Journal of Perianesthesia Nursing最新文献

{"title":"Differential Utilization of Parental Presence and Premedication for Induction of Anesthesia in Pediatric Patients","authors":"","doi":"10.1016/j.jopan.2023.11.013","DOIUrl":"10.1016/j.jopan.2023.11.013","url":null,"abstract":"<div><h3>Purpose</h3><p>Known disparities exist in pain treatment between African American, Latino, and White children. A recent study described ‘adultification’ of Black children, with Black children being less likely to have a parent present at induction of anesthesia<span><span> and less likely to receive an anxiolytic premedication before proceeding to the operating room. The aim of this study is to identify differences based on race and socioeconomic status when treating children and their families for </span>anesthetic induction. We hypothesize that differences exist such that certain populations are less likely to receive sedative premedication and less likely to have parents present at induction of anesthesia.</span></p></div><div><h3>Design</h3><p>This was a retrospective cohort study.</p></div><div><h3>Methods</h3><p>Demographic data were obtained along with type of surgical procedure, type of anesthesia induction, use of premedication, and involvement of child life services (including the plan for parental presence at induction) for all pediatric patients presenting for anesthetics from February 2019 to March 2020. Statistical analysis consisted of fitting logistic mixed effects models for caregiver presence or for midazolam use during induction, with fixed effects for sex, race, ethnicity, language, public/private insurance, and anesthetic risk, and with the provider as a random effect.</p></div><div><h3>Findings</h3><p>A total of 7,753 patients were included in our statistical analyses, and parental presence focused on 4,102 patients with documentation from child life specialists. Females were less likely than males to have parents present at induction (odds ratio [OR] 0.77, confidence interval [CI] [0.67, 0.89]). When looking at race, American Indian/Alaskan Native patients (OR 0.23 [CI 0.093, 0.47]) and Black/African American patients OR 0.64 [CI 0.47, 0.89]) were less likely to have a parent present induction than White patients. Patients with private insurance were more likely to have parents present than patients with public insurance (OR 0.63 CI [0.5, 0.78]). These findings held true in age-separated sensitivity analysis. Asian patients were less likely to receive midazolam premedication (OR 0.65 CI [0.49, 0.86]).</p></div><div><h3>Conclusions</h3><p>This study supports previous work showing differential use of parental presence at induction based on race. Additionally, it also shows different treatment based on sex and public insurance status, a surrogate for socioeconomic status.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742441","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":"Using a Cognitive Aid to Improve Confidence in Counseling Regarding Current Anesthesia-Related Breastfeeding Recommendations","authors":"","doi":"10.1016/j.jopan.2023.11.008","DOIUrl":"10.1016/j.jopan.2023.11.008","url":null,"abstract":"<div><h3>Purpose</h3><p>Although most anesthetic drugs are classified as compatible with breastfeeding, literature shows that anesthesia providers routinely advise patients to discard milk when receiving all types of anesthesia. The purpose of this project was to determine if a multimodal educational module and cognitive aid improved student registered nurse anesthetists’ knowledge and confidence to counsel lactating patients on current anesthesia-related recommendations.</p></div><div><h3>Design</h3><p>This project used a pre-experimental one-group, pretest and post-test design.</p></div><div><h3>Methods</h3><p>Preintervention and postintervention surveys measured knowledge and confidence to counsel lactating patients scheduled to receive anesthesia.</p></div><div><h3>Findings</h3><p>Significant improvement in knowledge and confidence after the intervention were noted.</p></div><div><h3>Conclusions</h3><p>A multimodal educational session and cognitive aid improved student registered nurse anesthetists’ knowledge about current anesthesia-related breastfeeding recommendations and their confidence in counseling these patients. Wider use of this educational module with the cognitive aid has the potential to positively impact breastfeeding patients and their children.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1089947223010523/pdfft?md5=d0429d6e60bb8c16c88771b3530b4859&pid=1-s2.0-S1089947223010523-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140013473","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":"Efficacy of Dexamethasone in Reducing Pain and Inflammation and Accelerating Total Hip Arthroplasty Postoperative Recovery: A Randomized Controlled Trial","authors":"","doi":"10.1016/j.jopan.2023.10.022","DOIUrl":"10.1016/j.jopan.2023.10.022","url":null,"abstract":"<div><h3>Purpose</h3><p>To evaluate the efficacy of dexamethasone in reducing pain and accelerating recovery after total hip arthroplasty (THA).</p></div><div><h3>Design</h3><p>A prospective randomized controlled trial.</p></div><div><h3>Methods</h3><p>A total of 98 patients who underwent THA received either low-dose (10 mg) dexamethasone (dexa group) or isotonic saline (placebo group). C-reactive protein and interleukin-6 levels were recorded at 24, 48, and 72 hours after surgery. Pain visual analog scale (VAS) score at rest and walking, the incidence of postoperative nausea and vomiting (PONV), nausea VAS score, postoperative identity-consequence fatigue scale rating, antiemetic use, postoperative length of stay (PLOS), and complications were also recorded and compared.</p></div><div><h3>Findings</h3><p>Inflammatory marker (C-reactive protein and interleukin-6) levels at 24, 48, and 72 hours postoperatively in the dexa group were lower than that in the placebo group (<em>P</em> &lt; .05). After 24 hours of rest, the dynamic pain VAS scores in the dexa group were lower than those in the placebo group (<em>P</em> &lt; .05). The incidence of PONV, nausea VAS score, and identity-consequence fatigue scale score in the dexa group were lower than those in the placebo group (<em>P</em> &lt; .05), and the dosages of analgesics and antiemetics were also lower (<em>P</em> &lt; .05). In addition, PLOS in the dexa group was shorter than that in the placebo group (<em>P</em> &lt; .05). No significant difference in perioperative complications between the two groups was observed (<em>P</em> &gt; .05).</p></div><div><h3>Conclusions</h3><p>Low-dose dexamethasone in the THA perioperative period can effectively reduce inflammatory marker levels, pain, nausea, postoperative fatigue, opioid analgesic use, and shorten PLOS without increasing complications.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1089947223010328/pdfft?md5=ae13f97fdc658a61216b780e02594c93&pid=1-s2.0-S1089947223010328-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139467299","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":"Association Between the Blood Glucose Value at PACU Discharge and Postoperative Hypoglycemia in Nondiabetic Patients With Hyperglycemia After Hysteroscopic Surgery: A Retrospective Cohort Study","authors":"","doi":"10.1016/j.jopan.2023.10.010","DOIUrl":"10.1016/j.jopan.2023.10.010","url":null,"abstract":"<div><h3>Purpose</h3><p>The target glycemic control for nondiabetic patients in the postanesthesia care unit (PACU) after hysteroscopic surgery remains unclear. Our goal is to determine the optimal level of glycemic control by finding the relationship between blood glucose level (BGL) leaving the PACU and postoperative hypoglycemia in nondiabetic patients.</p></div><div><h3>Design</h3><p>This retrospective cohort study was conducted at a comprehensive tertiary hospital in Chongqing, China between June 2018 and December 2020.</p></div><div><h3>Methods</h3><p>The target independent and dependent variables were BGL leaving the PACU and postoperative hypoglycemia, respectively. The primary outcome was the incidence of hypoglycemia. Logistic regression was used to explore the association between discharge BGL and hypoglycemia. The optimal glycemic control range was determined by using the receiver operating characteristic (ROC) curve.</p></div><div><h3>Findings</h3><p>Prior to insulin use, BGL in the insulin-using subgroup might be as high as 20 mmol/L. Hypoglycemia was related to the BGL while leaving the PACU (odds ratio (OR) 0.37 [95% confidence interval (CI) 0.22 to 0.65]). The best cut-off value (12.95 mmol/L) was determined by fitting the ROC curve.</p></div><div><h3>Conclusions</h3><p>If severe hyperglycemia develops during hysteroscopic surgery in individuals with 5% glucose as the mediator of uterine distention, the recommendation is to maintain blood glucose above 12.95 mmol/L when treated with insulin.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139459410","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":"Holding Patients and Loved Ones Through the Surgical Journey: The Implementation of a Surgical Nurse Liaison Program","authors":"","doi":"10.1016/j.jopan.2024.06.003","DOIUrl":"10.1016/j.jopan.2024.06.003","url":null,"abstract":"<div><h3>Background Information</h3><p>In 2018, the Perianesthesia and Operating Room Advisory Council and department leaders identified an opportunity surrounding the improvement of patient experience and communication during the perioperative journey. The 2018 Operating Room Gateway Program who presented the Nurse Liaison role as their Residency project inspired this idea. The Surgical Nurse Liaison role was created as a unique leadership opportunity to facilitate bidirectional communication between perioperative staff and patient/support persons.</p></div><div><h3>Objectives of Project</h3><p>The purpose of this role was to promote timely progress information to waiting families/support persons of surgical patients. Part time and full time perioperative RNs (from both Perianesthesia and the Operating Room) were selected based on their excellent verbal communication/listening skills, ability to manage ambiguity, empathy, and passion about the patient/family experience.</p></div><div><h3>Process of Implementation</h3><p>The Surgical Nurse Liaison application period opens in the Fall every year, excluding 2020-2021. Nurses are asked to apply during this period and the selection process is conducted by the current Nurse Liaison cohort. Once selected, the new cohort undergoes a thorough training program, which includes in-services about Patient and Guest Relations, Verbal De-Escalation Techniques, OR and Perianesthesia 101 etiquette, organizational experience standards, and informatics. After the in-service days, the new cohort has several shadow days in the family waiting room with the current nurse liaison staff.</p></div><div><h3>Statement of Successful Practice</h3><p>Since inception, there have been four total nurse liaison cohorts that have undergone training. This has been a tremendous staff and patient/family satisfier, as reflected in pulse surveys, patient/family experience surveys, and staff surveys. Nurses are able to function in the nurse liaison role as part of their required biweekly commitment and act as champions for their fellow staff as patients progress through the perioperative experience. The nurses are able to support the patient and families members in such a unique way, which adds value and meaning to their professional practice.</p></div><div><h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3><p>The Surgical Nurse Liaison role is unique to this entity within the health system. However, there is clear evidence on the benefit of having this role. Our recommendation would be that all perioperative areas should advocate to have someone within the Surgical Nurse Liaison role, as it will have a positive impact on the patient/family/staff experience.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959383","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 Need for Specialized Care in Perioperative Services: A Trauma Informed Care Review","authors":"","doi":"10.1016/j.jopan.2024.06.038","DOIUrl":"10.1016/j.jopan.2024.06.038","url":null,"abstract":"<div><h3>Background Information</h3><p>Patient care is more complex and nurses need to look at more than just the physical needs of a patient. Patients with mental illnesses and or previous trauma require compassion and empathy as they navigate healthcare. Trauma Informed Care (TIC) is an approach to meet the needs of the patient.</p><p>In Perioperative Services, our time with patients is limited in the pre-, intra,- and postoperative areas. The patients that we serve have complicated medical histories, however we often focus on the history that will affect a patient's procedure. We must find a way to understand the entire patient to help ensure we are providing individualized care that addresses their physical and psychological needs. Past trauma and mental illness can induce stress which can affect a patient’s psychological well-being preoperatively and postoperatively. More negative effects could occur for the patient if nurses do not understand how to manage these patients.</p></div><div><h3>Objectives of Project</h3><p>To create awareness of this need throughout the department.</p></div><div><h3>Process of Implementation</h3><p>A literature review was completed and information was reviewed by the team. After completing the literature review with key-words such as: anxiety, trauma informed care, surgery; it was found that there is not a lot of research on trauma informed care of the surgical patient.</p></div><div><h3>Statement of Successful Practice</h3><p>The information was accepted to the OSUWMC Nursing Excellence Fair and presented to the attendees. The fair was held on September 19, at the Richard M. Ross Heart Hospital Auditorium as well as on October 3, at the Wallace Auditorium at East Hospital for over 400 attendees to review and learn from.</p></div><div><h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3><p>More research must be completed to help surgical patients, who have endured trauma, feel like they are treated equally in the Perioperative setting. All staff members in Perioperative Services should be trained in TIC on a regular basis, to provide therapeutic communication and individualized care for each procedural patient. A specific TIC screening process should be developed for the department. It is recommended that patients undergoing procedures should be given the opportunity to be screened and disclose information about trauma several times throughout their surgical journey so that all clinicians caring for them are aware.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959397","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":"Malignant Hyperthermia Simulation","authors":"","doi":"10.1016/j.jopan.2024.06.006","DOIUrl":"10.1016/j.jopan.2024.06.006","url":null,"abstract":"<div><h3>Background Information</h3><p>Malignant Hyperthermia (MH) is a rare but high-risk complication of anesthetic drugs. Limited interaction with this emergency situation leads to a potential knowledge deficit for this patient population and clinical skills. Simulations constitutes of a variety of teaching methods and educational strategies to practice emergent situations and decision making skills in a safe learning environment.</p></div><div><h3>Objectives of Project</h3><p>By the end of the simulation scenario, the Registered Nurse will identify patients who may be at risk for MH, recognize agents that may trigger MH, identify clinical symptoms and manifestations of MH, demonstrate knowledge for PACU interventions, mobilize staff and equipment identifying where the MH Box is located and what item it contains, and demonstrate how to reconstitute Ryanodex.</p></div><div><h3>Process of Implementation</h3><p>A MH clinical scenario was developed in collaboration with the Simulation Center. Information was gathered from previous education and current policies and procedures. Two-thirty minute sessions were offered. There were four to five Registered Nurse participants for each session. A pre-brief was conducted on room surveillance and instructions, but did not disclose the simulation topic or scenario. An Anesthesiologist participated as the clinical expert and the Clinical Nurse Education Specialist (CNES) provided the post-simulation debrief.</p><p>During the post-simulation debrief, the CNES collected notes on the discussion and questions that each participant had for follow up. The patient’s situation, assessment findings, scenario objectives, interventions were discussed and reviewed. The scenario and debrief were summarized and presented to other Perianesthesia clinical nurses who were unable to attend.</p></div><div><h3>Statement of Successful Practice</h3><p>During the debrief there were opportunities for self-reflection and questions. In the beginning of the debrief many of the participants expressed they felt flustered, unprepared, and anxious. At the end of the debrief many of the participations felt more engaged, enlightened, and proud of their teamwork during the simulation. Areas of improvements were acknowledged, workflow changes and equipment locations were identified and discussed.</p></div><div><h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3><p>Simulation training provides a realistic-safe environment for clinical nurses to apply their knowledge and enhance their skills. It also serves as an opportunity for nurse leaders to review critical actions, resources, and potential needs to optimize critical and emergent situations.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959387","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":"Certification Campaign: Are You the Next CAPA/CPAN Star?","authors":"","doi":"10.1016/j.jopan.2024.06.023","DOIUrl":"10.1016/j.jopan.2024.06.023","url":null,"abstract":"<div><h3>Background Information</h3><p>Nursing certification stands as a high point of specialized knowledge and expertise. However, barriers, including limited resources, time constraints, inadequate support, and financial hindrances, continuously deter staff from seeking specialty certification leaving to low levels of certification rates.</p></div><div><h3>Objectives of the Project</h3><p>This project aims to promote an understanding among nurses regarding the significance of certification and to increase the specialty certification rates within the perioperative department.</p></div><div><h3>Process of Implementation</h3><p>Employing the Plan-Do-Study-Act (PDSA) Methodology for guidance, the initiative commenced with a rigorous identification of certification-related barriers, which set the stage for developing targeted action plans in 2020. Despite the disruptions caused by the pandemic, the campaign was revitalized in 2021 with significant adaptive strategies. Multi-faceted interventions were deployed to educate staff about specialty certification, clarify its theoretical underpinnings, and highlight organizational resources. Strategically, the implementation encompassed the distribution of flyers, insertion of weekly queries in newsletters, a systematic study plan, availability of specialized review courses, and online references. Moreover, a review book and corresponding blank answer keys were provided. Zoom sessions were judiciously designed, executed, and archived to focus on meticulous question reviews. To alleviate financial barriers, vouchers for the \"take two\" program were made available.</p></div><div><h3>Statement of Successful Practice</h3><p>The campaign's success was evident when two nurses secured certifications on their first attempt in 2021. The APU saw certification rates leap from 0% to over 50% for CAPA. Concurrently, PACU's rates soared from 0% to 85% for CPAN by spring 2023. Certified nurses received accolades in team huddles and staff assemblies. Leadership acknowledged their achievements through congratulatory emails, and commemorative photographs were captured where several achievers were prominently featured on the organization's social media platforms, exemplifying professional success.</p></div><div><h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3><p>Competence is non-negotiable in delivering high-caliber nursing care. Specialty certification, a robust marker of a nurse's competencies and professional commitment, is pivotal. Cultivating an organizational milieu that offers structured avenues for professional development, coupled with formal acknowledgment systems, has significantly increased specialty certification rates, affirming its indispensable role in enhancing the quality of nursing practice.</p></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959393","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, Jakob Hedlund, Karin Blomberg","doi":"10.1016/j.jopan.2024.04.010","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.04.010","url":null,"abstract":"<p><strong>Purpose: </strong>This study explores student nurse anesthetists' (SNAs) learning in the operating room during the coronavirus 2019 pandemic.</p><p><strong>Design: </strong>An explorative design with semistructured interviews was used.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","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":"","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, Aswathy Chackochan, Raiya S Al Bahri, Ramlaa Malallah Abdullah, Manisha Paul, Suman Subbaraya Kandachar, Sanjeev Gopalakrishnan Nair, Anjalika S Weerasinghe, Jayamohan Kulikadavunkal, Umesh Chandra Mohnani","doi":"10.1016/j.jopan.2024.04.004","DOIUrl":"https://doi.org/10.1016/j.jopan.2024.04.004","url":null,"abstract":"<p><strong>Purpose: </strong>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.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Methods: </strong>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.</p><p><strong>Findings: </strong>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%], P = .019), ICU admission (17 [28.3%] vs 27 [64.3%], P < .001), length of stay in ICU (3 [2 to 11.5] vs 18 [7 to 27], P = .001), postoperative length of stay (6 [3 to 10.75] vs 12 [5 to 25.25], P = .016) and pulmonary complication rates (11 [18.3%] vs 18 [42.9%], P = .008) in the symptomatic patients.</p><p><strong>Conclusions: </strong>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.</p>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":null,"pages":null},"PeriodicalIF":1.6,"publicationDate":"2024-08-01","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}