Journal of Perianesthesia Nursing最新文献

{"title":"Effect of Transcutaneous Electrical Acupoint Stimulation on Extubation-Related Stress Response in Noncardiac Surgery Patients: A Systematic Review and Meta-Analysis of Randomized Controlled Trials","authors":"Mengchao Jiang MMed ,&nbsp;Bei Wang MD ,&nbsp;Meinv Liu MMed ,&nbsp;Huanhuan Zhang MMed ,&nbsp;Jianli Li MD","doi":"10.1016/j.jopan.2024.01.015","DOIUrl":"10.1016/j.jopan.2024.01.015","url":null,"abstract":"<div><h3>Purpose</h3><div>Stress response is a common complication during extubation, mainly manifested by dramatic hemodynamic fluctuations. Transcutaneous electrical acupoint stimulation (TEAS) is widely applied in the perioperative period. We performed this meta-analysis to evaluate whether the TEAS could relieve the stress response during extubation in noncardiac surgery patients.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis of randomized controlled trials.</div></div><div><h3>Methods</h3><div>We searched six databases (PubMed, Web of Science, Embase, Cochrane Library, China National Knowledge Infrastructure, CNKI, and Wan Fang) for relevant literature. A risk of bias assessment was executed based on the Cochrane Criteria. We applied RevMan5.4.1 software to analyze data. When the χ² test did not show heterogeneity, we adopted the fixed-effect model. Otherwise, the random-effect model was used.</div></div><div><h3>Findings</h3><div>ln total, 12 randomized controlled trials with 1,347 participants were enrolled in this meta-analysis. Meta-analysis showed the heart rate and mean arterial pressure of the intervention group were significantly lower than the control group at immediately, 5 minutes, and 10 minutes after extubation. The occurrence rate of emergency agitation (RR 0.39, 95% CI [0.26,0.60]) and postoperative delirium (RR 0.40, 95% CI [0.22, 0.72] were also lower in the TEAS group. The consumption of propofol (standardized mean difference (SMD) 0.47, 95% CI [−0.77, −0.18]) and remifentanil (SMD 1.49, 95% CI [−2.01, −0.96]) of the intervention group were also significantly reduced compared with the control group.</div></div><div><h3>Conclusions</h3><div>TEAS was beneficial for improving stress response during extubation, emergence agitation, postoperative delirium, and reduced the consumption of intraoperative propofol and remifentanil, but it was necessary to note the limitations of the current evidence.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 990-998"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433113","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":"PONV Management in Adult Patients: Evidence-based Summary","authors":"Yiting Wang MSCN, SN,&nbsp;Jiaqi Shi MSCN, NP,&nbsp;Yanjun Wei MSCN, SN,&nbsp;Jin Wu MD","doi":"10.1016/j.jopan.2024.01.027","DOIUrl":"10.1016/j.jopan.2024.01.027","url":null,"abstract":"<div><h3>Purpose</h3><div>To summarize the evidence on perioperative nausea and vomiting management in adult patients worldwide.</div></div><div><h3>Design</h3><div>This is a summary of the best evidence on postoperative nausea and vomiting in adults.</div></div><div><h3>Methods</h3><div><span>Databases such as British Medical Journal Best Practice, Cochrane Library, Joanna Briggs Institute, National Institute for Health and Care Excellence, Scottish Intercollegiate Guidelines Network, National Guideline Clearing House, Guidelines International Network, American Society of Anesthesiologists (ASA), Association of periOperative Registered Nurses (AORN), Registered Nurses Association of Ontario, PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Yimaitong Clinical Guidelines, China Anesthesia Official website, SinoMed, China National Knowledge Infrastructure, Wanfang, and VIP were searched to collect the relevant guidelines for clinical decision-making, best practices, </span>systematic review, evidence summary, and expert consensus about perioperative nausea and vomiting management. The retrieval time was from the establishment of the database to January 2022. Two authors independently evaluated the quality of the included literature and extracted and summarized the evidence that met the quality criteria.</div></div><div><h3>Findings</h3><div>A total of 22 studies, including 1 best practice, 2 clinical decision-making articles, 7 evidence summaries, 1 clinical guideline, 9 systematic reviews, and 2 expert consensuses, were included. The summary of 37 pieces of evidence from 7 aspects: risk factors, assessment methods, multimodal prevention strategy, health education, nondrug intervention, drug prevention, postoperative analgesia management strategy, and organization management.</div></div><div><h3>Conclusions</h3><div>The health care team should select the best evidence according to the characteristics of the department and clinical practice, scientifically manage perioperative nausea and vomiting of patients, reduce the incidence and severity of nausea and vomiting, and promote the accelerated rehabilitation of patients.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1095-1103"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141460154","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":"Comparison of the Efficacy of Indwelling Gastric Tubes in Preoperative and Postoperative Patients With Oral and Maxillofacial Malignancies","authors":"Yi-lin Zeng RN ,&nbsp;Li-jun Zhu PhD, RN ,&nbsp;Min Lian RN ,&nbsp;Hui-ping Ma RN ,&nbsp;Hong Cui RN ,&nbsp;Yan-e Li RN","doi":"10.1016/j.jopan.2024.01.025","DOIUrl":"10.1016/j.jopan.2024.01.025","url":null,"abstract":"<div><h3>Purpose</h3><div>To explore the optimal plan for the timing of indwelling gastric tube placement in oral and maxillofacial malignant tumor patients.</div></div><div><h3>Design</h3><div>A prospective randomized controlled trial.</div></div><div><h3>Methods</h3><div>80 patients with oral and maxillofacial tumor were selected, and 40 patients were Pre-operative group. The remaining 40 patients were the control group, called Postoperative group. The body weight and hospital stay of the two groups were observed before and after surgery. Blood samples were taken before surgery and 1, 3 and 7 days after surgery to detect hemoglobin and plasma albumin.</div></div><div><h3>Findings</h3><div>The number of postoperative hospitalization days in the pre-operative group was significantly lower than that in the post-operative group; postoperative hemoglobin and plasma albumins were lower in both groups compared with the preoperative level.</div></div><div><h3>Conclusions</h3><div>Preoperative nasogastric tube ensured early postoperative administration of gastrointestinal nutrition, promoted postoperative plasma albumin recovery, and shortened the days of hospitalization.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1056-1061"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421511","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":"Children and the Opioid Crisis: We Can Make a Difference","authors":"Lisa Allison Herbinger DNP, CRNA","doi":"10.1016/j.jopan.2024.02.003","DOIUrl":"10.1016/j.jopan.2024.02.003","url":null,"abstract":"<div><div>The use of opioid-sparing and opioid-free strategies in children can provide adequate analgesia while decreasing the risk of adverse events and contributing to the ongoing battle against the opioid crisis. However, every child must be evaluated individually so that a safe and efficacious perioperative pain management plan can be created. A working knowledge of the risks and benefits of opioids, nonopioid adjuncts, and regional anesthesia along with the ethical considerations for balancing stewardship and beneficent care is essential to the success of these strategies. As perioperative practitioners caring for children, we have an obligation to consider opioid-sparing and opioid-free strategies to promote overall best outcomes. We can make a difference, one child at a time.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 943-948"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853355","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":"Certified Registered Nurse Anesthetists’ Experiences of Nursing in Anesthesia Care: An Interview Study","authors":"Henriette Simone Petersen MSN, CRNA ,&nbsp;Mette Juel Rothmann PhD, MHSc, RN ,&nbsp;Hanne Irene Jensen PhD, MHSc, CCN","doi":"10.1016/j.jopan.2024.01.024","DOIUrl":"10.1016/j.jopan.2024.01.024","url":null,"abstract":"<div><h3>Purpose</h3><div>The purpose of this study was to understand certified registered nurse anesthetists’ (CRNAs) experiences of nursing in anesthesia care.</div></div><div><h3>Design</h3><div>An explorative qualitative study was conducted with inspiration from Ricoeur’s hermeneutic phenomenological theory of interpretation.</div></div><div><h3>Methods</h3><div>Three focus group interviews were carried out with participants representing 5 anesthesiology departments from 3 hospitals in Denmark (a total of 14 participants). The participants were all CRNAs. The transcribed interviews were examined as one coherent text using a Ricoeur-inspired approach, in which the analysis was conducted on three levels: naive reading, structural analysis, and critical interpretation.</div></div><div><h3>Findings</h3><div>The structural analysis identified three themes relevant to the CRNAs’ experiences of nursing: (1) the relationship with the patient, in which caring and professionalism are equally important; (2) differences between professions when sitting in the operating room; and (3) conflicts between production and caring. The study showed that CRNAs are aware of their professional identities as nurses and view anesthesia nursing as an integration of technical tasks and caring, in which the relationship with the patient and serving as the patient’s representative are central. A major aspect of nursing is performed while the patient is anesthetized, and the CRNA attends to the patient’s basic needs. The study also found that CRNAs find it difficult to define nursing in anesthesia care because of the overlapping tasks and skills between CRNAs and anesthesiologists.</div></div><div><h3>Conclusions</h3><div>CRNAs are very aware of their professional identities as nurses. The professionalism involved in their relationships with patients is evident in the CRNAs’ representation of the patients themselves.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1049-1055"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141433112","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":"2025 National Conference in Dallas","authors":"","doi":"10.1016/S1089-9472(24)00540-9","DOIUrl":"10.1016/S1089-9472(24)00540-9","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Page 937"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757059","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":"Letter to the Editor: “Considering References”","authors":"Eleanor Shanklin Truex MLIS, BSN, RN ,&nbsp;Jean Hillyer MLS, MAE ,&nbsp;Emily N. Spinner MSIS, MA","doi":"10.1016/j.jopan.2024.06.117","DOIUrl":"10.1016/j.jopan.2024.06.117","url":null,"abstract":"","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 940-941"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142757062","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":"Worry as Important “Feelers” in Clinical Anesthesia Practice: A Mixed-Methods Study","authors":"Noa Robben CRNA ,&nbsp;Angelique T.M. Dierick-van Daele PhD ,&nbsp;Arthur R.A. Bouwman PhD, MD ,&nbsp;Fredericus H.J. van Loon PhD, CRNA","doi":"10.1016/j.jopan.2024.01.004","DOIUrl":"10.1016/j.jopan.2024.01.004","url":null,"abstract":"<div><h3>Purpose</h3><div>Worry is an intuitive sense that goes beyond logical reasoning and is valuable in situations where patients’ conditions are rapidly changing or when objective data may not fully capture the complexity of a patient’s situation. Nurse anesthetists’ subjective reasons for worry are quite vague as they are valued inconsistently and not accurately expressed. This study aimed to identify factors playing a role in the emergence of worry during anesthesia practice to clarify its concept.</div></div><div><h3>Design</h3><div>Mixed-methods design consisting of quantitative online surveys followed by qualitative focus group interviews including Dutch nurse anesthetists.</div></div><div><h3>Methods</h3><div>Both quantitative and qualitative thematic analyses were performed, followed by data and methodological triangulation to enhance the validity and credibility of findings and mitigate the presence of bias.</div></div><div><h3>Findings</h3><div>Surveys (N = 102) were analyzed, and 14 nurse anesthetists participated in the focus group interviews. A total of 89% of the survey respondents reported that at least once have had the feeling of worry, of which 92% use worry during clinical anesthesia practice. Worry was mentioned to be a vital element during anesthesia practice that makes it possible to take precautionary actions to change the anesthetic care plan in a changing situation or patient deterioration.</div></div><div><h3>Conclusions</h3><div>While a clear definition of worry could not be given, it is a valuable element of anesthesia practice as it serves as a catalyst for critical thinking, problem-solving, clinical reasoning, and decision-making. Use of the feeling of worry alongside technological systems to make an informed decision is crucial. Technology has significantly improved the ability of health care providers to detect and respond to patient deterioration promptly, but it is crucial for nurse anesthetists to use their feeling of worry or intuition alongside technological systems and evidence-based practice to ensure quick assessments or judgments based on experience, knowledge, and observations in clinical practice.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 964-970"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860800","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":"Surgical Patient Preoperative Readiness: Translation into French, Cultural Adaptation for Switzerland and Cross-Sectional Exploratory Study in a Tertiary Hospital","authors":"Zoé Wahl MSN, RN ,&nbsp;Cécile Courbon MD ,&nbsp;John Rey B. Macindo BSN, RN ,&nbsp;Gian Carlo S. Torres PhD, MAN, RN ,&nbsp;Claudia Lecoultre MSN, RN","doi":"10.1016/j.jopan.2024.02.005","DOIUrl":"10.1016/j.jopan.2024.02.005","url":null,"abstract":"<div><h3>Purpose</h3><div>Preoperative evaluation of elective surgery patients traditionally focuses on somatic and organizational aspects of the situation. Patient feelings of readiness, called preoperative readiness (PR), impacts postoperative outcomes, and yet is rarely evaluated. The Preoperative Assessment Tool (PART) is a validated and reliable 15-item questionnaire available in Filipino and English. A reliable tool is essential for evaluating PR within the Swiss health context to offer optimized and comprehensive perioperative care. The aim of this study was to both translate into French and adapt culturally the Preoperative Assessment Tool for Switzerland’s francophone population, and to explore patient PR in the preoperative consultation within a Swiss tertiary hospital.</div></div><div><h3>Design</h3><div>A mixed design with methodologic phases and descriptive study.</div></div><div><h3>Methods</h3><div>A mixed design in two phases with a methodologic phase with (1) translation and (2) cultural adaptation for Romandie of the PART, following Wild’s 10 steps methodology (n = 11) and (3) a cross-sectional exploratory descriptive study with pilot testing of the translated version in a general elective preoperative consultation in a tertiary hospital in Romandie (<em>N</em> = 88).</div></div><div><h3>Findings</h3><div>Translation and cultural adaptations are well accepted and understood by the participants (n = 9/11), modifications are accepted by the authors and deemed adequate by the participants (n = 11/11). Time of completion is short (<em>m</em> = 69.06 seconds) and adapted to clinical context. The translated version has a Cronbach (α = 0.85) comparable to the original validated scale (α = 0.86).</div></div><div><h3>Conclusions</h3><div>The translation and cultural adaptation for Switzerland of the PART was achieved, and PR was explored. Further psychometric testing of the PART-FrenCH must be conducted to assess fully the tool before its use in a clinical setting. Including PR in preoperative evaluations could enhance patient-centered approaches and lead to improvement in the quality of care.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1079-1087"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141181382","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":"Effect of a Forced-Air Warming Blanket on Different Parts of the Body on Core Temperature of Patients Undergoing Elective Open Abdominal Surgery: A Randomized Controlled Single-Blind Trial","authors":"Dan Jiang BSN, RN ,&nbsp;Qi Li MD ,&nbsp;Heng Wang MSc, RN ,&nbsp;Lu Liu BSN, RN ,&nbsp;Yi Liu BSN, RN ,&nbsp;Oufeng Tang MSc, RN","doi":"10.1016/j.jopan.2024.01.023","DOIUrl":"10.1016/j.jopan.2024.01.023","url":null,"abstract":"<div><h3>Purpose</h3><div>This study aimed to determine the effect of a forced-air warming blanket placed on different body parts on the core temperature of patients undergoing elective open abdominal surgery.</div></div><div><h3>Design</h3><div>Prospective, single-center, randomized, controlled, single-blind trial.</div></div><div><h3>Methods</h3><div>A total of 537 patients who underwent open abdominal surgery were randomized into groups A, B, and C and provided with different forced-air warming blankets. Group A was given an upper body blanket, group B a lower body blanket, and group C an underbody blanket. The incidence of intraoperative hypothermia, the time maintaining the core temperature over 36 ℃ before hypothermia, the duration of hypothermia, the rewarming rate, and relevant complications were compared among three groups.</div></div><div><h3>Findings</h3><div>Intraoperative hypothermia occurred in 51.4% of patients in group B, 37.6% of patients in group A, and 34.1% of patients in group C (<em>P</em> = .002). Maintaining the core temperature above 36 ℃ was longer before hypothermia in groups A and C (log-rank <em>P</em><span> = .006). In groups A and C, the duration of hypothermia was shorter, the rewarming rate was higher, and the incidence of shivering and postoperative nausea and vomiting were lower, compared to group B.</span></div></div><div><h3>Conclusions</h3><div><span>In patients undergoing elective open abdominal surgery, a forced-air warming blanket on the upper body part or underbody area decreased intraoperative hypothermia, prolonged the time to maintain the core temperature above 36 ℃ before hypothermia, and could better prevent further hypothermia when the core temperature had decreased below 36 ℃. In addition, it was significantly superior in reducing shivering and postoperative nausea and vomiting in the </span>postanesthesia care unit.</div></div>","PeriodicalId":49028,"journal":{"name":"Journal of Perianesthesia Nursing","volume":"39 6","pages":"Pages 1042-1048"},"PeriodicalIF":1.6,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285145","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}