Journal of Perianesthesia Nursing最新文献

{"title":"Comments on: The Effect of Melatonin on Analgesia, Anxiety, and Intraocular Pressure (IOP) in Cataract Surgery Under Topical Anesthesia","authors":"Basudev Pati MBBS, Venkata Ganesh MD, Naveen Naik B MD, Ajay Singh MD","doi":"10.1016/j.jopan.2024.05.014","DOIUrl":"10.1016/j.jopan.2024.05.014","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 249-250"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143746535","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 5-Year Clinical Experience of Pediatric Ophthalmic Ambulatory Surgery Under General Anesthesia From a Chinese Tertiary Children's Hospital","authors":"Zhehuan Zhang MD,&nbsp;Tianchen Wu MBBS,&nbsp;Anken Wang MD,&nbsp;Chenhao Yang MD, PhD","doi":"10.1016/j.jopan.2024.04.011","DOIUrl":"10.1016/j.jopan.2024.04.011","url":null,"abstract":"<div><h3>Purpose</h3><div>Ambulatory surgery (same-day or day surgery) is an efficient medical practice. However, there were few reports regarding the safety of ophthalmic ambulatory surgery for children under general anesthesia. This study aims to explore its clinical complications.</div></div><div><h3>Design</h3><div>A retrospective observational study.</div></div><div><h3>Methods</h3><div>The clinical data of pediatric patients who received ambulatory ophthalmic surgery under general anesthesia at the Children’s Hospital of Fudan University from January 2015 to December 2019 were analyzed retrospectively. Postoperative complications, unplanned reoperation, delayed discharge, and other adverse events were analyzed.</div></div><div><h3>Findings</h3><div>Consecutive patients (N = 4,616) had an average age of 4.6 ± 2.6 years. The primary surgical procedures included chalazion incision and curettage (62.89%), strabismus surgery (18.98%), trichiasis surgery (14.36%), eyelid or orbital mass resection (2.49%), blepharoptosis surgery (0.91%), and other procedures (0.37%). The average operative time was 25.28 ± 20.45 minutes (n = 2,698), while the average length of hospital stay was 8.45 ± 2.61 hours. No serious adverse events or death happened. One case had delayed postoperative hemorrhage, one had a postoperative infection, and two had delayed discharge. The rate of unplanned reoperation was 0.39% 90 days after surgery, with recurrence of chalazion and postoperative complications of ptosis as the primary reasons.</div></div><div><h3>Conclusions</h3><div>Pediatric ophthalmic ambulatory surgery under general anesthesia is a feasible and efficient operation mode with few complications for simple procedures with good general conditions. Further randomized controlled studies are needed to provide strong evidence of the safety and socioeconomic efficacy of this mode.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 300-304"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903352","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":"Perioperative Staff’s Experiences of Premedication for Children","authors":"Åsa Bromfalk CRNA ,&nbsp;Magnus Hultin PhD, MD ,&nbsp;Jakob Walldén PhD, MD ,&nbsp;Tomi Myrberg PhD, MD ,&nbsp;Åsa Engström PhD, CCRN","doi":"10.1016/j.jopan.2024.05.005","DOIUrl":"10.1016/j.jopan.2024.05.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Providing perioperative care for children who express anxiety or react with negative anxiety-associated consequences can be a challenge. The use of premedication is established as an important intervention for young children before surgery, yet research into care providers’ experiences of premedication is limited. The aim of this study was to explore perioperative staff’s experiences of premedication for preschool-age children.</div></div><div><h3>Design</h3><div>A descriptive inductive qualitative study was performed based on focus group discussions.</div></div><div><h3>Methods</h3><div>A purposive sample of a team from the operating department with experience in anesthetizing and caring for children in the perioperative period was interviewed in small focus groups: five preoperative and postoperative care nurses, five nurse anesthetists, and five anesthesiologists. The transcribed text was categorized using qualitative content analysis.</div></div><div><h3>Findings</h3><div>The content analysis revealed three themes: a matter of time, do not wake the sleeping bear, and on responsive tiptoes.</div></div><div><h3>Conclusions</h3><div>Care providers must adapt their work to the child’s emotional state of mind and needs, allowing time for the child to trust and accept the premedication and for the premedication to reach its peak effect. Premedication provides light sleep preoperatively, which requires careful treatment of the child to avoid emotional reactions, and the postoperative path is most peaceful when the premedication supports a long duration of sedation. Our findings highlight the need for safety precautions and a permissive and flexible organization with the goal of achieving a smooth and safe journey for the child in the perioperative path.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 310-317"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789560","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":"Improvement of Perioperative Efficiency via Pediatric Preanesthesia Respiratory Risk Training","authors":"Jamie L. Reddinger DNP, CPNP – AC/PC, CSN,&nbsp;Jennifer Dickman DNP, RN, CPN,&nbsp;Slava Martyn MD","doi":"10.1016/j.jopan.2024.04.001","DOIUrl":"10.1016/j.jopan.2024.04.001","url":null,"abstract":"<div><h3>Purpose</h3><div>This process improvement to the registered nurse (RN) preanesthesia telephone call interview applied an evidence-based bundle of interventions to improve perioperative efficiency. The overarching aim was to decrease RN subjectivity regarding pediatric upper respiratory tract infection (URI) symptoms during the preoperative telephone call family outreach interview to allow for early identification of respiratory illness that could lead to a day of surgery (DOS) cancellation.</div></div><div><h3>Design</h3><div>The design was an evidence-based process improvement with a pretest post-test design.</div></div><div><h3>Methods</h3><div>An E-learning module, on pediatric preanesthesia respiratory risk training, was delivered to the RN telephone call staff. An anesthesiology-created pediatric URI algorithm with use of the Current signs and symptoms, Onset, Lung disease, airway Device, Surgery (COLDS) score, a preanesthetic risk score for children with URI symptoms, were used to trigger consultation with anesthesiology for URI symptoms. Anesthesiology consultation cards following situation-background-assessment-recommendation were used to streamline consultation with an anesthesiology attending physician. Predata were obtained from the Quality Report Card on patient illness cancellations made both on the preoperative telephone call and DOS from the previous 24 months. A plan-do-study-act cycle was completed over 10 weeks.</div></div><div><h3>Findings</h3><div>RNs' confidence in their ability to recognize the need for anesthesiology consultation was 92% after completion of the E-learning module. The rate of DOS cancellations for patient illness decreased by 10% from 2021 and 7% from 2022. The rate of preoperative telephone call-identified patient illness cancellations increased by 10% from 2021 and 7% from 2022. Decreasing DOS cancellations by early identification of illness on the preoperative telephone call is preferred to avoid loss of operating room time, patient and family dissatisfaction with a DOS cancellation, and provide a safer time frame for surgery and anesthesia.</div></div><div><h3>Conclusions</h3><div>RNs’ confidence in anesthesiology consultation protocol was high after completion of the E-learning module. The process improvement to the RN workflow resulted in improved perioperative efficiency as evidenced by comparison of pretest post-test data indicating a reduction in DOS patient illness cancellations and an increase in preoperative telephone call patient illness cancellations.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 254-259"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141876458","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":"The Study of Remazolam Combined With Propofol on Painless Gastroscopy: A Randomized Controlled Trial","authors":"Xiaohong Wu MM ,&nbsp;Yali Chen MS ,&nbsp;Tuo Luo MM ,&nbsp;Yusong Liu MS ,&nbsp;Lin Zeng MM","doi":"10.1016/j.jopan.2024.04.006","DOIUrl":"10.1016/j.jopan.2024.04.006","url":null,"abstract":"<div><h3>Purpose</h3><div>Gastroscopy is one of the most commonly used diagnostic modalities for upper gastrointestinal disorders. Remazolam besylate, a new type of ultrashort-acting benzodiazepine drug, has been less studied in gastroscopy. In this study, we studied the efficacy and safety of remazolam combined with propofol for painless gastroscopy.</div></div><div><h3>Design</h3><div>This was a single-center, placebo-controlled randomized trial.</div></div><div><h3>Methods</h3><div>One hundred patients undergoing painless gastroscopy were included in this study and randomly divided into 2 groups (n = 50 per group): the control group (Con group) and the remazolam group (Rem group). Sufentanil, remazolam, and propofol were used to anesthetize the patients, and then, the effects of different solutions on these patients were compared and analyzed. The patient's general condition, vital signs at different times, the dosage of propofol (mg) and additional times, complications, duration of gastroscopy (minutes), recovery time (minutes), length of stay in the recovery room (minutes), and adverse reactions were recorded.</div></div><div><h3>Findings</h3><div>Rem group systolic blood pressure was more stable (<em>P</em> &lt; .05). The amount of additional propofol in Rem group was less (<em>P</em> &lt; .05). The incidence of hypotension, bradycardia, and dizziness was lower in Rem group, as well as the time of awakening and stay in the recovery room were shorter (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>Remazolam combined with sufentanil and propofol has less effect on hemodynamics in painless gastroscopy, and the patients have shorter awakening times.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 281-287"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890647","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 Emergency Agitation in Adults in the Postanesthesia Care Unit After General Anesthesia Is a Critical Concern That Demands Attention","authors":"Ulrica Nilsson PhD, RNA, FAAN","doi":"10.1016/j.jopan.2025.01.007","DOIUrl":"10.1016/j.jopan.2025.01.007","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 461-462"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143748350","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":"Global Research Trends in Postoperative Delirium and Its Risk Factors: A Bibliometric and Visual Analysis","authors":"Xing Liu MS, RN ,&nbsp;Zhao Huangfu MS, MD ,&nbsp;Xiao Zhang MS, MD ,&nbsp;Taohong Ma RN","doi":"10.1016/j.jopan.2024.04.002","DOIUrl":"10.1016/j.jopan.2024.04.002","url":null,"abstract":"<div><h3>Purpose</h3><div>Postoperative delirium (POD) is one of the most frequent complications after surgery which is closely associated with many adverse outcomes, including high mortality and low quality of life. This study aims to carry out a bibliometric analysis of POD and its risk factors from 2012 to 2022 to reveal the research status and hot spots.</div></div><div><h3>Design</h3><div>This study is a bibliometric and visualized analysis.</div></div><div><h3>Methods</h3><div>Relevant publications between 2012 and 2022 were extracted from the Web of Science Core Collection database. CiteSpace software (v6.1. R2, Drexel University), VOSviewer software (v1.6.18, Leiden University), and the Online Analysis Platform of Literature Metrology were used to analyze research attributes. These publications were used to analyze research attributes, including countries, journals, institutions, authors, keywords, and burst detection, to predict trends and hot spots.</div></div><div><h3>Findings</h3><div>We included a total of 1,324 related documents from 2012 to 2022. The literature on POD has increased significantly since 2016. The United States and Harvard University were the leading literature publishing country (436/1324, 32.9%) and institution (112/1324, 8.5%). <em>Anesthesia and Analgesia</em> was the most frequently published journal. Keywords analysis with VOSviewer revealed that the keywords could be divided into five clusters, including anesthesia techniques, cardiac surgery, risk factors, intraoperative anesthesia monitoring, and postoperative cognitive dysfunction. We included a total of 198 POD risk factors documents, and the literature on POD risk factors increased. The People’s Republic of China and Harvard University were the leading literature publishing country (53/198, 26.8%) and institution (12/198, 6.1%). Elderly, hip surgery, frailty, postoperative pain, cardiac surgery, dementia, and depression are keywords that are risk factors for POD.</div></div><div><h3>Conclusions</h3><div>The number of literature on POD in the field of anesthesia has increased significantly. Risk factors and anesthesia techniques are still key areas of research. Encephalogram, the use of sedatives, and perioperative nursing may be the new research focus. Older adults, hip fractures, cardiac surgery, liver transplants, dementia, and depression are hot words in the field of POD risk factors.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 400-414"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141903327","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":"Perioperative Management of Argininemia in a Child Undergoing Circumcision: A Case Report","authors":"Suki Ismet MD, MMED ,&nbsp;Muhamad Rafiqi Hehsan MBBCh, MMED","doi":"10.1016/j.jopan.2024.05.025","DOIUrl":"10.1016/j.jopan.2024.05.025","url":null,"abstract":"<div><div>Argininemia is a rare autosomal recessive metabolic disorder characterized by a deficiency of arginase, a vital enzyme in the urea cycle. This metabolic defect results in the accumulation of arginine and its metabolites, leading to hyperammonemia and associated neurological symptoms. We present a case detailing the perioperative management of an 11-year-old male child diagnosed with argininemia undergoing circumcision. The perioperative management of patients with argininemia presents unique challenges due to the risk of hyperammonemia and neurological decompensation triggered by physiological stress, fasting, and the catabolic state associated with surgery. This case report highlights the importance of individualized anesthetic strategies for patients with rare metabolic disorders like argininemia. A multidisciplinary approach involving collaboration among anesthesiologists, endocrinologists, dietitians, and surgeons is essential to ensuring a safe perioperative experience for these patients. Further research is essential to refine perioperative protocols and optimal anesthetic interventions for individuals with argininemia undergoing surgical procedures.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 251-253"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113859","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":"Impact of a Modified Protocol for Blood Collection on Hemolysis Rates and Nurses' Perceptions About Improving Their Practice Environment","authors":"Jennifer Stanton Gordon BSN, RN, CPAN ,&nbsp;Erin Niklinski MSN, RN, ONC, CPAN ,&nbsp;Huong Do MA ,&nbsp;Patricia Quinlan PhD, MPA, RN, CPHQ.","doi":"10.1016/j.jopan.2024.05.023","DOIUrl":"10.1016/j.jopan.2024.05.023","url":null,"abstract":"<div><h3>Purpose</h3><div>In 2019, approximately 5% of blood draws in the postanesthesia care unit (PACU) were hemolyzed compared to 1.1% across other hospital units. A preliminary review showed almost 60% of patients sampled blood employing arterial lines in the unit. The purpose of this quality improvement study was to improve blood drawing practices and reduce the occurrence of hemolysis. A secondary aim was for PACU nurses to lead this unit-based initiative.</div></div><div><h3>Design</h3><div>Team members led by PACU nurses used the Deming model of quality improvement as a framework to better the process of specimen collection.</div></div><div><h3>Methods</h3><div>The team employed the Plan-Do-Check-Act procedure to organize their improvement efforts. Specimen collection protocol was modified to include manual aspiration from arterial lines and hemolysis data was retrieved from laboratory generated reports and electronic medical records.</div></div><div><h3>Findings</h3><div>By changing blood drawing practices, the hemolysis rate was significantly reduced from 5.2% to 3.6%. Two years postimplementation, rates continue to decline with the current rate at 1.97%.</div></div><div><h3>Conclusion</h3><div>This nurse-led interdisciplinary improvement initiative identified and trialed evidence-based solutions to reduce blood specimen hemolysis.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 270-276"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142127118","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":"Impact of Prewarming on Maintaining Perioperative Body Temperature: A Randomized Clinical Trial","authors":"Vanessa de Brito Poveda PhD, RN ,&nbsp;Juliana Rizzo Gnatta PhD, RN ,&nbsp;Cassiane de Santana Lemos PhD, RN ,&nbsp;Amy Hagedorn Wonder PhD, RN ,&nbsp;Ariane Souza do Nascimento MSc, RN ,&nbsp;Michele Estevanatto Tose de Godoi RN ,&nbsp;João Francisco Possari RN ,&nbsp;Ulysses Ribeiro Jr PhD, MD","doi":"10.1016/j.jopan.2024.05.011","DOIUrl":"10.1016/j.jopan.2024.05.011","url":null,"abstract":"<div><h3>Purpose</h3><div>To determine the prewarming effect on body temperature in the perioperative period of patients undergoing conventional abdominal surgery and the level of thermal comfort.</div></div><div><h3>Design</h3><div>A randomized controlled clinical trial.</div></div><div><h3>Methods</h3><div>A Brazilian oncology hospital located in São Paulo. A total of 99 patients aged 18 years or over undergoing elective conventional abdominal surgeries, with a minimum duration of 1 hour of anesthesia. The study was carried out from 2019 to 2021. Patients were randomized into 3 groups: prewarming with a blanket and cotton sheet (control; n = 33); prewarming with a forced-air warming system for 20 minutes (intervention 1; n = 33); prewarming with a forced-air warming system for 30 minutes (intervention 2; n = 33). Central temperature was measured by a zero-heat-flux temperature sensor every 20 minutes from the preoperative period until the surgery end time. The level of thermal comfort was determined through self-report during the preanesthetic and postanesthetic periods.</div></div><div><h3>Findings</h3><div>There was a significant difference between the temperatures between the groups (<em>P</em> = .048), with evidence of greater benefit in maintaining the temperature in the group that received the prewarming intervention for 20 minutes. There was no significant difference between the percentage of temperatures below 36 °C among the groups (<em>P</em> = .135). Patients in the intervention groups were more comfortable during the postanesthetic recovery period than those in the control group (<em>P</em> = .048). Only 7 (8.24%) patients had postoperative chills (<em>P</em> = .399) and more than half of these incidents occurred in the control group (4; 13.3%).</div></div><div><h3>Conclusions</h3><div>Prewarming for 20 minutes obtained the best results, showing the lowest average of temperature episodes below 36 °C during the intraoperative period and greater thermal comfort as reported by patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 2","pages":"Pages 343-348"},"PeriodicalIF":1.6,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142299335","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}