Journal of Perianesthesia Nursing最新文献

{"title":"Effects of Sevoflurane and Propofol During Mechanical Ventilation: A Meta-analysis of Randomized Controlled Trials.","authors":"Peixia Yu, Lijun Bo","doi":"10.1016/j.jopan.2024.12.001","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.12.001","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the inflammatory response, hemodynamic stability, and postoperative recovery of sevoflurane versus propofol after mechanical ventilation during surgery, to provide references for rational anesthesia utility in clinical practice by meta-analysis.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Pubmed, Web of Science, Cochrane Library, Wanfang Data, China National Knowledge Infrastructure, and Chinese BioMedical Literature Database were searched by computer for trials on the anesthetic effects of sevoflurane and propofol after mechanical ventilation during surgery. A random- or fixed-effects model was applied to analyze the clinical indicators and adverse impact based on heterogeneity.</p><p><strong>Findings: </strong>As of April 21, 2023, 912 articles were retrieved, and 36 eligible articles were finally identified after screening, covering 2,691 surgical patients for meta-analysis. The combined results exhibited that the level of tumor necrosis factor (TNF)-α in alveolar lavage was significantly different between the 2 groups (-0.94, 95% confidence interval [CI]: -1.82 to -0.05, P = .038). Compared with sevoflurane, propofol significantly increased TNF-α levels in alveolar lavage. In plasma or serum, propofol significantly increased the levels of interleukin-10 (-0.73, 95% CI: -1.36 to -0.10, P = .023) and TNF-α (-0.65, 95% CI: -1.21 to -0.09, P = .022).</p><p><strong>Conclusions: </strong>At alveolar lavage and serum or plasma levels of inflammatory factors, the proinflammatory factor TNF-α was significantly lower in the sevoflurane group than in the propofol group. This indicates that sevoflurane has a certain role in alleviating local and systemic lung inflammation. However, more randomized controlled studies are warranted in the future to confirm whether there is a difference in hemodynamic stability and postoperative recovery of patients.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of Music Therapy on Preoperative Anxiety in Pediatric Patients Undergoing Anesthesia: A Systematic Review and Meta-analysis.","authors":"Haowen Li, Menghua Cheng, Shuying Jiang","doi":"10.1016/j.jopan.2024.11.016","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.11.016","url":null,"abstract":"<p><strong>Purpose: </strong>Preoperative anxiety remains a critical concern in pediatric anesthesia, often worsening surgical outcomes and complicating postoperative recovery. This systematic review and meta-analysis aimed to evaluate whether music therapy, as a nonpharmacological intervention, effectively reduces preoperative anxiety in children undergoing anesthesia.</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Studies examining the impact of music therapy on preoperative anxiety in pediatric patients were systematically identified, screened, and selected for inclusion. Data from eligible studies were synthesized using a random-effects model to assess the pooled effect size, with sensitivity analyses performed to verify result stability. Publication bias across the included studies was also investigated to ensure reliability of the findings.</p><p><strong>Findings: </strong>The analysis included 7 studies comprising a total of 440 pediatric participants. Findings indicated that music therapy led to a statistically significant reduction in anxiety levels, yielding a moderate effect size (standardized mean difference = -0.48; 95% confidence interval, -0.81 to -0.15; I² = 65.6%). Sensitivity analyses demonstrated consistent results, as the removal of individual studies did not significantly alter the overall effect estimate. Additionally, no substantial publication bias was detected, supporting the validity of the meta-analysis.</p><p><strong>Conclusions: </strong>The findings strongly endorse music therapy as an effective nonpharmacological strategy for managing preoperative anxiety in pediatric patients undergoing anesthesia. With a statistically significant moderate reduction in anxiety observed, music therapy emerges as a valuable tool for improving the perioperative experience and potentially enhancing recovery outcomes in pediatric surgical care.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Relationship Between Preoperative Anxiety Levels of Patients Undergoing Total Knee Arthroplasty and Postoperative Recovery.","authors":"Sevim Çelik, Rümeysa Birkanim, Sibel Altintaş, Elif Karahan","doi":"10.1016/j.jopan.2024.12.004","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.12.004","url":null,"abstract":"<p><strong>Purpose: </strong>Surgical interventions are significant factors that cause anxiety in individuals. This study aimed to determine the effect of preoperative anxiety on postoperative recovery in patients undergoing total knee arthroplasty.</p><p><strong>Design: </strong>A cross-sectional and correlational study.</p><p><strong>Methods: </strong>This study was conducted between February 2023 and September 2023 with 204 patients scheduled for total knee arthroplasty. Data were collected through face-to-face interviews using the Patient Information Form, Surgical Anxiety Questionnaire for Adult Patients, and Postoperative Recovery Index (PRI).</p><p><strong>Findings: </strong>The Surgical Anxiety Questionnaire for Adult Patients' mean score was 31.38 ± 13.91 and the PRI total score was 2.98 ± 0.76. The subscale showed that the highest scores were 12.14 ± 4.97 for health-related anxiety. The anxiety scores concerning recovery, surgical procedures, and invasive procedures were lower. Patients experienced moderate difficulty in the recovery of intestinal symptoms (2.55 ± 0.98) and psychological symptoms (2.43 ± 0.88), significant difficulty in the recovery of desire-wish symptoms (>2.5), and extreme difficulty in the recovery of physical symptoms (3.87 ± 0.81). A positive and statistically significant relationship was found between surgical anxiety levels and postoperative recovery index mean scores (P < .001).</p><p><strong>Conclusions: </strong>The study showed that preoperative surgical anxiety negatively impacts postoperative recovery. Identifying preoperative anxiety levels and implementing interventions to reduce or eliminate surgical anxiety will be beneficial in achieving positive outcomes in the postoperative recovery process.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Effects of Early Oral Intake in the Postanesthesia Care Unit on Nausea and Vomiting: A Meta-analysis of Randomized Controlled Trials.","authors":"Mi-Ra Kang, Hyun-Ju Seo, Ji Sung Lee, Yoon-Kyung Jang, Soyeon Lee, Hye-Jin Kim, Seo-Jin Won, Kyungja Kim, Eunyoung Im","doi":"10.1016/j.jopan.2025.01.001","DOIUrl":"https://doi.org/10.1016/j.jopan.2025.01.001","url":null,"abstract":"<p><strong>Purpose: </strong>This systematic review and meta-analysis aimed to investigate whether early oral fluid intake after surgery compared with delayed oral intake causes nausea and vomiting in pediatric patients who underwent general anesthesia in the postanesthesia care unit (PACU).</p><p><strong>Design: </strong>Systematic review and meta-analysis.</p><p><strong>Methods: </strong>Conducted in accordance with the Cochrane Handbook for Systematic Reviews of Interventions (version 6.4), this study searched electronic databases, including Pubmed, CINAHL, Embase, Cochrane CENTRAL, PubMed, RISS, and KoreaMed up to July 2023. The Risk of Bias 2 tool assessed the risk of bias, and R statistical software facilitated meta-analysis. The certainty of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation approach.</p><p><strong>Findings: </strong>A meta-analysis of 6 randomized controlled trials (RCTs) (2,723 patients) found early oral intake in the PACU decreased vomiting incidence by 36% compared with delayed oral fluid intake (risk ratio = 0.64, 95% confidence interval: 0.42 to 0.97, P = .040, I² = 7%) with moderate certainty of evidence. Another meta-analysis of 3 RCTs (2,185 participants) showed that early oral intake did not increase nausea compared with delayed oral intake (95% confidence interval: -0.76 to 0.07, P = .071, I² = 0%) with low certainty of evidence.</p><p><strong>Conclusions: </strong>Early oral fluid intake in the PACU decreases postoperative vomiting without raising nausea. Health care providers should consider implementing early oral fluid intake in the PACU for enhanced recovery of pediatric patients.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":" ","pages":""},"PeriodicalIF":1.6,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience of Student Nurse Anesthetists’ Learning in the Operating Room During the COVID-19 Pandemic: A Qualitative Interview Study","authors":"Maria Jaensson PhD, RN, RNA ,&nbsp;Jakob Hedlund MSc, RN, RNA ,&nbsp;Karin Blomberg PhD, RN","doi":"10.1016/j.jopan.2024.04.010","DOIUrl":"10.1016/j.jopan.2024.04.010","url":null,"abstract":"<div><h3>Purpose</h3><div>This study explores student nurse anesthetists’ (SNAs) learning in the operating room during the coronavirus 2019 pandemic.</div></div><div><h3>Design</h3><div>An explorative design with semistructured interviews was used.</div></div><div><h3>Methods</h3><div>Thirteen former SNAs and 12 clinical supervisors (8 of whom were included in the final analysis) were recruited from 6 counties in Sweden. Participants were purposively recruited. Inclusion criterion for former SNAs was having completed the nurse anesthesia program in the fall of 2020 to spring 2022; and for nurse anesthetists, those who have experience in supervising SNAs. The interviews were analyzed with thematic analysis.</div></div><div><h3>Findings</h3><div>The analysis identified one theme and five subthemes. The theme was that student learning was in focus despite an ongoing pandemic. Every learning situation contributed, and learning was triggered by the challenges. Both the SNAs and the supervisors exhibited resilience by accepting the situation and striving to do their absolute best in a nonoptimal learning environment. Over time, learning and supervision returned to normal.</div></div><div><h3>Conclusions</h3><div>During the pandemic, learning was ongoing despite stress, fear, and other challenging factors. Students’ learning appears to have been prioritized. The study highlights that nurse anesthetists and SNAs were resilient, resourceful, and able to find new ways to keep learning going.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 294-299"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postoperative Outcomes in Surgical Coronavirus Disease 2019 Patients: A Retrospective Cohort Study","authors":"Harihar V. Hegde MD,&nbsp;Aswathy Chackochan MD,&nbsp;Raiya S. Al Bahri MD,&nbsp;Ramlaa Malallah Abdullah MD,&nbsp;Manisha Paul FCPS,&nbsp;Suman Subbaraya Kandachar MD,&nbsp;Sanjeev Gopalakrishnan Nair MD,&nbsp;Anjalika S. Weerasinghe FWACS,&nbsp;Jayamohan Kulikadavunkal MD,&nbsp;Umesh Chandra Mohnani DA, DNB","doi":"10.1016/j.jopan.2024.04.004","DOIUrl":"10.1016/j.jopan.2024.04.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Patients infected with severe acute respiratory syndrome coronavirus-2 (SARS-COV-2) who require surgical procedures are likely to experience higher postoperative mortality and morbidity. Our objective was to evaluate the perioperative course of patients infected with SARS-COV-2 undergoing surgical procedures. The purpose of this study was to describe the characteristics, outcomes, and the effect of the presence of symptoms.</div></div><div><h3>Design</h3><div>Retrospective cohort.</div></div><div><h3>Methods</h3><div>We analyzed the records of patients with SARS-CoV-2 infection who underwent surgical procedures from March 2020 to March 2021. Patients with ongoing infection at the time of surgery and those who had recently recovered were included. The primary outcome measure was 30-day in-hospital mortality after surgery. Secondary outcomes were intensive care unit (ICU) admission, length of stay in ICU, postoperative length of stay, and complications.</div></div><div><h3>Findings</h3><div>Data from 102 patients were analyzed. Twenty-four patients (23.5%) died postoperatively in the hospital within 30 days. Forty-four patients required ICU admission (average stay 13 days). The median postoperative length of stay was 8 days (interquartile range, 3.75 to 19.25 days). Pulmonary, thromboembolic, and surgical complications were noted in 29 (28.4%), 14 (13.7%), and 18 (17.6%), respectively. Patients aged 41 to 60 years experienced higher rates of pulmonary and thromboembolic complications. Comparison of asymptomatic versus symptomatic patients revealed significantly higher 30-day in-hospital mortality (9 [15%] vs 15 [35.7%], <em>P</em> = .019), ICU admission (17 [28.3%] vs 27 [64.3%], <em>P</em> &lt; .001), length of stay in ICU (3 [2 to 11.5] vs 18 [7 to 27], <em>P</em> = .001), postoperative length of stay (6 [3 to 10.75] vs 12 [5 to 25.25], <em>P</em> = .016) and pulmonary complication rates (11 [18.3%] vs 18 [42.9%], <em>P</em> = .008) in the symptomatic patients.</div></div><div><h3>Conclusions</h3><div>Symptomatic SARS-COV-2 patients undergoing surgical procedures experience significantly higher 30-day in-hospital mortality, ICU admission, longer ICU and hospital stay, and pulmonary complications.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 277-280"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preoperative Oral Carbohydrate-Containing Fluid Versus Plain Water in Elective Cesarean Deliveries: A Randomized Clinical Trial","authors":"Sunil Thakur MD ,&nbsp;Manjit Singh Kanwar MD ,&nbsp;Anurag Sharma MD ,&nbsp;Sushruti Kaushal MS ,&nbsp;Poojan Dogra Marwaha MD ,&nbsp;Nisha Sharma MD ,&nbsp;Ravinder Kumar MD","doi":"10.1016/j.jopan.2024.05.007","DOIUrl":"10.1016/j.jopan.2024.05.007","url":null,"abstract":"<div><h3>Purpose</h3><div>Traditional prolonged fasting regimens have recently been replaced with guidelines to take carbohydrate-rich clear fluids until 2 hours before surgery. With this study, we wanted to study if the addition of carbohydrates to preoperative oral fluids confers any advantage.</div></div><div><h3>Design</h3><div>Randomized clinical trial.</div></div><div><h3>Methods</h3><div>The study was conducted at a single center in North India among singleton pregnancies at term, scheduled for elective cesarean section under subarachnoid block. Participants were randomized into 2 groups of 50 participants each. The “Carbohydrate group” received 400 mL of fluid containing 50 g of glucose, while the “plain water” group received 400 mL of water 2 to 4 hours before surgery. A visual analog scale was used to assess hunger, thirst, anxiety, fatigue, and nausea before surgery. Intraoperative mean arterial pressure, hypotension, nausea, and vomiting were noted. On the first postoperative day, recovery from anesthesia was assessed using the Quality of recovery from anesthesia- 40 (QoR-40) questionnaire. Blood sugar levels were compared on the first postoperative day and in cord blood.</div></div><div><h3>Findings</h3><div>Preoperative visual analog scale scores for hunger, thirst, anxiety, nausea, and fatigue were similar in both groups. The occurrence of hypotension (<em>P</em> = .688) and phenylephrine use (<em>P</em> = .39), recovery from anesthesia (<em>P</em> = .92), cord blood sugar levels (<em>P</em> = .24), and postoperative blood sugar levels were also not significantly different in both groups (<em>P</em> = .81).</div></div><div><h3>Conclusion</h3><div>This study did not find any significant advantage of preoperative carbohydrate-containing fluid over preoperative plain water in women undergoing elective cesarean delivery under Subarachnoid block.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 326-330"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk Factors Related to Postoperative Dizziness Among Patients Who Underwent General Anesthesia and Intraoperative Analgesics: A Prospective Cohort Study","authors":"Yen-Fan Chin PhD, RN ,&nbsp;Wei-Lin Wang MS, RNA ,&nbsp;Hsing-Yi Yu PhD, RN","doi":"10.1016/j.jopan.2024.05.015","DOIUrl":"10.1016/j.jopan.2024.05.015","url":null,"abstract":"<div><h3>Purpose</h3><div>To describe postoperative dizziness for patients who received analgesics during general anesthesia and to investigate the factors related to the trend of dizziness within 3 days after surgery.</div></div><div><h3>Design</h3><div>A prospective cohort study.</div></div><div><h3>Methods</h3><div>This is a longitudinal study. The severity of dizziness was assessed from the day of the surgery until the third day post surgery. Generalized estimation equation models were created to determine the predictive effect of each independent variable separately.</div></div><div><h3>Findings</h3><div>After surgery, the incidence of dizziness was 42.1%. Approximately 10% of participants experienced severe dizziness. Participants with postoperative nausea and vomiting were more likely to experience postoperative dizziness. In addition, age, education level, history of motion sickness, surgical specialties, laparoscopic surgery, and long-acting analgesic use had an impact on the trend of postoperative dizziness. More than 25% of participants who used long-acting analgesics experienced dizziness on the third postoperative day.</div></div><div><h3>Conclusions</h3><div>Postoperative dizziness was common among participants who received analgesics during general anesthesia. Monitoring for postoperative dizziness may need to be prolonged, especially in patients taking long-acting analgesics. For patients at high risk for postoperative dizziness, preventive measures such as adjusting analgesic and anesthetic medications may be necessary.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 365-370"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142005618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Use of Prophylactic Ketamine to Mitigate Postoperative Depressive Symptoms: A Systematic Review","authors":"Eleanor Yip BSN, MSN, AGACNP-BC,&nbsp;Desiree Fleck PhD, CRNP","doi":"10.1016/j.jopan.2024.05.026","DOIUrl":"10.1016/j.jopan.2024.05.026","url":null,"abstract":"<div><h3>Purpose</h3><div>Depression is predicted to be the leading burden of disease worldwide by 2030 with a prevalence of 10% to 60% in the surgical population. Depressive symptoms in the perioperative population are associated with a myriad of grave complications, including higher morbidity and mortality. This systematic review aims to determine whether a single dose of intravenous ketamine can be used prophylactically as a routine resilience-enhancing agent in all high-risk adult patients undergoing surgery to mitigate depressive symptoms postoperatively by appraising evidence of existing literature.</div></div><div><h3>Design</h3><div>An evidence-based systematic review.</div></div><div><h3>Methods</h3><div>The databases PubMed, CINAHL, and Scopus were searched, adhering to the Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines. Search and Medical Subject Headings (MeSH) terms used: “ketamine,” “surgical procedures,” “surgical,” “surgery,” “depression,” and “depressive disorder.”</div></div><div><h3>Findings</h3><div>In 9 randomized controlled trials (RCTs), bolus ketamine doses of 0.1 mg/kg to 1 mg/kg were administered intraoperatively or in the postanesthesia care unit. The primary outcome was the subjective feelings of depression as evaluated by different validated depression screening tools and seven RCTs observed statistically significant findings between the control and intervention (ketamine) groups with postoperative depression scores. Two RCTs did not find a significant change in depression scores.</div></div><div><h3>Conclusions</h3><div>Research on the use of prophylactic ketamine as an antidepressant in the perioperative population offers insight into changing routine practices and can shape how mental health is viewed in hospitals. Further research is warranted on the safety profile of ketamine, and risk stratification with careful consideration of baseline depressive symptoms, timing, and its use across a wider variety of surgical subspecialties.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 440-447"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Comprehensive Intervention Program for Postoperative Delirium Prevention in Elderly Patients Undergoing Cardiac Surgery","authors":"Hanqun Lin BD ,&nbsp;Dongxue Dong BD ,&nbsp;Kaiyan Zheng BD ,&nbsp;Qinhong Xu BD","doi":"10.1016/j.jopan.2024.05.018","DOIUrl":"10.1016/j.jopan.2024.05.018","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the application effect of a comprehensive intervention program for postoperative delirium (POD) prevention.</div></div><div><h3>Design</h3><div>Descriptive and comparative study.</div></div><div><h3>Methods</h3><div>This study included 82 elderly patients who underwent cardiac surgery as the control group to receive routine perioperative care. Seventy seven elderly patients who underwent cardiac surgery were selected as the observation group and received a comprehensive intervention program for POD prevention. This study further compared the length of stay in the hospital, nutritional status, pain score, and sleep quality between the two groups after intervention.</div></div><div><h3>Findings</h3><div>The postoperative length of stay in the hospital of the observation group was shorter than that of the control group (12.60 ± 2.97 vs 17.30 ± 7.10), and the incidence of POD was lower than that of the latter group (24.68% vs 47.56%, <em>X</em>² = 8.976, <em>P</em> = .003). The pain scores of the observation group were lower than those of the control group (<em>F</em> = 195.381, <em>P</em> &lt; .001). There was significant difference that the sleep quality score of the observation group was higher than that of the control group (<em>F</em> = 219.20, <em>P</em> &lt; .001). The levels of albumin and hemoglobin in the observation group were higher than those in the control group (54.38 ± 5.87 vs 38.40 ± 3.11; 124.64 ± 13.18 vs 109.00 ± 10.20). The observation group had shorter mechanical ventilation duration, intensive care unit stay, and lower total hospital expenses compared with the control group (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>The comprehensive intervention program for POD prevention based on evidence-based medicine has a positive effect. In addition, it can also improve patients' pain, sleep quality, and nutritional status.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 371-376"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}