Perioperative Care and Operating Room Management最新文献

{"title":"Updated risk prediction model for perioperative hypothermia in adults: A systematic review and meta-analysis","authors":"Na Zhang,&nbsp;Huijuan He,&nbsp;Guiyuan Qiao,&nbsp;Mengying Li,&nbsp;Ling Wang,&nbsp;Lei Yue,&nbsp;Xiangrong Wang","doi":"10.1016/j.pcorm.2025.100540","DOIUrl":"10.1016/j.pcorm.2025.100540","url":null,"abstract":"<div><h3>Aim</h3><div>To systematically review and critically assess existing risk prediction models for inadvertent perioperative hypothermia (IPH) in adult patients undergoing non-cardiac surgery.</div></div><div><h3>Design</h3><div>Systematic review and meta-analysis of observational studies.</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted from inception to December 31, 2023. The databases searched included PubMed, Web of Science, Medline, the Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang Database, and China Science and Technology Journal Database (VIP). Two researchers independently extracted data following CHARMS guidelines, and quality assessment was performed using the PROBAST checklist. Meta-analysis included studies with externally validated models, with effect measures calculated using MetaDiSc 1.4 software.</div></div><div><h3>Results</h3><div>A total of 1792 studies were retrieved, with 43 studies comprising 49 IPH prediction models included in the final review. Logistic regression was the most common method for model development. Model performance, assessed by AUC, ranged from 0.683 to 0.968. Frequent predictors included age, BMI, and ambient temperature. The meta-analysis of externally validated models showed a pooled AUROC of 0.908, demonstrating strong predictive capability.</div></div><div><h3>Conclusion</h3><div>Despite the promising performance of the IPH prediction models, their applicability to diverse populations needs further consideration. High risk of bias highlights the need for methodological rigor. Nonetheless, meta-analysis confirms the robustness of these models in predicting perioperative hypothermia.</div></div><div><h3>Implications</h3><div>Implementing robust IPH prediction models can aid healthcare professionals in identifying high-risk patients, thus improving perioperative temperature management and patient outcomes.</div></div><div><h3>Trial and Protocol Registration</h3><div>The review was registered in PROSPERO (ID: CRD42023343403).</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100540"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988554","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":"ChatGPT and American Society of Anesthesiologists (ASA) classifications - utilizing artificial intelligence in ASA classification of pediatric surgical patients","authors":"Chaitanya Challa ,&nbsp;Abdulla Ahmed ,&nbsp;Giuliana Geng-Ramos ,&nbsp;Jennica Luu ,&nbsp;Sohel Rana ,&nbsp;Jessica A. Cronin","doi":"10.1016/j.pcorm.2025.100547","DOIUrl":"10.1016/j.pcorm.2025.100547","url":null,"abstract":"<div><h3>Background</h3><div>The American Society of Anesthesiologists (ASA) physical status classification system is a widely used tool to assess preoperative risk. However, variability in assigning ASA scores due to subjectivity among healthcare workers remains an issue. Advances in artificial intelligence (AI) present an opportunity to improve the consistency of ASA classifications. The aim of this study was to evaluate the potential of ChatGPT, a large language model (LLM), to assign ASA scores in pediatric surgical patients. The authors hypothesized that ChatGPT's classifications would correlate with anesthesiologist-determined ASA scores.</div></div><div><h3>Methods</h3><div>This retrospective cross-sectional pilot study was conducted at a tertiary pediatric hospital, including 203 pediatric patients who underwent surgery between June 4–7, 2023. Summaries of each patient's medical history and surgery details were created and reviewed by a board-certified anesthesiologist. These summaries were presented to both a study anesthesiologist and entered into ChatGPT (x2) for ASA classification. The ASA classifications by ChatGPT were compared to those provided by both the study anesthesiologist and the day-of-surgery (DOS) anesthesiologist. Cohen's kappa with linear weighting was used to assess inter-rater agreement between ChatGPT and anesthesiologists and to measure intra-rater reliability between different ChatGPT outputs.</div></div><div><h3>Results</h3><div>A total of 203 pediatric cases were analyzed. The agreement between repeated ASA classifications from ChatGPT was significant (κ=0.61, 95% CI 0.52–0.69) with 66% exact match in classifications. The agreement between the first ChatGPT output and the study anesthesiologist showed statistical agreement (κ=0.60, 95% CI 0.51–0.69), with a 66% match. Similarly, the second ChatGPT output had agreement with the study anesthesiologist (κ=0.59, 95% CI 0.50–0.68), with a 67% match. The highest agreement (κ=0.72, 95% CI 0.62–0.81) was observed between the DOS anesthesiologist and the study anesthesiologist, with a 75% match.</div></div><div><h3>Conclusions</h3><div>The correlation between ChatGPT's ASA scores and those assigned by the pilot study anesthesiologist was found to be 66–67%. These findings indicate that AI has the potential to support pediatric anesthesiologists in determining patient ASA classifications.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100547"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007534","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":"Perceived barriers and facilitators for using video consultations in a surgical outpatient clinic – A qualitative study among clinicians with limited prior experience","authors":"Mia Grøftholdt Pedersen ,&nbsp;Helle Poulsen ,&nbsp;Lærke Kjær Tolstrup","doi":"10.1016/j.pcorm.2025.100546","DOIUrl":"10.1016/j.pcorm.2025.100546","url":null,"abstract":"<div><h3>Introduction</h3><div>Accelerated use of telehealth, including video consultations, is a highly relevant topic in healthcare worldwide. While video consultations offer potential benefits, clinicians remain reluctant to use them. Clinicians’ perspectives might affect the implementation of video consultations, however, research investigating clinicians’ perspectives is limited in surgical settings. This study aimed to investigate clinicians’ perspectives on barriers and facilitators for using video consultations in a surgical outpatient clinic among clinicians with limited prior experience with video consultations.</div></div><div><h3>Methods</h3><div>A qualitative study was conducted through three focus groups with thirteen nurses and seven physicians. The focus groups were based on dilemma games, using a semi-structured interview guide based on a contextual case to give participants different roles to reflect upon. Data were analyzed by systematic text condensation.</div></div><div><h3>Results</h3><div>Clinicians identified several barriers, including fear of failing technology, limited ability to conduct clinical assessments or to care for the patient, and difficulty in choosing the right consultation type. On the other hand, facilitators included time savings for patients and relatives, increased patient comfort, and advantages of video consultations over telephone consultations, including the ability to observe non-verbal cues during communication and the option to illustrate or screen-share.</div></div><div><h3>Conclusions</h3><div>The study identifies barriers and facilitators concerning video consultations in a surgical outpatient setting among clinicians with limited experience with video consultations. Identifying barriers and facilitators can possibly reduce potential resistance from clinicians, ensuring a better application of video consultations. Clinicians proposed initiatives to ease implementation, including adequate introduction, ‘How-to’ guides, and help from others.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100546"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144988551","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":"Strengthening professional commitment in Ethiopia’s operating rooms — Insights and imperatives","authors":"Alaye Debas Ayenew ,&nbsp;Tadesse Belayneh Melkie ,&nbsp;Nurhusen Riskey Arefayne ,&nbsp;Zewditu Abdissa Denu ,&nbsp;Belete Muluadam Admassie","doi":"10.1016/j.pcorm.2025.100545","DOIUrl":"10.1016/j.pcorm.2025.100545","url":null,"abstract":"<div><h3>Background</h3><div>Professional commitment is crucial in high-stress settings like operating rooms, directly influencing healthcare quality and patient outcomes. However, evidence on the commitment levels of operating room staff in low-resource settings remains scarce.</div></div><div><h3>Objective</h3><div>To assess professional commitment and its associated factors among operating room staff in referral hospitals in Northwest Ethiopia in 2023.</div></div><div><h3>Methods</h3><div>A multi-center, cross-sectional study was conducted from April 20 to May 20, 2023, involving 424 participants selected by simple random sampling. Data were collected using a pre-tested, self-administered questionnaire and analyzed with SPSS version 26. Factor analysis and multiple linear regression identified significant predictors at a 95 % confidence level.</div></div><div><h3>Results</h3><div>The response rate was 96.9 %. The mean professional commitment score was moderate at 67.4 % (95 % CI: 66.6–71.0). Key predictors included educational level, monthly income, work experience, affective and normative organizational commitment, personal characteristics, and ethical leadership.</div></div><div><h3>Conclusion</h3><div>Operating room staff showed moderate professional commitment. Improving commitment requires targeted interventions, including training, fair remuneration, and promotion of ethical leadership to strengthen workforce resilience and care quality in LMIC healthcare systems.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100545"},"PeriodicalIF":1.0,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144906836","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":"Intraoperative warming during abdominal surgery with a closed-circuit water sleeve","authors":"Allison McIntosh ,&nbsp;Stephanie Lewis ,&nbsp;Tanjina Jalil ,&nbsp;Gorgio Melloni ,&nbsp;Peter Wu ,&nbsp;Jeffery Weiss ,&nbsp;Enrico Camporesi","doi":"10.1016/j.pcorm.2025.100544","DOIUrl":"10.1016/j.pcorm.2025.100544","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-operative hypothermia is an adverse effect of anesthesia due to widespread inhibition of thermoregulatory processes, which can be mitigated through intraoperative warming. While forced warm-air systems are commonly used, they can pose challenges during procedures. Our study compared an enclosed water-sleeve warming system with a standard forced-air warming system, to compare their efficacy in maintaining normothermia during intrabdominal surgery.</div></div><div><h3>Methods</h3><div>In this controlled trial, 67 patients that underwent elective intrabdominal surgery were assigned to either the water-sleeve warming system (<em>N</em> = 30) or the forced-air warming system (<em>N</em> = 37). Patients gave written consent to the assignment of the warming method (IRB#1814, USF). The water-sleeve system utilized a plastic sleeve circulating warm sterile water at 40 °C on the patient's upper arm, with mild suction (-7 cm H2O) applied to promote venous dilation. The forced-air system used a disposable perforated blanket over the patient's upper body. Operating room temperatures were maintained at 20 °C. Temperatures were recorded preoperatively (sublingual), intraoperatively every 15 min (esophageal), and postoperatively upon arrival in PACU (sublingual).</div></div><div><h3>Results</h3><div>The water-sleeve group maintained a slightly higher median temperature intraoperatively compared to the control group, although the differences were not statistically significant. A Fisher test revealed that the water-sleeve group had fewer patients experiencing at least one intraoperative interval below 36 °C. Both warming methods successfully maintained normothermia upon arrival to the post-anesthesia care unit (PACU).</div></div><div><h3>Conclusions</h3><div>This study demonstrated that the water-sleeve warming system and the forced-air warming system were comparably effective in maintaining normothermia during intrabdominal surgery. No significant differences were observed in intraoperative or postoperative temperatures between the two groups. Given the similar efficacy and utility of the water-sleeve and forced-air warming systems, further research is needed to evaluate the cost-effectiveness of the water-sleeve warming system and to identify clinical scenarios where it may be preferable.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100544"},"PeriodicalIF":1.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865214","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":"Gender differences in prevalence of musculoskeletal disorders (MSDs) among surgeons","authors":"Layalee Abo-Naser ,&nbsp;Gideon Leibner ,&nbsp;Rotem Givoli Vilenski ,&nbsp;Shai Luria ,&nbsp;Yuval Kriger","doi":"10.1016/j.pcorm.2025.100542","DOIUrl":"10.1016/j.pcorm.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>work-related musculoskeletal disorders (MSDs) have been studied extensively in different types of occupations. Surgeons are especially prone to MSDs owing to their long working hours, high strain, and abnormal working postures. In this study, we examined the prevalence of MSDs in surgeons, with special regard to gender differences.</div></div><div><h3>Methods</h3><div>we surveyed surgeons at two tertiary referral hospitals, Soroka Medical Center, and Hadassah Medical Center. Participants were asked to complete standardized questionnaires regarding musculoskeletal symptoms using the Standardized Nordic Questionnaire.</div></div><div><h3>Results</h3><div>a total of 105 questionnaires were collected and analyzed. 43 % were filled by females and 57 % by males. Most respondents experienced MSDs in the last twelve months, with a higher proportion in females. females were also more likely to report symptoms in the upper extremity area in comparison to males.</div></div><div><h3>Conclusion</h3><div>the prevalence of MSDs in surgeons is high, females are more prone to MSDs than males. Further research is needed to identify the reasons and to provide a prevention plan.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100542"},"PeriodicalIF":1.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887327","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":"Laryngospasm in elective pediatric anesthesia: incidence and risk factors","authors":"Saliha Benabdi ,&nbsp;Meriem Amani ,&nbsp;Derouicha Matmour ,&nbsp;Nour eddine Chikh ,&nbsp;Kheira Daho ,&nbsp;Dalila Boumendil","doi":"10.1016/j.pcorm.2025.100543","DOIUrl":"10.1016/j.pcorm.2025.100543","url":null,"abstract":"<div><h3>Background</h3><div>Laryngospasm is a rare but potentially life-threatening critical event. The aim of this study was to identify the incidence and the associated risk factors of laryngospasm in elective pediatric anesthesia.</div></div><div><h3>Methods</h3><div>A prospective single-center cohort study was conducted in the pediatric anesthesia department at Canastel Hospital in Oran (Algeria). It included patients up to 16 years of age who underwent any elective procedure between July 2017 and August 2019. Children undergoing emergency surgery, those with an upper respiratory tract infection (URTI) within two weeks before the procedure, or those who had an asthma attack within 30 days before surgery were not included. Laryngospasm was defined as persistent hypoxemia with oxygen saturation (SpO2) &lt;90 % for ≥30 s, with inspiratory and expiratory stridor.</div></div><div><h3>Results</h3><div>We analyzed 1270 procedures, identifying 12 cases of laryngospasm (incidence 0.9 %). The mean age was 55.41 ± 43.233 months. 7 (58.33 %) of cases of laryngospasm occurred during awakening phase while 5 (41.67 %) were recorded at induction. The major risk factors included: age less than one year (RR: 5.667, 95 % CI: 1.744–17.779, <em>P</em> = 0.05), history of prematurity (RR: 0.161, 95 % CI: 0.0181–1.233, <em>P</em> = 0.042), and maxillofacial surgery (RR: 6.768, 95 % CI: 1.494–33.568, <em>P</em> = 0.045).</div><div>The multivariate analysis determined the following risk factors: age of less than one year (RR: 4.888, 95 % CI: 1.461–16.356, <em>P</em> = 0.01) and anesthesiologist experience of less than one year (RR: 2.324, 95 % CI: 1.014–5.323, <em>P</em> = 0.046). The study also revealed evidence of the beneficial effect of laryngeal mask airway management.</div></div><div><h3>Conclusion</h3><div>The findings highlight increased associations of laryngospasm in elective pediatric anesthesia with multiple factors.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100543"},"PeriodicalIF":1.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888844","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":"Incidence and predictors of post spinal anesthesia-induced hypotension for cesarean section in Ethiopia: A systematic review and meta-analysis","authors":"Sintayehu Samuel Lorato ,&nbsp;Feleke Doyore Agide ,&nbsp;Genanew Kassie Getahun ,&nbsp;Kedir Seid Yesuf ,&nbsp;Yohannes Addisu Wondimagne ,&nbsp;Mitiku Desalegn ,&nbsp;Dawit Tesfaye Rundasa ,&nbsp;Yohannes Godie ,&nbsp;Tolasa Yadate ,&nbsp;Yisehak wolde ,&nbsp;Eyob Ketema Bogale","doi":"10.1016/j.pcorm.2025.100541","DOIUrl":"10.1016/j.pcorm.2025.100541","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypotension is defined as a decrease in mean arterial blood pressure of more than 30% within a 10-minute period after spinal anesthesia. Spinal anesthesia is a subarachnoid block and is the preferred approach for certain surgical procedures, such as cesarean sections. Spinal anesthesia is the most often used neuraxial approach for patients in many institutions because of the superior quality of surgical anesthesia, quick onset of action, excellent patient comfort, and low complication rates. This systematic review and meta-analysis aimed to assess the incidence of SIH and related factors among patients who underwent cesarean sections in Ethiopia.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted using two different methods. The first was an exploration of electronic databases (PubMed, Scopus, Web of Science, MEDLINE, CINAHL, Cochrane Library, Embase, and Google Scholar) for the presence of evidence about the incidence of spinal-induced hypotension and its predictors among pregnant mothers who underwent cesarean section under spinal anesthesia in Ethiopia. Data were extracted using a Microsoft Excel spreadsheet and analyzed using Stata 17. Quality appraisal was conducted using the PRISMA guidelines and Newcastle‒Ottawa assessment scales. Higgins I2 tests were used to assess heterogeneity. Sensitivity and subgroup analyses were performed. Egger's test and funnel plots were employed to identify potential publication bias.</div></div><div><h3>Results</h3><div>The pooled incidence of SIH among pregnant women who underwent cesarean section in Ethiopia was 64.5% (95% CI: 56.2–72.8). The subgroup analysis by region revealed that the pooled incidence of SIH among pregnant mothers in Addis Ababa was 68.6%, and that in the Oromia region was 74%. Baseline systolic blood pressure &lt;120 mmHg (AOR 6, 95% CI 2.878–9.09), newborn weight (AOR 5.4, 95% CI 3.4–7.35), sensory block height (AOR 6.75, 95% CI 4.3–9.201), speed of injection &lt; 10 sec (AOR 4.47, 95% CI 2.348–6.215), and dose of local anesthetics &gt; 2.5 ml (AOR 7.8, 95% CI 6.3–11.56) were significantly associated with SIH.</div></div><div><h3>Conclusion</h3><div>This systematic review and meta-analysis revealed a high pooled incidence of SIH among pregnant women who underwent cesarean section under spinal anesthesia in Ethiopia. Hence, to reduce SIH and other maternal-related complications among pregnant women, much consideration must be given to increasing anesthesia professionals’ knowledge and skills in teaching universities and governmental hospitals in Ethiopia.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100541"},"PeriodicalIF":1.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865213","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A randomized controlled trial comparing transversalis fascia plane block and quadratus lumborum block for post-cesarean pain management: Efficacy, execution time, and practicality","authors":"Ayman Mohamady Eldemrdash,&nbsp;Hani Mohammed Ahmed Raslan,&nbsp;Taha Tairy Dardeer Alsawy,&nbsp;Ibrahim Elabd Hassan,&nbsp;Ahmed Khaled Mohamed,&nbsp;Mohammed Ahmed Alazhary","doi":"10.1016/j.pcorm.2025.100536","DOIUrl":"10.1016/j.pcorm.2025.100536","url":null,"abstract":"<div><h3>Background</h3><div>Transversalis Fascia Plane Block (TFPB) and Quadratus Lumborum Block (QLB) provide superior analgesia to Transversus Abdominis Plane Block (TAPB) for post-cesarean pain management. This study evaluates whether TFPB or QLB is preferable when their analgesic efficacy is nearly equal, focusing on ease of performance and execution time.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 108 patients scheduled for elective cesarean delivery under spinal anesthesia were randomized into three equal groups to receive either TAPB (control), TFPB, or QLB. Postoperative pain was assessed using the Numeric Pain Rating Scale (NRS) at 6, 12, and 24 hours as the primary outcome. Secondary outcomes included the time to first analgesic request, total opioid consumption within the first 24 hours, the ease of block performance (rated as easy, moderately difficult, or difficult), and the time required for block execution. All blocks were performed bilaterally under ultrasound guidance by a single experienced anesthesiologist to ensure consistency.</div></div><div><h3>Results</h3><div>Both the TFPB and QLB groups demonstrated significantly lower postoperative pain scores compared to the TAPB group at 6, 12, and 24 hours (<em>p</em> &lt; 0.001 for all time points), with no significant difference in analgesic efficacy between TFPB and QLB (<em>p</em> &gt; 0.05). In addition, patients in the TFPB and QLB groups required significantly less opioids within 24 hours and had a longer time before requesting analgesia than those in the TAPB group (<em>p</em> &lt; 0.001). Notably, the TFPB technique required significantly less time for execution and was rated as easier to perform than the QLB technique (<em>p</em> &lt; 0.001). No significant complications or adverse events were observed in any group during the study period.</div></div><div><h3>Conclusions</h3><div>Both TFPB and QLB offer superior postoperative analgesia compared to TAPB, with comparable pain relief between the two techniques. However, TFPB is associated with a shorter execution time and greater ease of performance, making it particularly advantageous in busy clinical settings. These findings suggest that TFPB may be the preferred method for post-cesarean analgesia, especially in high-volume obstetric units where efficiency and simplicity are paramount.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100536"},"PeriodicalIF":1.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842829","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":"Red cell distribution width as a predictor for post-operative atrial fibrillation after open heart surgeries","authors":"Ashraf Nabil Saleh,&nbsp;Khaled Abdou,&nbsp;Mohamed Dawood,&nbsp;Wail Abdelaal,&nbsp;Marwa Salem","doi":"10.1016/j.pcorm.2025.100539","DOIUrl":"10.1016/j.pcorm.2025.100539","url":null,"abstract":"<div><h3>Background</h3><div>Post operative Atrial Fibrillation _POAF_ is the most common type of arrhythmia after open heart surgeries with incidence 30–50 %. Atrial fibrillation has been a challenging postoperative morbidity, its mechanism is yet to be known, however, a lot of studies have tried to find a predictive biomarker for POAF, in this study we investigated the relationship between Red cell distribution width (RDW)_ and the prediction of POAF</div></div><div><h3>Methodology</h3><div>the eligible patients were 76 patients, the duration of study was 2 months of data collection, Patients enrolled in the study was allocated into two groups according to development of POAF. Group A: patients develop POAF. Group B: patients didn’t develop POAF. Pre operative RDW was compared between the two groups, ROC analysis is done for all patients to predict POAF.</div></div><div><h3>Results</h3><div>there were significant statistical difference between groups preoperative and post operative RDW (p-value 0.023, 0.011, respectively), ROC analysis for RDW in all patient to detect POAF sowed AUC 0.634 with cut off value &gt;15.1 with sensitivity 58.62 % and specificity 78.72 %.</div></div><div><h3>Conclusion</h3><div>We found that RDW was significantly higher in patients who developed POAF in comparison to patients who didn’t develop atrial fibrillation.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100539"},"PeriodicalIF":1.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893499","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}