Islam Mohamed Elbardan, Ahmed Sayed Shehab, Ahmed Galaleldin Yacout, Ibrahim Mabrouk Mabrouk
{"title":"Efficacy of the intravenous formulation of fentanyl citrate administered orally as premedication in paediatric patients undergoing open cardiac surgery.","authors":"Islam Mohamed Elbardan, Ahmed Sayed Shehab, Ahmed Galaleldin Yacout, Ibrahim Mabrouk Mabrouk","doi":"10.1177/17504589241301311","DOIUrl":"10.1177/17504589241301311","url":null,"abstract":"<p><strong>Background: </strong>Recently, fentanyl has become prevalent as a sedative premedication.</p><p><strong>Methods: </strong>A non-inferiority parallel design quadruple-blinded randomised controlled trial of 1- to 7-year-old children scheduled for elective cardiac surgery was conducted. Participants were assigned a 1:1 allocation ratio to a control group (<i>n</i> = 50) given a parenteral formulation of midazolam 0.5 mg/kg and an intervention group (<i>n</i> = 50) given a parenteral formulation of fentanyl 10 μg/kg 30 min before admission to the operating room.</p><p><strong>Results: </strong>Fentanyl was shown to be inferior when compared to midazolam during inhalational induction but not in the 'after premedication' and 'during separation' periods. A lower percentage of children disliked the medication in the fentanyl group.</p><p><strong>Conclusions: </strong>A parenteral formulation of fentanyl can be a satisfactory alternative when given orally as a sedative pre-anaesthetic medication in paediatric cardiac surgery before admission to the operating room.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"326-335"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142865812","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":"Evaluation and comparison of the effect of same versus different anaesthetist on preoperative visits on preoperative anxiety and quality of recovery: A randomised controlled trial.","authors":"Geetanjali T Chilkoti, Vinesh Meena, Swati Jain, Ashok Kumar Saxena, Spirha Tiwari","doi":"10.1177/17504589251370538","DOIUrl":"10.1177/17504589251370538","url":null,"abstract":"<p><strong>Background: </strong>Preoperative anxiety is one of the leading causes of morbidity in the perioperative period. Quality of Recovery (QoR)is a recent and valid questionnaire to assess recovery process in this time.</p><p><strong>Methods: </strong>Ninety patients were visited by an anaesthetist twice in the preoperative period, by either the same or a different anaesthetist. The effect of the visits was evaluated on the basis of preoperative anxiety, and QoR.</p><p><strong>Results: </strong>The mean APAIS (Amsterdam Preoperative Anxiety and Information Scale) result for the group with visits from different anaesthetists was significantly higher when compared to the group which received visits from the same anaesthetist (16.09 [14.51 to 17.67]) vs (12.40 [10.82 to 13.98]) (<i>p</i> = 0.002). However, time taken to discharge, QoR, and the Numeric Rating Scale (NRS) pain score were not significantly affected by the intervention.</p><p><strong>Conclusion: </strong>Providing preoperative visits by the same anaesthetist may considerably lower preoperative anxiety.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"336-340"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016355","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":"Effect of volume control ventilation versus pressure control ventilation with volume-guaranteed mode on intraoperative respiratory mechanics and postoperative pulmonary functions in patients undergoing scoliosis surgery: A randomised control trial.","authors":"Kadali Vejendla, Srilata Moningi, Shibani Padhy, Padmaja Durga","doi":"10.1177/17504589241287513","DOIUrl":"10.1177/17504589241287513","url":null,"abstract":"<p><strong>Background: </strong>Posterior spinal fusion surgery for thoracolumbar scoliosis in the prone position, places the patient at high risk of pulmonary complications. The pressure-controlled ventilation volume-guaranteed mode regulates the inspiratory pressure limits to achieve a set tidal volume with the lowest airway pressure. We hypothesised that pressure-controlled ventilation volume-guaranteed mode would result in improved pulmonary mechanics, gas exchange and lower incidence of atelectasis than ventilation volume-guaranteed mode in patients undergoing corrective surgery for scoliosis in the prone position.</p><p><strong>Methods: </strong>Patients of thoracolumbar scoliosis scheduled for posterior spinal fusion surgery were randomly allocated to the ventilation volume-guaranteed (n = 24) or pressure-controlled ventilation volume-guaranteed group (n = 27). As primary endpoints, peak airway pressure (Ppeak), dynamic lung compliance (Cdyn) and arterial blood gas parameters were evaluated at predefined time points. Screening for atelectasis was done by lung ultrasonography on intensive care unit arrival.</p><p><strong>Results: </strong>Pressure-controlled ventilation volume-guaranteed resulted in significantly reduced Ppeak and Cdyn as well as lower PaCO<sub>2</sub> and arterial to end-tidal carbon dioxide gradient. Both the groups were comparable with regard to oxygenation, hemodynamic variables and total lung ultrasound scores.</p><p><strong>Conclusion: </strong>Pressure-controlled ventilation volume-guaranteed confers significant advantages like improved airway mechanics and lower dead space ventilation in patients undergoing corrective surgery for scoliosis.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"267-274"},"PeriodicalIF":1.0,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294995","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}
Shajie Ur Rehman Usmani, Syeda Zainab Kazmi, Syed Muhammad Moaaz Bin Sultan, Arooba Iqbal, Zobia Ahmad, Javeria Malik, Daniel McBurney Morgan
{"title":"Comparison of low molecular weight heparins with direct oral anticoagulants for the prevention of venous thromboembolism in major abdominopelvic surgeries: A systematic review and meta-analysis.","authors":"Shajie Ur Rehman Usmani, Syeda Zainab Kazmi, Syed Muhammad Moaaz Bin Sultan, Arooba Iqbal, Zobia Ahmad, Javeria Malik, Daniel McBurney Morgan","doi":"10.1177/17504589261440451","DOIUrl":"https://doi.org/10.1177/17504589261440451","url":null,"abstract":"<p><strong>Introduction: </strong>Venous thromboembolism is the leading cause of postoperative death in patients undergoing oncological surgery. This systematic review and meta-analysis compares the efficacy of low-molecular-weight heparin with direct oral anticoagulants in preventing venous thromboembolism in major abdominopelvic surgeries.</p><p><strong>Methods: </strong>This systematic review was conducted according to a predefined protocol registered in PROSPERO (ID: 1307005) and is reported in accordance with the PRISMA 2020 statement. A search was conducted in the Cochrane Library, PubMed Central/Medline, and Google Scholar from 2000 until September 2024. The analysis was performed using RevMan 5.4.1.</p><p><strong>Results: </strong>A total of seven studies were included. There was no significant difference in incidence of venous thromboembolism (Risked Ratio = 1.77, p = 0.08), major bleeding events (RR = 0.60, p = 0.51), or pulmonary embolism incidence (Risked Ratio = 3.38, p = 0.17) among the seven included studies. A subgroup analysis of five studies performed for incidence of venous thromboembolism in gynaecological procedures also showed an insignificant difference between the two groups.</p><p><strong>Conclusions: </strong>Direct oral anticoagulants offer efficacy and safety comparable to low-molecular-weight heparins. Further large-scale randomised controlled trials are needed to validate these findings.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589261440451"},"PeriodicalIF":1.0,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147821064","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":"Implementing a multidisciplinary perioperative pathway in a public hospital: First-year outcomes and lessons from real-world practice.","authors":"Patrícia Sousa, Jhonny Abreu, Ricardo Rodrigues, Catarina Lemos, Mariana Luís","doi":"10.1177/17504589261440246","DOIUrl":"https://doi.org/10.1177/17504589261440246","url":null,"abstract":"<p><p>BackgroundMultidisciplinary perioperative pathways are associated with improved outcomes in colorectal surgery, but evidence on real-world implementation is still scarce, especially in limited-resource settings.</p><p><strong>Methods: </strong>An audit was conducted targeting first-year outcomes after implementation of the Optimised Recovery Programme in Colorectal Surgery at a tertiary public hospital since February 2024. Results were compared with a historical pre-implementation cohort treated in 2022. Outcomes and quality indicators were analysed using descriptive statistics.</p><p><strong>Results: </strong>Despite a higher proportion of patients with severe systemic disease in the optimised recovery cohort, mean hospital length of stay decreased substantially, as well as readmission rates, with no increase in 30-day mortality.</p><p><strong>Conclusions: </strong>Real-world implementation of a multidisciplinary perioperative pathway was feasible and safe, even in a high comorbidity population and limited-resource setting. These findings support the value of structured perioperative systems of care and multidisciplinary coordination in routine clinical practice.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589261440246"},"PeriodicalIF":1.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783576","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":"Unnecessary sleepovers? A retrospective audit identifying day surgery rates and reasons for overnight admission following elective urology procedures.","authors":"Joshua Louis Siegert, Leena Nagappan","doi":"10.1177/17504589261441425","DOIUrl":"https://doi.org/10.1177/17504589261441425","url":null,"abstract":"<p><p>Same-day discharge after elective surgery improves hospital efficiency, reduces costs, and enhances patient outcomes. This audit evaluated current practice at Fiona Stanley Hospital, Perth, for elective urological procedures often considered appropriate for day surgery according to the British Association of Day Surgery (BADS) directory. A retrospective review of elective cases performed between 31 August 2023 and 31 August 2024 was undertaken. Of 241 patients audited, 16 met exclusion criteria, 87 (38.7%) were completed as day cases, and 138 (61.3%) were admitted overnight. Common reasons for overnight admission included administration of intravenous antibiotics, awaiting urinary catheter removal/trial of void, continuous bladder irrigation, and social or non-medical factors. In a large number of cases, there was no documented justification for overnight admission. Late arrival at the ward following a surgical procedure was common in those admitted overnight. This audit demonstrates scope to improve same-day discharge rates through improved theatre scheduling, preoperative planning and careful consideration regarding the necessity of certain intra and postoperative interventions.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589261441425"},"PeriodicalIF":1.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783623","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":"Early detection of Ogilvie syndrome as the key to successful postoperative management: A case report.","authors":"Joshua Christian Suyanto, Mariza Fitriati","doi":"10.1177/17504589261440440","DOIUrl":"https://doi.org/10.1177/17504589261440440","url":null,"abstract":"<p><p>Ogilvie syndrome is a rare complication in postoperative patients, including in caesarean section. The syndrome was characterised by gastrointestinal tract obstruction without a precise mechanical cause. The lateness in diagnosis and therapy can cause intestinal perforation, leading to fatalities. This report aims to highlight that early detection and prompt multidisciplinary management are key to preventing severe complications of Ogilvie syndrome in postoperative caesarean section patients. A 35-year-old woman without any previous known medical comorbidities and with a prior caesarean section for undiagnosed placenta percreta was diagnosed with Ogilvie syndrome during the current pregnancy. Postoperatively, the patient indicated severe ileus accompanied by abdominal pain and fever, which did not improve. Within the first 24 h after the indications emerged, an interdisciplinary discussion for diagnostic confirmation was conducted, involving anaesthesia, digestive surgery, and obstetrics. Conservative management, pharmacology, and surgical decompression were performed to manage the complications. With early detection, integrated therapy, and close monitoring, Ogilvie syndrome in this patient was successfully resolved, and severe complications were prevented. The patient was subsequently discharged in stable condition.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589261440440"},"PeriodicalIF":1.0,"publicationDate":"2026-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147783641","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}
Phoebe J Cope, Finn Highfield, Elizabeth Camfield, Charlotte Taylor, Aaisha Saqib
{"title":"Fewer cancellations, better care: Supporting patients with diabetes through surgery.","authors":"Phoebe J Cope, Finn Highfield, Elizabeth Camfield, Charlotte Taylor, Aaisha Saqib","doi":"10.1177/17504589261427976","DOIUrl":"https://doi.org/10.1177/17504589261427976","url":null,"abstract":"<p><strong>Background: </strong>Every year 15% of all operative procedures take place in people with diabetes. Suboptimal glycaemic control is associated with increased postoperative complications. This study aimed to identify why people with diabetes have their operations cancelled and introduce interventions to reduce the rate of cancellation.</p><p><strong>Methods: </strong>A retrospective review of all adult people with diabetes with cancelled surgery in 2024 was completed in an inner-city teaching hospital. A new perioperative guideline for elective surgery in people with diabetes was implemented and cancellations were re-audited in June 2025.</p><p><strong>Results: </strong>Postintervention 7% of cancellations were due to suboptimal diabetes control, with none occurring within 2 weeks of surgery (previously 10% and 63%). Prior to intervention, only 32% of patients proceeded to surgery within 1 year of initial cancellation.</p><p><strong>Conclusion: </strong>People with diabetes experience significant delays to surgery; however, targeted perioperative guidelines enable early identification of suboptimal glycaemic control and reduced cancellations. This work highlights the importance of locally tailored perioperative pathways.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589261427976"},"PeriodicalIF":1.0,"publicationDate":"2026-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147692650","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}
Penelope Sweeting, Jutharat Attawet, Elaine Correia Moll, Kim M Caudwell
{"title":"Intraoperative competence, more than the sum of its parts: A scoping review.","authors":"Penelope Sweeting, Jutharat Attawet, Elaine Correia Moll, Kim M Caudwell","doi":"10.1177/17504589251409975","DOIUrl":"https://doi.org/10.1177/17504589251409975","url":null,"abstract":"<p><strong>Aim: </strong>To explore the holistic nature of intraoperative nurse competence and its assessment methods.</p><p><strong>Background: </strong>Safe and effective nursing care in the intraoperative setting requires specialised knowledge, skills and attributes. Understanding what makes a competent intraoperative nurse and how to measure it is necessary to set professional expectations and inform future education initiatives.</p><p><strong>Methods: </strong>A scoping review of peer-reviewed studies published from 2009 was conducted following the Joanna Briggs Institute (JBI) methodology and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) extension for scoping reviews guidelines.</p><p><strong>Results: </strong>Fifteen studies from eight different countries were included. Studies described similar competency domains, related to perioperative-specific technical skills and knowledge, and individual non-technical skills that enabled effective teamwork and collaboration. The Perceived Perioperative Competence Scale-Revised (PPCS-R) was the most frequently used assessment tool. Potential gaps in the competency domains included those related to patient assessment and cultural competence.</p><p><strong>Conclusion: </strong>Intraoperative nursing competence is complex and multidimensional, involving both technical and interpersonal capabilities. Challenges arise when assessing self-reported competence, and current approaches to measurement may need to expand their scope to ensure that competencies required for contemporary practice are adequately captured and measured.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251409975"},"PeriodicalIF":1.0,"publicationDate":"2026-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147595343","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":"Comparison of intravenous dexmedetomidine and ketamine with femoral nerve block for positional pain before spinal anaesthesia in patients with fracture femur: A prospective randomised study.","authors":"Jyotsna Ch V, Sapna Annaji Nikhar, Akhya Kumar Kar, Padmaja Durga","doi":"10.1177/17504589231224559","DOIUrl":"10.1177/17504589231224559","url":null,"abstract":"<p><strong>Introduction: </strong>Patient positioning for spinal anaesthesia in patients with femur fracture is extremely painful and various methods have been tried to reduce mobilisation pain.</p><p><strong>Aim: </strong>To compare the analgesic efficacy of intravenous dexmedetomidine, ketamine and femoral nerve block in patients posted for fractured femur for alleviating the positional pain before spinal anaesthesia.</p><p><strong>Materials and methods: </strong>A total of 75 patients (25 per group) of American Society of Anaesthetists Grade I-III patients of age group 18-80 years with fractured femur scheduled for elective surgery. All patients in Group C (n = 25) were given the femoral nerve block, Group D (n = 25) were given intravenous dexmedetomidine 0.5µg/kg and Group K (n = 25) were given intravenous ketamine 0.3mg/kg. The parameters assessed were quantitative relief of pain by a numerical rating scale and patient satisfaction score, quality of patient positioning and time to perform spinal anaesthesia along with hemodynamics and sedation score.</p><p><strong>Results: </strong>The pain scores and patient satisfaction scores were significantly decreased in all three groups but were much significantly lower in Group K.</p><p><strong>Conclusion: </strong>Ketamine was found to be superior to the other two groups in terms of reducing positional pain.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"179-185"},"PeriodicalIF":1.0,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142972435","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}