Journal of Perianesthesia Nursing最新文献

{"title":"Development of a Preoperative Screening Tool to Reduce Morbidity and Mortality of COVID-19-positive Hepatobiliary Patients","authors":"Lihui Li RN ,&nbsp;Honghui Zhang MSc ,&nbsp;Ting Dai RN ,&nbsp;Dan Liu RN ,&nbsp;Shan Xiao MSc ,&nbsp;Yuting Xiao MSc ,&nbsp;Ling Huang MSc","doi":"10.1016/j.jopan.2024.03.024","DOIUrl":"10.1016/j.jopan.2024.03.024","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to create a preoperative risk assessment form for COVID-19-positive hepatobiliary patients to guide further prevention of complications after surgery and reduce morbidity and mortality.</div></div><div><h3>Design</h3><div>Based on the literature, focus groups, and case studies, a multidisciplinary panel of 15 experts conducted three rounds of a Delphi study that resulted in the development of a preoperative risk assessment form to be used by healthcare professionals in the treatment of COVID-19-positive hepatobiliary patients.</div></div><div><h3>Methods</h3><div>A preoperative risk assessment form for health professionals to use among COVID-19-positive hepatobiliary patients was developed based on literature, focus groups, and case studies. A 3-round Delphi study was conducted to validate and revise the risk assessment form using a multidisciplinary panel of 15 experts involved in hepatobiliary surgery.</div></div><div><h3>Findings</h3><div>The experts demonstrated high cooperation and familiarity with the research topic, with positive coefficients ranging from 93.33% to 100% and authority coefficients ranging from 0.83 to 0.86. The coordination coefficients were 0.33, 0.26, and 0.22, respectively, indicating good coordination among expert opinions. The final risk assessment form included 9 primary (first-level) indicators, 38 secondary (second-level) indicators, and 122 tertiary (third-level) indicators.</div></div><div><h3>Conclusions</h3><div>The preoperative risk assessment form for hepatobiliary surgery patients infected with COVID-19 is scientifically rigorous, reliable, and valid. This screening tool may be used by health providers to identify high-risk patients, prevent postoperative complications, and reduce morbidity and mortality.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 120-125.e2"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604360","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 and Safety of Adding Ketamine to Lidocaine in Intravenous Regional Anesthesia: A Meta-analysis of Randomized Controlled Trials","authors":"Jun Du MSc,&nbsp;Chan Li MSc,&nbsp;Wenwen Zhang MSc,&nbsp;Xing Lu MSc,&nbsp;Yanfei Xia MSc,&nbsp;Xiarong Qin BSc","doi":"10.1016/j.jopan.2024.03.013","DOIUrl":"10.1016/j.jopan.2024.03.013","url":null,"abstract":"<div><h3>Purpose</h3><div>To systematically evaluate the efficacy and safety of adding ketamine (K) to lidocaine (L) for intravenous regional anesthesia (IVRA).</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search of the Cochrane library, Embase, PubMed, Web of Science, and ProQuest databases, and the Google Scholar search engine was conducted from inception to March 2023. All retrieved articles were imported into Endnote X20 software and independently screened by two researchers according to predetermined inclusion and exclusion criteria. The data were analyzed using Revman 5.4 software and the assessed outcomes included the time of sensory and motor block onset, time of sensory and motor block recovery, fentanyl consumption, time of tourniquet pain onset, intraoperative and postoperative visual analog scale scores, and complications.</div></div><div><h3>Findings</h3><div>A total of 532 patients from 11 randomized controlled trials were included in the meta-analysis. The results showed that the time of sensory (<em>P</em> &lt; .00001) and motor block onset (<em>P</em> &lt; .00001) were shorter in the L + K group than in the L-only group. The time of sensory (<em>P</em> = .01) and motor block recovery (<em>P</em> = .006) and time of tourniquet pain onset (<em>P</em> &lt; .00001) were longer in the L + K group than in the L-only group. There was a significant reduction in fentanyl consumption (<em>P</em> = .0002) in the L + K group compared to the L-only group. Moreover, the visual analog scale scores in the L + K group were significantly lower than the L-only group 10 minutes (<em>P</em> = .04), 20 minutes (<em>P</em> = .0004), 30 minutes (<em>P</em> &lt; .00001), and 40 minutes (<em>P</em> &lt; .0001) after tourniquet inflation, and 5 minutes (<em>P</em> &lt; .00001), 15 minutes (<em>P</em> = .04), 30 minutes (<em>P</em> = .008), 1 hour (<em>P</em> = .002), 2 hours (<em>P</em> &lt; .00001), and 4 hours (<em>P</em> &lt; .00001) after tourniquet deflation. There was no evidence that the use of K as an adjuvant in IVRA increased adverse effects.</div></div><div><h3>Conclusions</h3><div>The addition of K to L in IVRA shortened the onset time, prolonged the block time, and reduced intraoperative and postoperative pain without increasing complications.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 195-204.e5"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141604361","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":"Medical Adhesive-related Skin Injuries Caused by Eye Taping: A Case Report","authors":"Qing Li BSN, MPH, RN,&nbsp;Ting Liu BSN, RN,&nbsp;Xiaoxu Chen BSN, RN","doi":"10.1016/j.jopan.2024.03.003","DOIUrl":"10.1016/j.jopan.2024.03.003","url":null,"abstract":"<div><div>This case report discusses medical adhesive-related skin injuries (MARSIs) caused by eye taping during an emergency open reduction internal fixation surgery under general anesthesia. The presented case involves a 72-year-old woman with a proximal humeral fracture, where 3M Transpore adhesive tape caused blisters on both eyelids. This tape is an acrylic-based medical adhesive and is commonly used to keep eyelids closed during general anesthesia. MARSIs can largely be prevented through evidence-based clinical guidance. Enhancing awareness of MARSIs among anesthesia providers and perianesthesia nurses is crucial to prevent and manage such injuries effectively.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 10-12"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460152","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":"Implementation of Continuous Capnography Protocol in a Postanesthesia Care Unit for Adult Patients at High-risk of Postoperative Respiratory Depression","authors":"Lorrin N. Gavitt DNP, CRNA ,&nbsp;Denise H. Tola DNP, CRNA, CHSE ,&nbsp;Emily Funk DNP, CRNA ,&nbsp;Nicolette B. Hooge DNP, MBA, CRNA ,&nbsp;Stephanie Pinero DNP, CRNA ,&nbsp;Jennie C. De Gagne PhD, DNP, RN, NPD-BC, CNE, ANEF, FAAN","doi":"10.1016/j.jopan.2024.02.011","DOIUrl":"10.1016/j.jopan.2024.02.011","url":null,"abstract":"<div><h3>Purpose</h3><div>This project aimed to implement a continuous capnography protocol in the postanesthesia care unit (PACU) for postoperative adult patients who are at high risk for respiratory failure.</div></div><div><h3>Design</h3><div>A preintervention and postintervention quality improvement design with retrospective chart reviews evaluated patient demographics (age, weight, body mass index [BMI], perioperative fluid intake and output, use of intraoperative positive-end expiratory pressure), length of surgery, average length of PACU stay, incidence of respiratory events, and adherence to a PACU capnography protocol.</div></div><div><h3>Methods</h3><div>Preimplementation data were collected from retrospective chart reviews over a 3-month period. A continuous capnography protocol was implemented for same-day surgery patients with a BMI of 35 kg/m² or greater and who received general anesthesia. Postimplementation data were collected over 3 months in addition to adherence to the capnography protocol. This was presented using descriptive statistics.</div></div><div><h3>Findings</h3><div>Age, length of surgery, weight, BMI, perioperative fluid intake and output, and use of positive-end expiratory pressure did not impact PACU length of stay. The average PACU length of stay decreased from 76.76 to 71.82 minutes postimplementation but was not statistically significant (<em>P</em> = .470). The incidence of respiratory events was 6% (n = 3). After the implementation of the continuous capnography protocol, adherence to the continuous capnography monitoring was 86% (n = 43).</div></div><div><h3>Conclusions</h3><div>Patients who are at high risk for postoperative respiratory failure may benefit from continuous capnography monitoring in the PACU. Capnography monitoring may decrease PACU length of stay and provide earlier detection of pending respiratory depression or failure than pulse oximetry alone.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 13-17"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141471894","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":"Outcomes of Aromatherapy in Nausea and Vomiting After Total Knee Arthroplasty","authors":"So Won Baek RN ,&nbsp;Jung Ho Noh MD, PhD ,&nbsp;Dongyun Lee MD","doi":"10.1016/j.jopan.2024.03.008","DOIUrl":"10.1016/j.jopan.2024.03.008","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study is to assess the effectiveness of aromatherapy for postoperative nausea and vomiting (PONV) after total knee arthroplasty (TKA) under spinal anesthesia.</div></div><div><h3>Design</h3><div>Prospective randomized four-arm placebo-controlled trials</div></div><div><h3>Methods</h3><div>One hundred and twenty subjects were allocated to each of the four groups based on the application of aromatic oil in subjects manifesting PONV: group 1 (lavender), group 2 (lemon), group 3 (peppermint), and group 4 (normal saline placebo). Aromatherapy was administered to all subjects immediately after surgery. Antiemetics were provided to subjects with significant nausea or vomiting. The severity of nausea and vomiting in subjects post-TKA was evaluated using the Halpin nausea and vomiting scale (HNV). The HNV and the concentration of antiemetic drug use were evaluated. Subjects’ satisfaction with treatment for PONV was evaluated at discharge.</div></div><div><h3>Findings</h3><div>HNV scores did not differ significantly between groups immediately after surgery until the third postoperative day (<em>P</em> &gt; .05). The amount of antiemetic drug used in group 3 was significantly lower among the groups (<em>P</em> = .030). The subject satisfaction scale did not differ significantly among groups (<em>P</em> = .837).</div></div><div><h3>Conclusions</h3><div>Aromatherapy using peppermint oil reduced the amount of antiemetics used to treat PONV after TKA under spinal anesthesia with comparable subject satisfaction. Lavender and lemon oils did not reduce the use of antiemetics after TKA.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 62-68"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789559","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":"Enhancing Postanesthesia Care Unit Management Based on Noise Reduction Strategies Grounded in Comfort Theory","authors":"Lingling Xu BSN, RN,&nbsp;Zhuanyun Zhang BSN, RN,&nbsp;Ping Du BSN, RN","doi":"10.1016/j.jopan.2024.03.020","DOIUrl":"10.1016/j.jopan.2024.03.020","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the management improvement measures and application effects of reducing noise in postanesthesia care unit (PACU) based on Comfort Theory.</div></div><div><h3>Design</h3><div>Randomized controlled clinical trial.</div></div><div><h3>Methods</h3><div>A total of 1,300 patients who underwent general anesthesia or combined nerve block anesthesia and were transferred to the PACU in May and August 2021 were divided into a control group (630 cases) and a study group (670 cases) based on time. The control group received routine PACU management, and management based on Comfort Theory to reduce the noise in the PACU was implemented with the study group, including physiological comfort, psychological and spiritual comfort, social and cultural comfort, and environmental comfort. The overall noise level in PACU, retention time in PACU, incidence of nursing adverse events, and patient satisfaction were compared before and after implementation.</div></div><div><h3>Findings</h3><div>In the observation group, the noise values of the four time periods in the PACU were significantly decreased, the retention time was (59.92 ± 22.0) minutes, the incidence of nursing adverse events and vomiting was 0.1%, and the patient satisfaction was 99.8%, which were significantly better than those in the control group, and the differences were statistically significant (<em>P</em> &lt; .05).</div></div><div><h3>Conclusions</h3><div>The management of noise reduction in PACU based on Comfort Theory can significantly reduce the noise level in PACU, effectively shorten the PACU retention time, reduce the incidence of nursing adverse events, and improve the nursing satisfaction of patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 100-106"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141793861","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":"Enhancing the Preanesthesia Evaluation: Consensus Development of the Cannabis Use and Behaviors Assessment Tool (CUBAT)","authors":"Nadia Sladkey BSN, RN ,&nbsp;Daniel D. King DNP, CRNA, CPPS, CNE ,&nbsp;Lynn J. Reede DNP, MBA, CRNA, FNAP","doi":"10.1016/j.jopan.2024.03.011","DOIUrl":"10.1016/j.jopan.2024.03.011","url":null,"abstract":"<div><h3>Purpose</h3><div>This project aimed to develop an evidence-based preanesthesia cannabis use assessment tool to acquire complete and accurate patient history and develop a best-informed, individualized anesthesia and analgesia care plan.</div></div><div><h3>Design</h3><div>Modified Delphi.</div></div><div><h3>Methods</h3><div>Using an evidence synthesis and multistage, modified Delphi process, eight experts from across the United States developed a consensus-based tool to aid in developing a best-informed, individualized plan for anesthesia and analgesia care.</div></div><div><h3>Findings</h3><div>Two survey rounds integrated informed evidence-based tool revisions. The final tool included instructions for use, a glossary of terms, and seven key assessment items aimed at gathering the most influential information regarding cannabis use.</div></div><div><h3>Conclusions</h3><div>The Cannabis Use and Behaviors Assessment Tool is a first-of-its-kind tool providing an essential framework for preanesthesia cannabis use assessment.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 83-89"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460150","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 Ileus and Nonpharmacological Nursing Interventions for Colorectal Surgery: A Systematic Review","authors":"Hande Nur Arslan RN ,&nbsp;Sevilay Şenol Çelik PhD, RN ,&nbsp;Gamze Bozkul RN","doi":"10.1016/j.jopan.2024.03.012","DOIUrl":"10.1016/j.jopan.2024.03.012","url":null,"abstract":"<div><h3>Purpose</h3><div>This review evaluates nonpharmacological interventions for postoperative ileus (POI) prevention and treatment.</div></div><div><h3>Design</h3><div>We systematically reviewed articles from various databases between January 2012 and February 2023 on POI prevention in colorectal surgery patients, emphasizing nursing interventions.</div></div><div><h3>Methods</h3><div>Inclusion was based on criteria such as language (English or Turkish), date range, and study type. The risk of bias was evaluated using Cochrane's RoB2 tool.</div></div><div><h3>Findings</h3><div>Of the 3,497 articles found, 987 unique articles were considered. After title and abstract reviews, 977 articles were excluded, leaving 52 randomized controlled trials for examination. Common interventions included chewing gum, early hydration, acupuncture, and coffee consumption. Compared to control groups, intervention groups had quicker bowel function return, shorter hospital stays, fewer complications, and enhanced quality of life.</div></div><div><h3>Conclusion</h3><div>Nondrug nursing interventions post colorectal surgery can effectively mitigate POI, optimize bowel function, and boost patient satisfaction, warranting their incorporation into post-surgery care protocols.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 181-194"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141545411","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 Level and Postoperative Pain Outcomes in Total Hip and Knee Replacement Surgery: A Cross-sectional Study","authors":"Ebru Çalışkan MSc, RN ,&nbsp;Nilgün Aksoy PhD, RN","doi":"10.1016/j.jopan.2024.03.010","DOIUrl":"10.1016/j.jopan.2024.03.010","url":null,"abstract":"<div><h3>Purpose</h3><div>Preoperative anxiety is considered a common part of the surgerical experience and can be associated with serious postoperative side effects. This study aims to determine the relationship between preoperative anxiety level and postoperative pain outcomes in patients undergoing total hip replacement (THR) and total knee replacement (TKR).</div></div><div><h3>Design</h3><div>The study used a cross-sectional and correlational research method.</div></div><div><h3>Methods</h3><div>The study was conducted with a total of 104 participants, who underwent 17 THR and 87 TKR, at the Orthopedic Clinic of a state hospital in southern Turkey between June 2021 and June 2022. The State-Trait Anxiety Inventory (STAI) was used to determine preoperative anxiety level, and the Visual Analog Scale (VAS) and the Revised American Pain Society Patient Outcome Questionnaire (APS-POQ-R) were used to assess postoperative pain level.</div></div><div><h3>Findings</h3><div>The mean preoperative STAI-I and STAI-II scores of the participants who underwent THR and TKR were 53.95 ± 10.51 and 44.20 ± 10.55, respectively. There was a moderate positive correlation between STAI-I scores and VAS pain scores at preoperative and postoperative 6th, 12th, 24th, and 36th hours. There was a moderate positive correlation between STAI-I scores and affective subdimension scores, a moderate positive correlation with pain severity and sleep interference and activity interference, and a weak positive correlation between STAI-II scores and pain severity and sleep interference, activity interference and affective. The factors independently affecting the 6th-hour VAS pain score were determined as male gender, THR procedure, and increasing STAI score.</div></div><div><h3>Conclusions</h3><div>We found that high preoperative state anxiety was associated with early postoperative pain outcomes. State anxiety was associated with pain in the 6th postoperative hour. Considering the multidimensional nature of anxiety, further research is recommended to understand the anxiety domain in surgical patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 76-82"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141560109","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":"Dumbing Down Our Residents or Going With the Times?","authors":"Oliver C. Radke MD, PhD, DEAA, MHBA","doi":"10.1016/j.jopan.2024.10.012","DOIUrl":"10.1016/j.jopan.2024.10.012","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"40 1","pages":"Pages 241-242"},"PeriodicalIF":1.6,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143076065","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}