GON radiofrequency ablation effectively reduced headache episodes, disability, and sleep disturbance. However, the proximal approach had a more sustained impact on pain intensity, indicating better long-term relief for neck pain and migraines.</div></div><div><h3>Trial registration</h3><div>ClinicalTrials.gov (identifier: NCT06121037)</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100571"},"PeriodicalIF":1.0,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363656","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":"Comparative efficacy of low-dose prothrombin complex concentrate + fresh frozen plasma combination and fresh frozen plasma in postoperative haemostasis after on-pump and off-pump coronary arterial bypass grafting surgery","authors":"Reza Widianto Sudjud,&nbsp;Erwin Pradian,&nbsp;Suwarman,&nbsp;Jenifer Kiem Aviani,&nbsp;Phillipus Andre,&nbsp;Dian Nuryanda","doi":"10.1016/j.pcorm.2025.100572","DOIUrl":"10.1016/j.pcorm.2025.100572","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative bleeding is a major cause of morbidity and mortality in CABG. While FFP is commonly used for bleeding management, high doses may increase the risk of acute lung injury and infection. PCC offers a safer alternative. This study compares low-dose PCC + FFP versus FFP alone in on-pump and off-pump CABG.</div></div><div><h3>Methods</h3><div>Medical records of CABG patients (2022–2023) were reviewed. Statistical analysis included Independent T-Test, Mann-Whitney U, and Chi-Square Test.</div></div><div><h3>Results</h3><div>The combination of low-dose PCC (500 IU) and FFP achieved significantly more rapid hemostasis within the first 3 hours postoperatively (277.00 ± 60.48 mL vs. 416.00 ± 34.00 mL; <em>p</em> &lt; 0.0001), without any serious adverse events. However, no significant differences in bleeding volume were observed between the groups beyond the 3-hour mark. On-pump surgery patients had longer ICU stays (mean difference: 0.52 [0.31–0.73], p &lt; 0.00001). In-hospital mortality was higher in the PCC group (RR 2.63 [1.25–5.59], p = 0.0149), particularly in on-pump cases, those with three anastomoses, and male patients, but 30-day mortality was similar between groups (RR 1.53 [0.90–2.63], p = 0.1681).</div></div><div><h3>Conclusion</h3><div>Low-dose PCC provides rapid hemostasis within 3 hours in CABG but should be used cautiously in male patients, multiple anastomoses, and on-pump surgeries.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100572"},"PeriodicalIF":1.0,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268770","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":"The perceived influence of burnout on quality of perioperative care among surgical team in teaching hospitals in a peri-urban city in southwestern Nigeria","authors":"Rafiat Omotayo ISHOLA ,&nbsp;Olufemi Oyebanji OYEDIRAN ,&nbsp;Iyanuoluwa Oreofe OJO ,&nbsp;Johnson Adewale AKINOSO ,&nbsp;Emmanuel Olufemi AYANDIRAN","doi":"10.1016/j.pcorm.2025.100567","DOIUrl":"10.1016/j.pcorm.2025.100567","url":null,"abstract":"<div><h3>Aim</h3><div>This study assessed the perceived influence of burnout on the quality of perioperative care provided by surgical teams in selected teaching hospitals in Nigeria.</div></div><div><h3>Background</h3><div>Burnout among surgical teams is a significant issue that can negatively impact patient safety, team performance and the overall quality of perioperative care.</div></div><div><h3>Design</h3><div>This study adopted a descriptive cross-sectional design.</div></div><div><h3>Methods</h3><div>Conducted in January 2025, the study assessed the level of burnout among surgical teams and its perceived influence on the quality of perioperative care in selected teaching hospitals in Nigeria. A stratified random sampling technique was used to select 229 respondents from surgical teams. A structured questionnaire was used to collect the data, which was analysed using the Statistical Package for the Social Sciences (SPSS) version 27. Descriptive and inferential statistics were used to present the data at a significance level of p = 0.05.</div></div><div><h3>Results</h3><div>The results of this study revealed that more than two-thirds of respondents (62.6%) experienced a high level of burnout. Contributing factors included a lack of effective equipment, an imbalance in work-life experience, unmet job expectations, poor working relationships within the surgical team and an increased workload. Additionally, slightly more than half of the respondents (51.2%) perceived the quality of perioperative care to be good, while 48.8% reported poor quality. The results also showed that age, educational background, area of specialisation, and years of experience were predictors of burnout among the surgical team (P = 0.001, 0.009, 0.014, and 0.000, respectively). Additionally, no significant relationship was found between burnout and quality of perioperative care (t/f = 1.981, p = 0.161).</div></div><div><h3>Conclusion</h3><div>This study concluded that burnout levels among surgical teams are high. Therefore, there is a need to provide a support system and adequate equipment to ease the workload and reduce burnout among surgical team members in Nigeria.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100567"},"PeriodicalIF":1.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145321808","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":"Remimazolam versus propofol for gastrointestinal endoscopic sedation: A systematic review and meta-analysis of randomized controlled trials with GRADE assessment","authors":"Abdallfatah Abdallfatah ,&nbsp;Bishoy Beshay ,&nbsp;Mark Nasseem ,&nbsp;Imad Samman Tahhan ,&nbsp;Mohammad Kloub ,&nbsp;Riddhi Machchhar ,&nbsp;Samaa Daoud ,&nbsp;Mohamed Hamed ,&nbsp;Hazem Abosheaishaa","doi":"10.1016/j.pcorm.2025.100569","DOIUrl":"10.1016/j.pcorm.2025.100569","url":null,"abstract":"<div><h3>Background</h3><div>Gastrointestinal endoscopy is one of the most performed procedures worldwide, and sedation is often necessary to enhance patient satisfaction and improve procedural outcomes. Although propofol is the preferred sedative due to its rapid onset and recovery, it is associated with adverse effects such as hypotension and respiratory depression. Recently, remimazolam has emerged as a promising alternative sedative. Our aim is to evaluate the efficacy and safety of remimazolam compared to propofol.</div></div><div><h3>Methods</h3><div>We performed a systematic review and meta-analysis following PRISMA guidelines, and our study was registered in the PROSPERO database (CRD42025635440). We performed a literature search across multiple databases up to January 2025. Two independent reviewers carried out data extraction and quality assessment, with a third author resolving any conflicts. We conducted the SRMA using RevMan version 5.4. The primary outcome was hypotension.</div></div><div><h3>Results</h3><div>We included 29 Randomized controlled trials; the overall risk of bias was low to moderate. Remimazolam significantly reduced the risk of hypotension (27 studies, OR: 0.26, 95 % CI: 0.21–0.33; P &lt; 0.00001). Additionally, remimazolam was associated with lower rates of respiratory depression (OR: 0.33; P &lt; 0.00001) and bradycardia (OR: 0.36; P &lt; 0.00001), and reduced injection site pain (OR: 0.09; P &lt; 0.00001. There was no significant difference in the sedation success rate for remimazolam and propofol (13 studies, OR: 0.44, 95 % CI: 0.28–0.69; P = 0.0004; I² 0 %). Moreover, patients reported higher satisfaction with remimazolam (8 studies; MD: 0.43, 95 % CI: 0.16–0.70; P &lt; 0.00001).</div></div><div><h3>Conclusion</h3><div>Our systematic review and meta-analysis demonstrated that remimazolam is clinically comparable to propofol for sedation in gastrointestinal endoscopy, offering superior hemodynamic stability, greater safety, and higher patient satisfaction. However, caution is advised in interpreting these findings.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100569"},"PeriodicalIF":1.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269387","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":"Postoperative care in pediatric neurosurgery: An overview","authors":"Chayanika Kutum ,&nbsp;Prashant Lakhe","doi":"10.1016/j.pcorm.2025.100570","DOIUrl":"10.1016/j.pcorm.2025.100570","url":null,"abstract":"<div><div>Pediatric neurosurgery encompasses a wide range of conditions, including congenital anomalies, brain tumors, hydrocephalus, trauma, and epilepsy, that often require complex surgical interventions tailored to the child’s developmental stage. Postoperative care in this population is uniquely challenging due to age-related physiological variations, neurodevelopmental considerations, and disease-specific risks. The immediate postoperative period is particularly critical, necessitating vigilant monitoring and a multidisciplinary approach to prevent complications and ensure optimal recovery. This review provides a comprehensive overview of postoperative care in pediatric neurosurgery, focusing on key aspects such as airway management, hemodynamic and respiratory stability, neurological monitoring, pain control, fluid and electrolyte balance, and complication surveillance. Criteria for postoperative disposition—whether to ward, PACU, or neuro ICU—are discussed based on procedure type and perioperative risk. Systemic and neuromonitoring protocols and strategies for managing common issues like pain, nausea, temperature instability, glycemic fluctuations, and nutrition are outlined. Postoperative complications, including intracranial hemorrhage, raised intracranial pressure, seizures, meningitis, and cranial nerve deficits, are addressed, with emphasis on early recognition and intervention. Procedure-specific considerations are also highlighted, including tailored care following surgeries for brain tumors, craniovertebral junction anomalies, vascular malformations, neural tube defects, and CSF diversion procedures. Effective postoperative management in pediatric neurosurgery requires individualized care plans, age-appropriate interventions, and collaboration among neurosurgeons, anesthesiologists, intensivists, and nursing teams. Standardization of care pathways and further research are essential to improve outcomes and reduce variability across institutions.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100570"},"PeriodicalIF":1.0,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269385","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":"Cognition, literacy, and education in colonoscopy preparation for older adults: Highlights from two clinical case reports","authors":"Yonah Joffe ,&nbsp;Juliana S. Burt ,&nbsp;Kara Eversole ,&nbsp;David Estores ,&nbsp;David J. Libon ,&nbsp;Franchesca Arias ,&nbsp;Christoph N. Seubert ,&nbsp;Benjamin A. Chapin ,&nbsp;Cynthia Wilson Garvan ,&nbsp;Catherine C. Price","doi":"10.1016/j.pcorm.2025.100566","DOIUrl":"10.1016/j.pcorm.2025.100566","url":null,"abstract":"<div><h3>Introduction</h3><div>Cognitive function, literacy, and education may affect adherence to colonoscopy bowel preparation and predict clinical outcomes. The two case studies presented include preoperative cognitive and educational information rarely captured for routine colonoscopies. Using a novel clinical service, we highlight the relationship between specific preoperative variables and failed colonoscopy bowel preparation.</div></div><div><h3>Case presentations</h3><div>Case CR is a 69-year-old White non-Hispanic male who showed symptoms of amnestic mild cognitive impairment upon preoperative evaluation. CR's at-home bowel preparation was inadequate due to poor instruction adherence and ultimately led to an incomplete colonoscopy. Case JR is an 85-year-old Black non-Hispanic male with 4 years of education, 3rd grade reading level, and memory deficits. JR misunderstood the pre-procedure instructions, causing him to complete the bowel preparation on the wrong day. Subsequently, JR rescheduled the procedure several times, missed his preoperative evaluation for his rescheduled procedure, and ultimately never received his recommended colonoscopy.</div></div><div><h3>Conclusion</h3><div>Unsuccessful colonoscopy procedures have significant consequences, including missed precancerous polyps and malignant lesions and inefficient allocation of medical and financial resources. Cases highlight the need for interdisciplinary colonoscopy procedure planning for older patients with high-risk neurocognitive and educational profiles.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100566"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145268772","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":"Role of perioperative anxiety and stress response in laparoscopic cholecystectomy","authors":"Alexander Gomez ,&nbsp;Rachna Jayaprakash ,&nbsp;Arun Muthukumar","doi":"10.1016/j.pcorm.2025.100563","DOIUrl":"10.1016/j.pcorm.2025.100563","url":null,"abstract":"","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100563"},"PeriodicalIF":1.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222725","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":"Identifying factors associated with prolonged mechanical ventilation following isolated coronary artery bypass grafting: a retrospective observational study","authors":"Joseph AbuRahma ,&nbsp;Penny S. Reynolds ,&nbsp;Joseph C. Goldstein ,&nbsp;Jennifer Bromwell ,&nbsp;Thomas Beaver ,&nbsp;Yong G. Peng","doi":"10.1016/j.pcorm.2025.100565","DOIUrl":"10.1016/j.pcorm.2025.100565","url":null,"abstract":"<div><h3>Background</h3><div>The Society of Thoracic Surgeons has advocated for enhanced recovery after cardiac surgery and recommends extubation of patients within 6 h following routine coronary artery bypass grafting (CABG). Early extubation has been shown to decrease mortality and postoperative complications. The primary objective of this study was to create a preliminary prediction model that would identify modifiable factors associated with prolonged postoperative mechanical ventilation following isolated CABG at our institution.</div></div><div><h3>Methods</h3><div>This was a single-center retrospective observational records review study. Case records for 85 patients who had undergone an isolated, elective CABG between January 2021 and December 2022 were evaluated. A multivariable logistic regression model with backwards selection was used to estimate probability of prolonged postoperative mechanical ventilation (&gt;6 h). Predictor variables were based on readily available clinical information on patient demographics, comorbidities, and factors related to operative management (time on bypass, opioid use, patient acid-base status, core temperature). Models were internally validated by bootstrapping, and model performance was evaluated by optimism-corrected c-statistics.</div></div><div><h3>Results</h3><div>Twenty-six of 85 patients (31 %) were intubated for &gt;6 h. Base deficit, age, core temperature, and history of chronic obstructive pulmonary disease (COPD) were the strongest and most consistent predictors of prolonged intubation. Model discrimination and calibration were satisfactory (c-statistics &gt; 0.75). A simple probability chart was constructed from the final model to estimate patient risk of prolonged intubation.</div></div><div><h3>Conclusions</h3><div>Older (&gt;75 years), increased base deficit (base deficit ≤ -6 mmol/L), and hypothermic (&lt;36 °C) patients with history of COPD had the highest estimated probability of prolonged intubation (&gt;90 %) following isolated CABG. Future validation studies will require a larger cohort. Nevertheless, findings from this study have led to proactive changes in patient management at our institution to identify high-risk patients and prevent or partially reverse base deficit and hypothermia before patient arrival to the intensive care unit.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100565"},"PeriodicalIF":1.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145222724","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":"The effect of professional ethics training on the awareness and attitude of operating room nurses","authors":"Fardin Amiri ,&nbsp;Sina Haghi ,&nbsp;Alice Khachian ,&nbsp;Seyed Abolfazl Hosseini ,&nbsp;Namamali Azadi","doi":"10.1016/j.pcorm.2025.100564","DOIUrl":"10.1016/j.pcorm.2025.100564","url":null,"abstract":"<div><h3>Introduction</h3><div>Adherence to the principles of professional ethics is a fundamental and challenging cornerstone of the nursing profession, particularly in the high-pressure environment of the operating room. Despite the importance of training in this domain, a distinct research gap exists in evaluating the impact of educational interventions on the \"awareness\" and \"attitude\" of operating room nurses. The present study was designed and conducted to precisely evaluate the effect of an educational intervention on these two key variables.</div></div><div><h3>Methods</h3><div>This quasi-experimental study was conducted on 64 operating room nurses employed at the educational-therapeutic centers of Iran University of Medical Sciences, who were selected via simple random sampling. Data were collected using a valid and reliable researcher-developed questionnaire before and 20 days after a CD-based educational intervention. The collected data were analyzed using the Wilcoxon test.</div></div><div><h3>Results</h3><div>The findings indicated that the educational intervention had a statistically significant effect on enhancing both variables. The mean total scores for awareness (pre: 45.68 ± 6.01, post: 50.15 ± 4.7) and attitude (pre: 49.04 ± 4.5, post: 65.12 ± 3.4) of the nurses increased significantly following the training (<em>P</em> &lt; 0.001).</div></div><div><h3>Discussion and Conclusion</h3><div>This study demonstrates that targeted education through standardized media, such as an instructional CD, is an effective and practical strategy for strengthening the foundations of professional ethics among operating room nurses. Therefore, the implementation of this educational approach in the retraining and professional development programs for nurses is strongly recommended.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100564"},"PeriodicalIF":1.0,"publicationDate":"2025-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269386","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":"The benefits from the video laryngoscope on postoperative sore throat: A randomized controlled trial","authors":"Yasmine Trabelsi,&nbsp;Faten Haddad,&nbsp;Khalil Becheikh,&nbsp;Hajer Arfaoui,&nbsp;Amani ben Haj Youssef,&nbsp;Emna Kammoun,&nbsp;Asma ben Souissi,&nbsp;Mhamed Sami Mebazaa","doi":"10.1016/j.pcorm.2025.100560","DOIUrl":"10.1016/j.pcorm.2025.100560","url":null,"abstract":"<div><h3>Background</h3><div>Postoperative sore throat (POST) is a frequent complication of orotracheal intubation. The aim of our study was to assess the impact of video laryngoscopy (VL) type McGrath on postoperative sore throat following surgery with intubation.</div></div><div><h3>Methods</h3><div>This was a prospective, randomized study conducted over a 9 months period. We included 136 patients with non-difficult airway, with American Society of Anesthesiologists classification 1 to 3 and over 18 years old. The patients were randomized into two groups: the DL group including 70 patients intubated with a direct laryngoscope (DL) and the VL group including 66 patients intubated with a VL. Our primary outcome was POST assessed by a pain scale from 0 to 10 at 6 h postoperatively. We also evaluated the dysphonia and dysphagia, cough at emergence of anesthesia and Cormack and Lehane classification as secondary outcomes.</div></div><div><h3>Results</h3><div>Patients’ demographic and anthropometrical characteristics were comparable, as well as medical history. POST 6 h after surgery was lower in VL group: 0 [0–1.25] (Min:0 – Max:3) versus 2 [2–3] (Min:0 – Max:6) (<em>p</em> &lt; 0.001). Pain scores were also lower in DL group at H1, H2, H12 and H24 (<em>p</em> &lt; 0.001). Hoarseness at H12 (32.4 % versus 15.2 %; <em>p</em> = 0.02) and dysphagia at H2 (17.1 % versus 4.5 %; <em>p</em> = 0.02) were less frequent in VL group. Cough at emergence of anesthesia and hemodynamic response to intubation were comparable between the two groups. Difficult laryngoscopies were less frequently encountered in VL group (<em>p</em> = 0.007). Multivarious analysis assessed the impact of direct laryngoscopy, with adjusted OR = 8.5 [3.6; 19.8] and <em>p</em> &lt; 0.001. The subgroups analysis showed that the use of VL reduced POST among female and patients with body mass index over 25 kg/m² (<em>p</em> &lt; 0.001).</div></div><div><h3>Conclusion</h3><div>The use of the VL reduces POST, dysphonia and dysphagia. It also reduces the incidence of difficult laryngoscopies among patients with non-difficult airway.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100560"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145223405","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}