Journal of perioperative practice最新文献

{"title":"Comparative assessment of 5-factor modified frailty index and American Society of Anesthesiologists classification for morbidity and mortality prediction in arthroplasty: A prospective observational study.","authors":"Soumya Sarkar, Deepak Gautam, Rahul Kumar Anand, Devansh Goyal, Sahil Batra, Rajesh Malhotra, Puneet Khanna, Dalim Kumar Baidya","doi":"10.1177/17504589251315706","DOIUrl":"https://doi.org/10.1177/17504589251315706","url":null,"abstract":"<p><strong>Background: </strong>Identifying early predictors of postoperative complications is paramount in frail patients. While the American Society of Anaesthesiologists classification is subjective, the 5-factor modified frailty index is simpler and associated with promising results in predicting morbidity and mortality in various surgical specialities.</p><p><strong>Methods: </strong>This prospective observational study assessed the comparative utility of 5-factor modified frailty index and American Society of Anaesthesiologists classification in predicting intensive care unit admission and revision surgery in 220 patients following arthroplasty with standardised anaesthesia techniques under the same group of surgeons. The 5-factor modified frailty index and American Society of Anaesthesiologists class were assessed 1 day before surgery, and postoperatively, all the patients were followed up for 30 days.</p><p><strong>Results: </strong>American Society of Anaesthesiologists and 5-factor modified frailty index had a significant association with postoperative intensive care unit requirements (odds ratio = 7.5, 95% confidence interval 1.3 to 42.4 and odds ratio = 8.3, 95% confidence interval 1.6 to 17.6, respectively). Only the 5-factor modified frailty index was significantly associated (odds ratio = 5.3, 95% confidence interval 1.3 to 9.7) with revision surgery. Patients with the 5-factor modified frailty index value of 3 had the best predictive odds for postoperative intensive care unit admission (odds ratio = 73.6, 95% confidence interval 7.5 to 718.8) and revision of surgery, particularly during total hip replacement (odds ratio = 54, 95% confidence interval 3.3).</p><p><strong>Conclusion: </strong>The 5-factor modified frailty index exhibited a more robust predictive capacity for postoperative intensive care unit requirements and the likelihood of revision surgery, particularly a 5-factor modified frailty index score of 3 in total hip replacement procedures.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251315706"},"PeriodicalIF":1.2,"publicationDate":"2025-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469012","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":"To assess the usefulness of 6-min walk test for determining autonomic dysfunction in diabetic patients compared with non-diabetic patients during preoperative evaluation: A prospective observational controlled study.","authors":"Naqiya Noorain, Mohammed Ismail Nizami, Shibani Padhy, Kavitha Jayaram","doi":"10.1177/17504589251318229","DOIUrl":"https://doi.org/10.1177/17504589251318229","url":null,"abstract":"<p><strong>Background: </strong>The incidence of perioperative cardiovascular morbidity and mortality in diabetic patients is due to impaired cardiovascular response to exercise caused by impairment in peripheral blood flow and oxygen diffusion to the exercising muscle. Preoperative bedside testing by 6-min walk for autonomic dysfunction in diabetic patients might reduce haemodynamic instability and cardiovascular complications.</p><p><strong>Methods and materials: </strong>Sixty patients with American Society of Anaesthesiologists grade 1 classification and 60 diabetic patients (total of 120) of age 30-60 years, of either sex, undergoing elective surgery under general anaesthesia were recruited. A 6-min walk test, breath-holding time and five clinical bedside tests for autonomic dysfunction were performed. Based on that, patients were classified into non-diabetic patients (group C), diabetic patients without autonomic dysfunction (group D) and diabetic patients with autonomic dysfunction (group A).</p><p><strong>Results: </strong>The incidence of autonomic dysfunction was 31.7%. Among all the parameters, breath-holding time, steps and distance covered by 6-min walk test was significantly less in group A. The incidence of intraoperative tachycardia and hypotension was significantly higher (78.9% and 57.9%, respectively) in group A.</p><p><strong>Conclusion: </strong>The 6-min walk test can be used as one of the preliminary tests for detection of cardiac autonomic neuropathy in diabetes since it had association with distance covered and intraoperative haemodynamic disturbances.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251318229"},"PeriodicalIF":1.2,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441929","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":"How anaesthetic drugs are selected to account for patient and surgical factors: A case report.","authors":"Bevan Michael Scott","doi":"10.1177/17504589251320317","DOIUrl":"https://doi.org/10.1177/17504589251320317","url":null,"abstract":"<p><p>The patient's health and nature of the surgery are important considerations when selecting anaesthetic drugs. This report considers the anaesthetic drugs selected for a patient undergoing day case diagnostic laparoscopy for chronic pelvic pain. Appropriate drug selection for patients with a suspected history of cancer is crucial. Anaesthetic agent selection requires a balance between possible postoperative complications and long-term survival. Total intravenous anaesthesia was selected for its favourable long-term survival rate, its effect on reducing immunosuppression, and to aid with providing a bloodless field. Metaraminol was selected to prevent profound hypotension and to provide normotension when assessing bleeding. Sugammadex has a high binding affinity for steroidal hormones, potentially contributing to contraceptive failure. Neostigmine was selected as the reversal agent due to the childbearing age of the patient. A muscle relaxant was selected to improve surgical conditions via a pneumoperitoneum. Rocuronium was selected due to its rapid onset and rapid reversibility with sugammadex. A thorough understanding of anaesthetic drugs is required if they are to be used appropriately. Inappropriate anaesthetic drug selection may provide sub-optimal operating conditions, contribute to unplanned pregnancy, worsen patient outcomes, and delay discharge.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251320317"},"PeriodicalIF":1.2,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143441926","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":"Do the current continuous professional development approaches for registered nurses and operating department practitioners within perioperative care meet their learning needs?","authors":"Teopista Namubiru Ssemakula","doi":"10.1177/17504589251316391","DOIUrl":"https://doi.org/10.1177/17504589251316391","url":null,"abstract":"<p><p>In the highly specialised and rapidly evolving field of perioperative care, continuous professional development is essential for maintaining the competencies of healthcare professionals, directly impacting patient safety and the quality of care. This project aimed to assess the effectiveness of current continuous professional development approaches in meeting the learning needs of registered nurses and operating department practitioners within perioperative care in a United Kingdom National Health Service Trust hospital. A comprehensive self-assessment strategy was intended to evaluate the condition of current continuous professional development approaches, identify areas for improvement, and explore innovative uptake for improvement. Using a mixed-methods design, data were collected via an online survey of 76 participants. The data demonstrated significant knowledge, skill, and competency deficiencies, revealing that many current continuous professional development approaches lacked accessibility and relevance. This study may provide valuable insights for refining continuous professional development programmes to meet evolving learning needs better and improve patient outcomes.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251316391"},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415417","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":"Language-specific approaches to reduce perioperative stress and anxiety related to anaesthesia for patients with limited English proficiency: A narrative review.","authors":"Kanwarpreet Kaur Dhaliwal, Sherry Sandhu, Nitasha Puri, Amolpreet Toor","doi":"10.1177/17504589251316744","DOIUrl":"https://doi.org/10.1177/17504589251316744","url":null,"abstract":"<p><p>Many patients experience perioperative anxiety due to a variety of different reasons. Essential processes of shared decision-making and informed consent may help to mitigate anxiety, yet language barriers may hinder this particularly in diverse patient populations. As such, language-specific approaches in anaesthesia care play a crucial role in reducing perioperative stress and anxiety among patients with limited English proficiency. This review examines which methods during anaesthetic assessments and shared decision-making processes enable anaesthetists to communicate effectively with patients who have limited English proficiency and thereby reduce perioperative stress. Findings suggest that collaborating with patients in their native language significantly reduces anxiety and improves understanding, while transcreation - culturally adapted translation - enhances the effectiveness of communication. To decrease perioperative anxiety among populations with limited English proficiency and improve surgical outcomes, it is important to enhance anaesthesia-focused training for interpreters, increase diversity in the anaesthesia field, and develop culturally relevant patient education materials.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251316744"},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415418","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":"Unexpected haemodynamic changes during endoscopic transnasal pituitary tumour excision - Possible causes.","authors":"Geetanjali T Chilkoti, Swati Jain, Chhavi S Sharma, Anurati Raina","doi":"10.1177/17504589241311698","DOIUrl":"https://doi.org/10.1177/17504589241311698","url":null,"abstract":"","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589241311698"},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143410707","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":"Risk factors of blood transfusion following primary total hip replacement.","authors":"Mohamed Askar, Yasmine Zedan, Owain Davies, Alun John","doi":"10.1177/17504589251317325","DOIUrl":"https://doi.org/10.1177/17504589251317325","url":null,"abstract":"<p><strong>Background: </strong>Total hip replacement is a quality of life-enhancing procedure. Postoperative blood transfusion is a risk factor compromising the outcome of total hip replacement and increasing the risk of deep infection. The aim of this study is to determine the risk factors for postoperative blood transfusion after total hip replacement.</p><p><strong>Methods: </strong>In this retrospective study, 3901 patients underwent primary total hip replacement, in the period between January 2015 and December 2023. The mean age of the participants was 67.3 (SD: 12.6) years, and 61% of them were females. Participants were divided into 'transfusion' and 'non-transfusion' groups.</p><p><strong>Results: </strong>Forty-two patients (1.1%) received blood transfusion after total hip replacement. In a multivariable logistic regression analysis, preoperative haemoglobin was the only independent risk factor that reduced the odds of postoperative transfusion by 0.3 (95% confidence interval: 0.23-0.39) for every 1 g/dL increase.</p><p><strong>Conclusion: </strong>Postoperative blood transfusion is a rare, yet potentially serious, occurrence after total hip replacement. In this study, preoperative haemoglobin level was the only independent risk factor associated with postoperative transfusion. We recommend aiming to achieve minimum preoperative haemoglobin level of 13 g/dL to minimise the risk of postoperative transfusion.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251317325"},"PeriodicalIF":1.2,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415419","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":"Perioperative hiccup mystery: A comprehensive case report.","authors":"Cheila Batista, Joana Correia Brandão, Sofia Valente, Alexandra Guedes","doi":"10.1177/17504589251318121","DOIUrl":"https://doi.org/10.1177/17504589251318121","url":null,"abstract":"<p><p>Persistent hiccups in the perioperative setting, although uncommon, can substantially impact a patient's wellbeing and recovery after surgery. We present a case of a 51-year-old male who developed persistent hiccups during total knee replacement surgery under neuraxial anaesthesia. The hiccups persisted postoperatively, leading to multidisciplinary interventions, including the introduction of central-acting muscle relaxant, baclofen. This case highlights the complexity of managing persistent hiccups in the perioperative period, where both aetiology and treatment are multifactorial, emphasising the need for further research in this field.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251318121"},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383466","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":"Risk factors for urinary septic shock following ureteroscopy for stone disease.","authors":"Ameer Nsair, Michael Mullerad, Oleg Goldin, Gilad E Amiel, Michael Reumi, Kamil Malshy, Azik Hoffman","doi":"10.1177/17504589251318120","DOIUrl":"https://doi.org/10.1177/17504589251318120","url":null,"abstract":"<p><strong>Objective: </strong>We aimed to identify risk factors associated with urinary septic shock following ureteroscopy.</p><p><strong>Methods: </strong>A retrospective review was conducted on patients who underwent ureteroscopy between 2010 and 2021. Data collected included demographics and preoperative variables. Septic shock was defined as the need for vasopressors for sepsis. A comparison was made between patients who developed septic shock and a randomly selected control group (N = 115). Multivariate logistic regression was used to identify independent risk factors.</p><p><strong>Results: </strong>Of 5000 ureteroscopy procedures, 20 cases of septic shock were identified. These patients were older, had a higher median body mass index, more hypertension, higher preoperative urinary drainage, longer drainage duration and positive preoperative urine cultures. On multivariate analysis, age over 55 years, body mass index above 26 and positive preoperative urine culture were significant predictors of septic shock.</p><p><strong>Conclusion: </strong>Consistent with findings reported in previous studies, older age, higher body mass index and positive preoperative urine cultures are key risk factors for postureteroscopy septic shock. Enhanced safety measures are essential for high-risk patients.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589251318120"},"PeriodicalIF":1.2,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383469","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":"Pulmonary embolism following bilateral quadriceps tendon repair with unilateral tourniquet use: A case report.","authors":"Francis X Cedeño-Rodriguez, Hans W Hess Arcelay, José I Acosta Julbe, Emil Varas-Rodríguez, Jerry Cruz, Francisco Otero, Kenneth Cintron, Julian Girod","doi":"10.1177/17504589241305299","DOIUrl":"https://doi.org/10.1177/17504589241305299","url":null,"abstract":"<p><strong>Case: </strong>An active healthy 68-year-old male sustained a bilateral quadriceps tendon rupture while running. He underwent a simultaneous bilateral quadriceps tendon repair in a dual-surgeon approach. The right quadriceps tendon was repaired with a tourniquet, while the left quadriceps tendon tear was repaired without one. Postoperatively, the patient developed deep vein thrombosis in the right leg, which led to a bilateral pulmonary embolism. This case illustrates a potential complication of tourniquet use in patients undergoing quadriceps tendon repairs.</p><p><strong>Conclusion: </strong>The use of tourniquets in orthopaedic surgeries may be associated with potential risks, such as development of venous thromboembolism including deep vein thrombosis and pulmonary embolism. This case highlights the importance of carefully considering tourniquet use for quadriceps tendon repairs and close postoperative monitoring, early mobility, and thromboprophylaxis to prevent severe complications.</p>","PeriodicalId":35481,"journal":{"name":"Journal of perioperative practice","volume":" ","pages":"17504589241305299"},"PeriodicalIF":1.2,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053706","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}