Pub Date : 2025-09-22DOI: 10.1016/j.pcorm.2025.100556
S. Podder , I.A. Khan , L Shenoy , A. Satish , M. Kulkarni , R.R. Krishnabhat , D. Shetty , S. Thimmaiah Kanakalakshmi
Background
Spinal anaesthesia is the preferred technique for caesarean delivery, owing to the several benefits it carries for mother and fetus. Appropriate patient positioning is vital as it improves the patient comfort, reduces the time taken, the number of attempts required, and decreases the number of needle and bone contacts during the procedure. Our study primarily aimed to compare number of attempts taken for successful needle placement in a sitting position versus a cross-legged sitting position. Secondary objectives included patient comfort, ease of palpation, and block characteristics.
Methods
Our study was a prospective, nonblinded, single-centre study. The patients were randomly assigned to one of the two groups using a computer-generated randomisation table and opaque envelope technique. A total of 110 parturients posted for the elective caesarean delivery received spinal anaesthesia in either a traditional sitting position or a cross-legged sitting position.
Results
The parturients in both groups were comparable in terms of age, height and weight. The number of attempts was equal in both groups, with 60 % of patients were successful at 1st attempt; n = 33 p-Value = 0.384). The landmark palpability, block characteristics and patient comfort were comparable in both groups
Conclusion
We found comparable results in both positions, either traditional sitting position can be used to administer spinal anaesthesia in parturients based on their comfort and preference
{"title":"A comparison of spinal Anaesthesia in traditional sitting position versus cross-legged sitting position in Parturients undergoing elective caesarean section—a Randomised controlled trial","authors":"S. Podder , I.A. Khan , L Shenoy , A. Satish , M. Kulkarni , R.R. Krishnabhat , D. Shetty , S. Thimmaiah Kanakalakshmi","doi":"10.1016/j.pcorm.2025.100556","DOIUrl":"10.1016/j.pcorm.2025.100556","url":null,"abstract":"<div><h3>Background</h3><div>Spinal anaesthesia is the preferred technique for caesarean delivery, owing to the several benefits it carries for mother and fetus. Appropriate patient positioning is vital as it improves the patient comfort, reduces the time taken, the number of attempts required, and decreases the number of needle and bone contacts during the procedure. Our study primarily aimed to compare number of attempts taken for successful needle placement in a sitting position versus a cross-legged sitting position. Secondary objectives included patient comfort, ease of palpation, and block characteristics.</div></div><div><h3>Methods</h3><div>Our study was a prospective, nonblinded, single-centre study. The patients were randomly assigned to one of the two groups using a computer-generated randomisation table and opaque envelope technique. A total of 110 parturients posted for the elective caesarean delivery received spinal anaesthesia in either a traditional sitting position or a cross-legged sitting position.</div></div><div><h3>Results</h3><div>The parturients in both groups were comparable in terms of age, height and weight. The number of attempts was equal in both groups, with 60 % of patients were successful at 1st attempt; <em>n</em> = 33 <em>p-</em>Value = 0.384). The landmark palpability, block characteristics and patient comfort were comparable in both groups</div></div><div><h3>Conclusion</h3><div>We found comparable results in both positions, either traditional sitting position can be used to administer spinal anaesthesia in parturients based on their comfort and preference</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100556"},"PeriodicalIF":1.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159806","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 : 2025-09-22DOI: 10.1016/j.pcorm.2025.100559
Ahmed Omar Mahmoud , Gamal Mohamed Abu Dahab Ibrahim , Mahmoud Alhasan Mohamed Hasan , Waleed Ahmad Ali Hussein Atteia , Ahmed Abdelkader Ahmed , Mostafa Hassanien Hassanien Bakr
Background
Effective pain management after caesarean delivery is essential to promote maternal recovery, facilitate early mobility, and support mother-infant bonding. Traditionally, intrathecal morphine (ITM) has been widely used due to its strong analgesic effects, but concerns about opioid-related side effects have led to growing interest in alternative regional techniques such as the quadratus lumborum block (QLB). Comparative evidence on the efficacy of these approaches in obstetric patients remains limited.
Methods
In a randomized trial, 70 cesarean patients underwent spinal anesthetic at Assiut University Hospital. The study compared bilateral posterior QLB with 0.25 % bupivacaine to 100 μg ITM. Secondary outcomes included pain scores, time to first morphine request, side effects, quality of recovery, and functional outcomes; the primary outcome was 24-hour IV morphine consumption.
Results
Morphine consumption over 24 h was similar between the ITM and QLB groups, averaging 6.4 mg and 8.5 mg, respectively. Pain levels at rest and during movement did not differ significantly between the two groups at any time point. However, a subgroup analysis showed that QLB patients with a BMI of 30 kg/m² or higher required more morphine and reported higher peak pain scores compared to those in the ITM group (10.5 mg vs 7.4 mg, p < 0.05). No such difference was seen in patients with a BMI below 30 kg/m². In a multivariate analysis, BMI emerged as the only significant predictor of 24-hour morphine consumption (p = 0.016).
Conclusion
ITM and posterior QLB provide comparable postoperative analgesia after cesarean delivery for the general population. However, patient factors such as BMI and age may influence postoperative opioid requirements and should be considered when selecting an analgesic technique to optimize recovery and minimize side effects.
背景剖宫产后有效的疼痛管理对于促进产妇康复、促进早期活动和支持母婴关系至关重要。传统上，鞘内吗啡（ITM）因其强大的镇痛作用而被广泛使用，但对阿片类药物相关副作用的担忧导致人们对替代区域性技术（如腰方肌阻滞（QLB））的兴趣日益浓厚。关于这些方法在产科患者中的疗效的比较证据仍然有限。方法对70例剖宫产患者在阿西尤特大学医院行脊髓麻醉进行随机对照试验。该研究将双侧后路QLB与0.25%布比卡因和100 μg ITM进行比较。次要结局包括疼痛评分、到第一次吗啡请求的时间、副作用、恢复质量和功能结局；主要终点为24小时静脉注射吗啡。结果ITM组和QLB组24 h吗啡摄取量相似，平均分别为6.4 mg和8.5 mg。两组在休息和运动时的疼痛水平在任何时间点均无显著差异。然而，亚组分析显示，与ITM组相比，BMI为30 kg/m²或更高的QLB患者需要更多的吗啡，并报告更高的峰值疼痛评分（10.5 mg vs 7.4 mg, p < 0.05）。BMI低于30 kg/m²的患者没有这种差异。在多变量分析中，BMI是24小时吗啡摄入量的唯一显著预测因子（p = 0.016）。结论itm与后路QLB对一般人群剖宫产术后镇痛效果相当。然而，BMI和年龄等患者因素可能会影响术后阿片类药物的需求，在选择镇痛技术时应考虑这些因素，以优化恢复并减少副作用。
{"title":"Comparative efficacy of intrathecal morphine and posterior quadratus lumborum block for post-caesarean analgesia","authors":"Ahmed Omar Mahmoud , Gamal Mohamed Abu Dahab Ibrahim , Mahmoud Alhasan Mohamed Hasan , Waleed Ahmad Ali Hussein Atteia , Ahmed Abdelkader Ahmed , Mostafa Hassanien Hassanien Bakr","doi":"10.1016/j.pcorm.2025.100559","DOIUrl":"10.1016/j.pcorm.2025.100559","url":null,"abstract":"<div><h3>Background</h3><div>Effective pain management after caesarean delivery is essential to promote maternal recovery, facilitate early mobility, and support mother-infant bonding. Traditionally, intrathecal morphine (ITM) has been widely used due to its strong analgesic effects, but concerns about opioid-related side effects have led to growing interest in alternative regional techniques such as the quadratus lumborum block (QLB). Comparative evidence on the efficacy of these approaches in obstetric patients remains limited.</div></div><div><h3>Methods</h3><div>In a randomized trial, 70 cesarean patients underwent spinal anesthetic at Assiut University Hospital. The study compared bilateral posterior QLB with 0.25 % bupivacaine to 100 μg ITM. Secondary outcomes included pain scores, time to first morphine request, side effects, quality of recovery, and functional outcomes; the primary outcome was 24-hour IV morphine consumption.</div></div><div><h3>Results</h3><div>Morphine consumption over 24 h was similar between the ITM and QLB groups, averaging 6.4 mg and 8.5 mg, respectively. Pain levels at rest and during movement did not differ significantly between the two groups at any time point. However, a subgroup analysis showed that QLB patients with a BMI of 30 kg/m² or higher required more morphine and reported higher peak pain scores compared to those in the ITM group (10.5 mg vs 7.4 mg, <em>p</em> < 0.05). No such difference was seen in patients with a BMI below 30 kg/m². In a multivariate analysis, BMI emerged as the only significant predictor of 24-hour morphine consumption (<em>p</em> = 0.016).</div></div><div><h3>Conclusion</h3><div>ITM and posterior QLB provide comparable postoperative analgesia after cesarean delivery for the general population. However, patient factors such as BMI and age may influence postoperative opioid requirements and should be considered when selecting an analgesic technique to optimize recovery and minimize side effects.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100559"},"PeriodicalIF":1.0,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145159871","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 : 2025-09-18DOI: 10.1016/j.pcorm.2025.100554
Gabriele Caggianelli , Irene Dello Iacono , Rita Patrizia Tomasin , Pamela Pellini , Luana Di Marte , Eleonora Bruno , Claudia Angelucci , Paolo Mazzuca , Fabio Petrelli , Sara Morales Palomares , Giovanni Cangelosi , Stefano Mancin
Purpose
To achieve consensus on essential elements of a clinical competency assessment for operating room nurses (OR) in Italy
Design
Delphi study
Methods
Between October 2023 and September 2024, 24 experts, including OR nurses, coordinators, and managers, identified key elements. Data collection involved two Delphi rounds and the analytic hierarchy process. Consensus was reached with a mean score ≥ 3.5 or variance < 20 %.
Findings
Five key dimensions were identified: Professional, Ethical, and Legal Practice; Nursing Care & Perioperative Practice; Interpersonal Relationships & Communication; Organizational, Managerial & Leadership Skills; and Education, Research & Professional Development. The framework, with 66 competency elements, highlights the central role of nursing care and perioperative practice.
Conclusions
This framework highlights the multifaceted nature of perioperative nursing, with the Nursing Care & Perioperative Practice dimension being central. It also emphasizes the importance of non-technical competencies, such as communication, leadership, and professional development, in improving patient outcomes and teamwork.
{"title":"Development of a clinical competency evaluation index for operating room nurses in the Italian context: Delphi method and analytic hierarchy process","authors":"Gabriele Caggianelli , Irene Dello Iacono , Rita Patrizia Tomasin , Pamela Pellini , Luana Di Marte , Eleonora Bruno , Claudia Angelucci , Paolo Mazzuca , Fabio Petrelli , Sara Morales Palomares , Giovanni Cangelosi , Stefano Mancin","doi":"10.1016/j.pcorm.2025.100554","DOIUrl":"10.1016/j.pcorm.2025.100554","url":null,"abstract":"<div><h3>Purpose</h3><div>To achieve consensus on essential elements of a clinical competency assessment for operating room nurses (OR) in Italy</div></div><div><h3>Design</h3><div>Delphi study</div></div><div><h3>Methods</h3><div>Between October 2023 and September 2024, 24 experts, including OR nurses, coordinators, and managers, identified key elements. Data collection involved two Delphi rounds and the analytic hierarchy process. Consensus was reached with a mean score ≥ 3.5 or variance < 20 %.</div></div><div><h3>Findings</h3><div>Five key dimensions were identified: Professional, Ethical, and Legal Practice; Nursing Care & Perioperative Practice; Interpersonal Relationships & Communication; Organizational, Managerial & Leadership Skills; and Education, Research & Professional Development. The framework, with 66 competency elements, highlights the central role of nursing care and perioperative practice.</div></div><div><h3>Conclusions</h3><div>This framework highlights the multifaceted nature of perioperative nursing, with the Nursing Care & Perioperative Practice dimension being central. It also emphasizes the importance of non-technical competencies, such as communication, leadership, and professional development, in improving patient outcomes and teamwork.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100554"},"PeriodicalIF":1.0,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145121053","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 : 2025-09-17DOI: 10.1016/j.pcorm.2025.100555
Neslihan Ilkaz , Dercan Gencbas
Background
Operating room nurses play a critical role in maintaining safety for both patients and staff during the perioperative period. Given the distinct nature of open and laparoscopic surgical procedures, they must identify and address procedure-specific safety risks through preventive strategies.
Aim
This study aimed to investigate the factors that threaten patient and staff safety in open and laparoscopic surgeries.
Methods
Data were collected through semi-structured interviews with 18 operating room nurses from various surgical units selected via purposive sampling. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.
Results
Analysis yielded three main themes: Operating room environment, Staff responsibility,and Risk specific for surgical procedure. Sub-themes included environmental and psychological factors, team harmony, risk in surgical preparation, and risk during intraoperative. The findings showed that open and laparoscopic surgical procedures posed different risks to patient and staff safety.
Conclusions
Recognizing the safety challenges of different surgical methods is essential for improving outcomes. Operating room nurses and surgical teams should implement proactive, procedure-specific strategies to mitigate risks across all phases of surgery.
{"title":"Patient and staff safety differences between open and laparoscopic surgical procedures: A qualitative study of operating room nurses' perspectives","authors":"Neslihan Ilkaz , Dercan Gencbas","doi":"10.1016/j.pcorm.2025.100555","DOIUrl":"10.1016/j.pcorm.2025.100555","url":null,"abstract":"<div><h3>Background</h3><div>Operating room nurses play a critical role in maintaining safety for both patients and staff during the perioperative period. Given the distinct nature of open and laparoscopic surgical procedures, they must identify and address procedure-specific safety risks through preventive strategies.</div></div><div><h3>Aim</h3><div>This study aimed to investigate the factors that threaten patient and staff safety in open and laparoscopic surgeries.</div></div><div><h3>Methods</h3><div>Data were collected through semi-structured interviews with 18 operating room nurses from various surgical units selected via purposive sampling. Interviews were audio-recorded, transcribed verbatim, and thematically analyzed.</div></div><div><h3>Results</h3><div>Analysis yielded three main themes: Operating room environment, Staff responsibility,and Risk specific for surgical procedure. Sub-themes included environmental and psychological factors, team harmony, risk in surgical preparation, and risk during intraoperative. The findings showed that open and laparoscopic surgical procedures posed different risks to patient and staff safety.</div></div><div><h3>Conclusions</h3><div>Recognizing the safety challenges of different surgical methods is essential for improving outcomes. Operating room nurses and surgical teams should implement proactive, procedure-specific strategies to mitigate risks across all phases of surgery.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100555"},"PeriodicalIF":1.0,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145120953","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}
Effective communication is a crucial non-technical skill in high-pressure clinical environments like operating rooms, impacting patient safety and team coordination. However, operating room students face obstacles in developing these skills during clinical training. This study aimed to explore and provide an in-depth understanding of the contextual and system-level factors shaping communication barriers encountered by operating room students in clinical settings.
Methods
A qualitative study with a conventional content analysis approach was conducted in 2025 among ten undergraduate operating room students from Hamadan University of Medical Sciences, western Iran. Participants were selected through purposive sampling, and recruitment continued until data saturation was achieved. Data were collected through semi-structured interviews and analyzed concurrently using the Graneheim and Lundman method. Trustworthiness was ensured using Guba and Lincoln’s criteria.
Results
The analysis identified five main themes:(1) Intrapersonal barriers (fear of mistakes, low self-esteem, introversion, lack of interest in the clinical environment),(2) Restrictive organizational and hierarchical structures (surgeons’ authoritarianism, hierarchical culture, lack of formal communication channels),(3) Gap between academic training and clinical demands (insufficient communication skills training, exclusive focus on technical skills, lack of structured feedback),(4) Clinical environmental pressures (heavy workload, time constraints, adverse physical and psychological conditions), and (5) Lack of professional support (absence of active clinical instructors, neglect of students’ roles by the healthcare team, scarcity of positive communication role models).
Conclusion
Communication barriers among operating room students are multifaceted, shaped by individual, organizational, educational, and environmental factors. Addressing these challenges requires curriculum revisions, strengthened professional support, and fostering psychologically safe clinical environments.
{"title":"Communication challenges faced by operating room students in clinical environments: Insights from a qualitative content analysis","authors":"Fatemeh Davodabadi , Amirali Alizadeh , Fatemeh Samiee , Behzad Imani","doi":"10.1016/j.pcorm.2025.100553","DOIUrl":"10.1016/j.pcorm.2025.100553","url":null,"abstract":"<div><h3>Background</h3><div>Effective communication is a crucial non-technical skill in high-pressure clinical environments like operating rooms, impacting patient safety and team coordination. However, operating room students face obstacles in developing these skills during clinical training. This study aimed to explore and provide an in-depth understanding of the contextual and system-level factors shaping communication barriers encountered by operating room students in clinical settings.</div></div><div><h3>Methods</h3><div>A qualitative study with a conventional content analysis approach was conducted in 2025 among ten undergraduate operating room students from Hamadan University of Medical Sciences, western Iran. Participants were selected through purposive sampling, and recruitment continued until data saturation was achieved. Data were collected through semi-structured interviews and analyzed concurrently using the Graneheim and Lundman method. Trustworthiness was ensured using Guba and Lincoln’s criteria.</div></div><div><h3>Results</h3><div>The analysis identified five main themes:(1) <em>Intrapersonal barriers</em> (fear of mistakes, low self-esteem, introversion, lack of interest in the clinical environment),(2) <em>Restrictive organizational and hierarchical structures</em> (surgeons’ authoritarianism, hierarchical culture, lack of formal communication channels),(3) <em>Gap between academic training and clinical demands</em> (insufficient communication skills training, exclusive focus on technical skills, lack of structured feedback),(4) <em>Clinical environmental pressures</em> (heavy workload, time constraints, adverse physical and psychological conditions), and (5) <em>Lack of professional support</em> (absence of active clinical instructors, neglect of students’ roles by the healthcare team, scarcity of positive communication role models).</div></div><div><h3>Conclusion</h3><div>Communication barriers among operating room students are multifaceted, shaped by individual, organizational, educational, and environmental factors. Addressing these challenges requires curriculum revisions, strengthened professional support, and fostering psychologically safe clinical environments.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100553"},"PeriodicalIF":1.0,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099038","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 : 2025-09-12DOI: 10.1016/j.pcorm.2025.100552
Ghada Mohammad AboElfadl , Obey Mohamed Shaker , Ismail Elsaid Eldeeb , Mahmoud Mamdouh Ekram , Ahmad Mohamed Aboelfadl
Background
Optimal post-cesarean analgesia remains challenging. We compared the efficacy of erector spinae plane block (ESB), quadratus lumborum block (QL), and intrathecal morphine (ITM) in a randomized trial.
Methods
Patients undergoing cesarean delivery under spinal anesthesia were randomized to three groups 40 patients each. ITM group (hyperbaric bupivacaine + 150 µg morphine), QL group (ITM + bilateral QL block with 0.25 % bupivacaine + dexamethasone), ESB group (ITM + bilateral ESB block with 0.25 % bupivacaine + dexamethasone). The primary outcome was the time to first rescue analgesia. Secondary outcomes included pain scores (NRS at rest and on movement), the amount of analgesics consumption during the first 24 h following surgery, changes in hemodynamics, side effects, and patient satisfaction.
Results
QLB group provided a significantly longer time to the first analgesic request compared to both ESB and ITM (17.53 ± 1.92 h, 12.63 ± 1.19 h, 8.43 ± 1.13 h respectively), with p < 0.001. QLB group also resulted in a significantly lower number of analgesic doses compared to ITM and ESB groups. Numeric Rating Scale (NRS)pain scores at rest & on movement was significantly lower in the QLB and ESB group at various times compared to ITM. Patient satisfaction was highest in the QLB group.
Conclusion
QL and ESB blocks are superior to ITM alone, with QL potentially offering better visceral analgesia.
{"title":"Comparative analgesic efficacy of erector spinae block, quadratus lumborum block, and intrathecal morphine for post-operative pain relief after cesarean section: A randomized study","authors":"Ghada Mohammad AboElfadl , Obey Mohamed Shaker , Ismail Elsaid Eldeeb , Mahmoud Mamdouh Ekram , Ahmad Mohamed Aboelfadl","doi":"10.1016/j.pcorm.2025.100552","DOIUrl":"10.1016/j.pcorm.2025.100552","url":null,"abstract":"<div><h3>Background</h3><div>Optimal post-cesarean analgesia remains challenging. We compared the efficacy of erector spinae plane block (ESB), quadratus lumborum block (QL), and intrathecal morphine (ITM) in a randomized trial.</div></div><div><h3>Methods</h3><div>Patients undergoing cesarean delivery under spinal anesthesia were randomized to three groups 40 patients each. ITM group (hyperbaric bupivacaine + 150 µg morphine), QL group (ITM + bilateral QL block with 0.25 % bupivacaine + dexamethasone), ESB group (ITM + bilateral ESB block with 0.25 % bupivacaine + dexamethasone). The primary outcome was the time to first rescue analgesia. Secondary outcomes included pain scores (NRS at rest and on movement), the amount of analgesics consumption during the first 24 h following surgery, changes in hemodynamics, side effects, and patient satisfaction.</div></div><div><h3>Results</h3><div>QLB group provided a significantly longer time to the first analgesic request compared to both ESB and ITM (17.53 ± 1.92 h, 12.63 ± 1.19 h, 8.43 ± 1.13 h respectively), with <em>p</em> < 0.001. QLB group also resulted in a significantly lower number of analgesic doses compared to ITM and ESB groups. Numeric Rating Scale (NRS)pain scores at rest & on movement was significantly lower in the QLB and ESB group at various times compared to ITM. Patient satisfaction was highest in the QLB group.</div></div><div><h3>Conclusion</h3><div>QL and ESB blocks are superior to ITM alone, with QL potentially offering better visceral analgesia.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100552"},"PeriodicalIF":1.0,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099036","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 : 2025-09-06DOI: 10.1016/j.pcorm.2025.100551
Leila Sadati, Seyedeh Sanaz Mirrahimi, Rana Abjar
Introduction
Surgical technologists play a crucial role in maintaining patient safety and ensuring the overall quality of care in surgical settings. Their performance in the field of decontamination and sterilization of laparoscopic instruments is as important as it directly affects the risk of surgical complications. Therefore, the present study aimed to appraise the performance of surgical technologists in laparoscopic instrument decontamination and sterilization by A 360-degree performance appraisal method in selected hospitals in Alborz Province, Iran.
Methods
The present study is a cross-sectional study which was conducted among 110 surgical technologists in Alborz Province, Iran from May 2024 to January 2025 using convenient sampling. Data were collected using a performance checklist and the 360-degree evaluation method. The checklist's validity was confirmed through content validity and expert panel opinions. Its reliability was established with a 0.91 agreement coefficient between two external raters and an intraclass correlation coefficient (ICC) of 0.822 for the questionnaire. Data were analyzed using SPSS version 28 software and one-sample t-test, independent groups t-test, and one-way analysis of variance.
Results
The findings on the performance of surgical technologists in the decontamination and sterilization of laparoscopic instruments reveal that 2 technologists were classified in the low performance category, with scores between 0 and 16. A total of 101 technologists fell into the moderate performance category, achieving scores ranging from 17 to 33. Furthermore, 7 technologists achieved the high-performance level, with scores between 34 and 50.
Conclusion
This study utilized the 360-degree feedback method, which revealed that surgical technologists perform moderately in reprocessing laparoscopic instruments. To gain a clearer understanding of their strengths and areas needing improvement, it is important to conduct ongoing evaluations using a range of methods.
{"title":"Evaluation of surgical technologists' performance in laparoscopic instrument decontamination and sterilization by 360-degree appraisal method: An observational study","authors":"Leila Sadati, Seyedeh Sanaz Mirrahimi, Rana Abjar","doi":"10.1016/j.pcorm.2025.100551","DOIUrl":"10.1016/j.pcorm.2025.100551","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical technologists play a crucial role in maintaining patient safety and ensuring the overall quality of care in surgical settings. Their performance in the field of decontamination and sterilization of laparoscopic instruments is as important as it directly affects the risk of surgical complications. Therefore, the present study aimed to appraise the performance of surgical technologists in laparoscopic instrument decontamination and sterilization by A 360-degree performance appraisal method in selected hospitals in Alborz Province, Iran.</div></div><div><h3>Methods</h3><div>The present study is a cross-sectional study which was conducted among 110 surgical technologists in Alborz Province, Iran from May 2024 to January 2025 using convenient sampling. Data were collected using a performance checklist and the 360-degree evaluation method. The checklist's validity was confirmed through content validity and expert panel opinions. Its reliability was established with a 0.91 agreement coefficient between two external raters and an intraclass correlation coefficient (ICC) of 0.822 for the questionnaire. Data were analyzed using SPSS version 28 software and one-sample <em>t</em>-test, independent groups <em>t</em>-test, and one-way analysis of variance.</div></div><div><h3>Results</h3><div>The findings on the performance of surgical technologists in the decontamination and sterilization of laparoscopic instruments reveal that 2 technologists were classified in the low performance category, with scores between 0 and 16. A total of 101 technologists fell into the moderate performance category, achieving scores ranging from 17 to 33. Furthermore, 7 technologists achieved the high-performance level, with scores between 34 and 50.</div></div><div><h3>Conclusion</h3><div>This study utilized the 360-degree feedback method, which revealed that surgical technologists perform moderately in reprocessing laparoscopic instruments. To gain a clearer understanding of their strengths and areas needing improvement, it is important to conduct ongoing evaluations using a range of methods.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100551"},"PeriodicalIF":1.0,"publicationDate":"2025-09-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145099035","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 : 2025-09-01DOI: 10.1016/j.pcorm.2025.100550
Serveh Mohammadi , Behzad Imani , Abbas Khalilpour , Yaser Ghaderi , Habib Azimi , Mohsen Akbaribazm
This case report describes a highly unusual presentation of extensive subcutaneous emphysema (SE), pneumomediastinum (PM), and right-sided pneumothorax in a 6-year-old boy following an otherwise uneventful elective tonsillectomy. The patient’s intraoperative course, including the wound closure phase, remained completely stable, with no notable changes in hemodynamics or respiratory status observed. However, in the post-anesthesia care unit (PACU), the patient was suddenly diagnosed with crepitus, which rapidly spread from the face toward the chest. Concurrently, capnography showed persistent hypercapnia, with end-tidal CO₂ values ranging from 60 to 70 mmHg. Chest imaging confirmed the presence of SE, PM, and pneumothorax in the absence of tracheal or esophageal injury. The patient was managed conservatively with supplemental oxygen and close monitoring in an intensive care unit. No surgical intervention was required, and full recovery was observed within one week. This report also provides a brief literature review exploring the possible mechanisms behind these rare complications, as well as current evidence-based management strategies.
{"title":"Unveiling a rare yet critical peril: Subcutaneous emphysema and pneumomediastinum post-tonsillectomy - A case report","authors":"Serveh Mohammadi , Behzad Imani , Abbas Khalilpour , Yaser Ghaderi , Habib Azimi , Mohsen Akbaribazm","doi":"10.1016/j.pcorm.2025.100550","DOIUrl":"10.1016/j.pcorm.2025.100550","url":null,"abstract":"<div><div>This case report describes a highly unusual presentation of extensive subcutaneous emphysema (SE), pneumomediastinum (PM), and right-sided pneumothorax in a 6-year-old boy following an otherwise uneventful elective tonsillectomy. The patient’s intraoperative course, including the wound closure phase, remained completely stable, with no notable changes in hemodynamics or respiratory status observed. However, in the post-anesthesia care unit (PACU), the patient was suddenly diagnosed with crepitus, which rapidly spread from the face toward the chest. Concurrently, capnography showed persistent hypercapnia, with end-tidal CO₂ values ranging from 60 to 70 mmHg. Chest imaging confirmed the presence of SE, PM, and pneumothorax in the absence of tracheal or esophageal injury. The patient was managed conservatively with supplemental oxygen and close monitoring in an intensive care unit. No surgical intervention was required, and full recovery was observed within one week. This report also provides a brief literature review exploring the possible mechanisms behind these rare complications, as well as current evidence-based management strategies.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100550"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145104342","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 : 2025-09-01DOI: 10.1016/j.pcorm.2025.100548
Hatice Çiftçi , Sevda Korkut , Mustafa Mart , Zerrin Özçelik
Background
Nurses' comfort level plays an important role in their ability to perform their professional duties effectively and in supporting their job satisfaction and physical-psychological well-being. Comfort can reduce stress levels and increase a person's ability to cope with challenges in their work or personal life. The study was conducted to determine the relationship between comfort and burnout level of operating room nurses.
Methods
This cross-sectional study was completed with the participation of 115 operating room nurses. Descriptive Characteristics Form, Nurse Comfort Questionnaire and Maslach Burnout Inventory were used to collect the study data.
Results
The burnout level of the nurses was significant and negatively correlated with the total comfort level, sociocultural, psychospiritual and physical comfort. The physical, sociocultural and psychospiritual comfort predicted 49% of the total variance in emotional exhaustion and 18% of the total variance in depersonalization.
Conclusions
As the comfort of the nurses working in the operating room decreased, their burnout levels increased. The nurses' emotional burnout level was significantly and negatively correlated with total comfort level, sociocultural and psychospiritual comfort, and depersonalization level was significantly and negatively correlated with total comfort level, sociocultural, psychospiritual and physical comfort level. In addition, comfort sub-dimensions significantly predicted emotional exhaustion and depersonalization. In order to improve the quality of healthcare services and increase nurses' overall well-being and job satisfaction, it is recommended that future studies focus on intervention-based studies aimed at increasing nurses' comfort.
{"title":"The relationship between operating room nurses' comfort and burnout levels: A cross-sectional study","authors":"Hatice Çiftçi , Sevda Korkut , Mustafa Mart , Zerrin Özçelik","doi":"10.1016/j.pcorm.2025.100548","DOIUrl":"10.1016/j.pcorm.2025.100548","url":null,"abstract":"<div><h3>Background</h3><div>Nurses' comfort level plays an important role in their ability to perform their professional duties effectively and in supporting their job satisfaction and physical-psychological well-being. Comfort can reduce stress levels and increase a person's ability to cope with challenges in their work or personal life. The study was conducted to determine the relationship between comfort and burnout level of operating room nurses.</div></div><div><h3>Methods</h3><div>This cross-sectional study was completed with the participation of 115 operating room nurses. Descriptive Characteristics Form, Nurse Comfort Questionnaire and Maslach Burnout Inventory were used to collect the study data.</div></div><div><h3>Results</h3><div>The burnout level of the nurses was significant and negatively correlated with the total comfort level, sociocultural, psychospiritual and physical comfort. The physical, sociocultural and psychospiritual comfort predicted 49% of the total variance in emotional exhaustion and 18% of the total variance in depersonalization.</div></div><div><h3>Conclusions</h3><div>As the comfort of the nurses working in the operating room decreased, their burnout levels increased. The nurses' emotional burnout level was significantly and negatively correlated with total comfort level, sociocultural and psychospiritual comfort, and depersonalization level was significantly and negatively correlated with total comfort level, sociocultural, psychospiritual and physical comfort level. In addition, comfort sub-dimensions significantly predicted emotional exhaustion and depersonalization. In order to improve the quality of healthcare services and increase nurses' overall well-being and job satisfaction, it is recommended that future studies focus on intervention-based studies aimed at increasing nurses' comfort.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100548"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144925475","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 : 2025-09-01DOI: 10.1016/j.pcorm.2025.100549
Şeyda Gür , Tamer Eren
Operating rooms are one of the most critical units of hospitals and, therefore, the health system. Managers need to keep the effectiveness of these units at a high level. Since the results of operating room performance directly affect patient health, maintenance in these priority areas must be carried out regularly and properly. For this reason, it is necessary to determine the factors affecting the planned maintenance strategy and to prevent the adverse effects that these factors may cause. This required maintenance increases the economic life of the expensive equipment in the operating rooms and ensures the continuity of the use of the operating rooms. In this study, the factors influencing the maintenance processes of operating rooms were identified, and their impact on the performance of these rooms was evaluated. In this evaluation phase, the fuzzy analytic hierarchy method was used. According to the results obtained, suggestions were made to hospital managers.
{"title":"Prioritization of operating room maintenance factors with fuzzy analytic hierarchy process","authors":"Şeyda Gür , Tamer Eren","doi":"10.1016/j.pcorm.2025.100549","DOIUrl":"10.1016/j.pcorm.2025.100549","url":null,"abstract":"<div><div>Operating rooms are one of the most critical units of hospitals and, therefore, the health system. Managers need to keep the effectiveness of these units at a high level. Since the results of operating room performance directly affect patient health, maintenance in these priority areas must be carried out regularly and properly. For this reason, it is necessary to determine the factors affecting the planned maintenance strategy and to prevent the adverse effects that these factors may cause. This required maintenance increases the economic life of the expensive equipment in the operating rooms and ensures the continuity of the use of the operating rooms. In this study, the factors influencing the maintenance processes of operating rooms were identified, and their impact on the performance of these rooms was evaluated. In this evaluation phase, the fuzzy analytic hierarchy method was used. According to the results obtained, suggestions were made to hospital managers.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100549"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145048554","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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