Perioperative Care and Operating Room Management最新文献

{"title":"Surgical smoke knowledge and practices before and after onset of COVID-19: A national survey of OR personnel","authors":"Doreen Wagner ,&nbsp;Sharon Pearcey ,&nbsp;Christopher J. Hudgins ,&nbsp;Brenda C. Ulmer","doi":"10.1016/j.pcorm.2024.100411","DOIUrl":"10.1016/j.pcorm.2024.100411","url":null,"abstract":"<div><h3>Background</h3><p>At the start of the COVID-19 pandemic, new recommendations to evacuate surgical smoke were made due to unknown viral hazards. We evaluated perioperative registered nurses’ and surgical technicians/technologists’ knowledge of surgical smoke and determined smoke evacuation practices before and after the onset of COVID.</p></div><div><h3>Methods</h3><p>An electronic survey was developed, validated, and distributed nationally. Means and percentages were used for analysis of descriptive data. For comparison analyses, repeated measures were conducted on continuous variables with paired <em>t</em>-tests and mixed factor ANOVAs.</p></div><div><h3>Results</h3><p>We found gaps in knowledge regarding surgical smoke hazards, low evacuation device usage, lack of smoke evacuation policies, and little to no air quality or exposure monitoring in ORs. Smoke evacuation practices did not change significantly following the onset of COVID-19.</p></div><div><h3>Conclusions</h3><p>Implications for leadership, education, and research may provide perioperative personnel with improved work environments without surgical smoke hazards.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100411"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141852286","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-sectional investigation of activated clotting time after administration of different intravenous heparin doses in patients undergoing on-pump coronary artery bypass graft surgery","authors":"Ali Karami ,&nbsp;Hossein Hosseini ,&nbsp;Zeinabsadat Fattahi Saravi ,&nbsp;Fatemeh Talebi ,&nbsp;Bisma Zulfiqar","doi":"10.1016/j.pcorm.2024.100404","DOIUrl":"10.1016/j.pcorm.2024.100404","url":null,"abstract":"<div><h3>Introduction</h3><p>Achieving optimal anticoagulation during coronary artery bypass graft (CABG) surgery remains a challenge, with variations in heparin response attributed to differences in demographic and clinical factors. Deviations from the target activated clotting time (ACT) during CABG have been linked to adverse outcomes. This study aimed to assess the impact of different intravenous heparin doses on ACT in patients undergoing on-pump CABG.</p></div><div><h3>Methods</h3><p>A cross-sectional study was conducted on 54 patients scheduled for CABG surgery with cardiopulmonary bypass in 2021. ACT measurements were taken 5 min after the initial bolus dose of 200 IU/kg and a secondary dose of 100 IU/kg heparin. Demographic and clinical data, including ACT measures, hemoglobin levels, bypass time, and mortality, were collected.</p></div><div><h3>Results</h3><p>The study population predominantly comprised of male patients, with a mean age of 61.18 ± 8.81 years. The patients received 4 (3–4) grafts over 75 (65–80) minutes. Baseline ACT was 149.91±17.48 s, increasing to 410 (359–472) and 604 (542–679) seconds after the initial and additional heparin, respectively. Only 22.2 % of the study subjects achieved target ACT&gt;480 s with 200 IU/kg, and the remaining 77.8 % required an additional 100 IU/kg heparin to reach the target ACT. No cases of heparin resistance, mortality, or dropouts were reported at the end of the study. Preoperative and postoperative hemoglobin levels were positively correlated (<em>r</em> = 0.59, <em>p</em> &lt; 0.0001).</p></div><div><h3>Conclusion</h3><p>A 300 IU/kg heparin dose appears safer than lower doses for initiating cardiopulmonary bypass in on-pump CABG. Preoperative hemoglobin optimization may help minimize perioperative hemoglobin drop. Further research is needed to refine dosing strategies and personalize CABG management.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100404"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141959936","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Survey of perioperative utilization of professional medical interpreters for limited-English proficient patients: Towards a framework for systems-level improvement","authors":"Betty M. Luan-Erfe ,&nbsp;Bruno DeCaria ,&nbsp;Cinar Tuncel ,&nbsp;Obianuju Okocha ,&nbsp;Bobbie-Jean Sweitzer","doi":"10.1016/j.pcorm.2024.100399","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100399","url":null,"abstract":"<div><h3>Introduction</h3><p>Surgical patients in United States’ hospitals have grown more linguistically diverse. However, professional medical interpreter (PMI) utilization remains inconsistent at many healthcare institutions for limited-English proficient (LEP) patients. Numerous studies demonstrate that inadequate perioperative access to PMI leads to worse care and outcomes for LEP patients. The perioperative setting presents unique challenges for providers in caring for LEP patients including obtaining informed consent, a transient team of multi-disciplinary providers, and the time pressure of operating room practice.</p></div><div><h3>Objective</h3><p>Our study is the first to assess barriers to consistent PMI use in the immediate perioperative setting and to identify system-level approaches to improve PMI use.</p></div><div><h3>Method</h3><p>We surveyed a multidisciplinary team of perioperative nurses, advanced practice providers, anesthesiology and surgical trainees and faculty on their personal practices and perceived barriers to PMI use. An anonymous online 13-question survey was used. Answer options included rank order, multiple choice, Likert scale, and free text. Survey data was analyzed using univariate statistics and stratified based on providers having received information on the Title VI Civil Rights Act of 1964 and their medical training status. Pearson's chi-squared test was performed and odds ratios calculated to determine if these provider characteristics were associated with increased preference for PMI over bilingual staff and patients’ family members for interpretation and with other LEP evidence-based care practices.</p></div><div><h3>Results</h3><p>We received a total of 262 responses with a 28.3 % response rate. Among survey participants, 19.1 % of participants did not know where to find patients’ language preferences in the electronic health record (EHR) and 69.8 % of participants did not know how to update language preferences in the EHR. When a bilingual staff was present, 31.0 % and 24.8 % of providers would forgo using video and phone PMI, respectively. Comparatively, trainees were more likely to use PMI instead of patients’ family or bilingual staff. Providers who received training on the Title VI Civil Rights Act of 1964 were more likely to use PMI for interpretation and provide translated consent forms, and least likely to utilize patients’ families for interpretation. Barriers to PMI use included difficulty obtaining video consoles or phones, long wait times for interpreters, unavailability of language, unfamiliarity with using video consoles or accessing interpreters, poor sound quality and internet connectivity issues. As many as 26 % of respondents cited time pressure for starting a surgical case as the reason for not using an interpreter.</p></div><div><h3>Discussion</h3><p>Based on these survey results, we developed a framework for quality improvement initiatives to effect system-level change in similar hi","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100399"},"PeriodicalIF":0.0,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141084663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum regarding missing Declaration of Competing Interest statements in previously published articles","authors":"","doi":"10.1016/j.pcorm.2024.100397","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100397","url":null,"abstract":"","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100397"},"PeriodicalIF":0.0,"publicationDate":"2024-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2405603024000311/pdfft?md5=75e877bb203ca3030a48b923c2cf66b4&pid=1-s2.0-S2405603024000311-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141084450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monitored anesthesia care: Dexmedetomidine-ketamine versus dexmedetomidine-propofol combination during burr-hole surgery for chronic subdural hematoma: A randomized trial","authors":"Alshaimaa Abdel Fattah Kamel ,&nbsp;Mohamed Gaber Mohamed El Sayed ,&nbsp;Sara Mohamed Abdel Naby ,&nbsp;Wael Abd Elrahman Ali Elmesallamy ,&nbsp;Dina Abdelhameed Elsadek Salem","doi":"10.1016/j.pcorm.2024.100398","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100398","url":null,"abstract":"<div><p><strong>Background and Aim:</strong> Selecting the ideal drug combination for effective monitored anesthesia care to keep patients comfortable and safe during evacuation of chronic subdural hematoma is a challenge. Our hypothesis was that the combination of dexmedetomidine with ketamine might provide safer monitored anesthesia care keeping airway patency and stable hemodynamics in comparison to dexmedetomidine-propofol combination during burr-hole surgery for evacuating chronic subdural hematoma in high-risk patients.</p><p><strong>Methods:</strong> A total of 56 paticipants were allocated into two groups in this randomized prospective double-blind study by a computer-generated randomization table. DK group (<em>n</em> = 28): Patients were given a mix of ketamine (1 mg/kg) and dexmedetomidine (1 µg/kg) diluted in 10 ml of saline solution infused over 10 min as an intravenous bolus dose. This was followed by a continuous infusion of 0.5 µg/kg/h dexmedetomidine with 0.5 mg/kg/h ketamine. DP group (<em>n</em> = 28): Patients were given a mix of propofol (0.5 mg/kg) and dexmedetomidine (1 µg/kg) diluted in 10 ml of saline solution infused over 10 min as an intravenous bolus dose. This was followed by a continuous infusion of 0.5 µg/kg/h dexmedetomidine with 0.5 mg/kg/h propofol. The infused solutions were in two separate syringe pumps. The target was to achieve a modified Observer's Assessment of Alertness and Sedation score (OAA/S) of 3, and the infusion was stopped by finishing the skin suture.</p><p><strong>Results:</strong> The onset of sedation using OAA/S was significantly longer in the DK group (413.21 ± 49.18 s.) compared to (297.21 ± 37.68 s.) in the DP group. The number of participants with an airway obstruction score of 1 and 2 was significantly higher in the DK group compared to the DP group; however, those with a score of 3 were significantly higher in the DP group. The total number of patients needing intraoperative fentanyl was comparable between groups. The number of patients who developed intraoperative hypotension, bradycardia, bradypnea, and hypoxemia was significantly higher in the DP group compared to the DK group (<em>p</em> &lt; 0.05). There was an improvement in postoperative Markwalder's Neurological Grading Scale (MNG) scores compared to preoperatively in both the DK and DP groups. The recovery time was significantly longer in the DK group (8.75 ± 1.17 min) compared to (5.73 ± 0.75 min) in the DP group, with comparable surgeon satisfaction.</p><p><strong>Conclusions:</strong> Combining dexmedetomidine with ketamine is safer than dexmedetomidine with propofol for effective monitored anesthesia care in high-risk patients undergoing burr-hole surgery for evacuating chronic subdural hematoma.</p><p>Institutional Review Board approval (ref: 6434/25-10-2020).</p><p>ClinicalTrials.gov (ref: NCT04621526, the date of registration: 9-11-2020).</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100398"},"PeriodicalIF":0.0,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141067918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A robust mixed-integer binary programming model for operating theater scheduling to the patient and the surgeon under uncertainty in an open-heart Surgery Department","authors":"Bahareh Rahmani Manshadi","doi":"10.1016/j.pcorm.2024.100391","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100391","url":null,"abstract":"<div><p>In hospitals, the surgical ward is both a cost and revenue center. In this ward, hospitals face challenges such as increasing demand, limited resources, and rising costs. Consequently, the decisions made have an implications effect on the hospital's performance. Therefore, in this paper a robust mixed-integer binary programming model is proposed with three objectives of maximizing the efficiency of available resources, minimizing the patients waiting time, and minimizing surgery costs that are formulated utilizing the augmented epsilon constraint approach. This model allocates the operating room to the patient and the surgeon and then obtains the required bed capacity inside the downstream units for stand-alone cardiac hospitals. This model includes different preferences for hospital, surgeon, and patient: waiting time, patient cancellations, tardiness, uncertainties in surgery durations, the patient operation start times, the overtime per working day, time windows, SICU beds, planning horizon, and the idle times of the surgeons, operating theater, and working day. The proposed model is solved using robust optimization to deal with stochastic. The proposed model is formulated on the stochastic programming method proposed by Bertsimas and Sim. In the proposed model, a rolling horizon method is used to reschedule the program after cancellation. The computational results illustrate that the rolling horizon method reduces waiting time and increases throughput. The results illustrate that the benefit obtained from the introduced model has improvements in reducing the surgery costs, and patient waiting time, and increasing the efficiency of available resources. This study has been performed at Shahid Rajaei Heart Hospital in Iran.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100391"},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918553","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Environmental health risks faced by operating room nurses: A descriptive study","authors":"Çağla Kuş ,&nbsp;Aynur Koyuncu ,&nbsp;Ayla Yava ,&nbsp;Kadiriye Pehlivan","doi":"10.1016/j.pcorm.2024.100394","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100394","url":null,"abstract":"<div><h3>Background</h3><p>There is limited research on the environmental risks faced by operating room nurses (ORNs). This prospective descriptive study aimed to identify the risk factors encountered by ORNs in their work environment.</p></div><div><h3>Methods</h3><p>The study included 139 ORNs working in six hospitals in southeastern Turkey. Data were collected between September 2019 and February 2020 through a questionnaire using the Occupational Risk Factors Scale and analyzed using SPSS 22.0 software.</p></div><div><h3>Results</h3><p>ORNs reported varying types and rates of risks, including radiation, biological, ergonomic, chemical, psychological, and physical risks. Common risk factors included infection, radiation and chemical exposure, musculoskeletal issues from prolonged standing, exposure to extreme cold, and heavy workloads. Risk levels vary based on age, education, experience, certification, and work assignment.</p></div><div><h3>Conclusions</h3><p>These identified risk factors must be addressed by implementing national education programs focusing on factors influencing safety in ORs.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100394"},"PeriodicalIF":0.0,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140918554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Productivity of operating room from viewpoint operating room nurses in Iran: A national cross-sectional study","authors":"Armin Fereidouni ,&nbsp;Maryam Ghanavati ,&nbsp;Negar shahkarami ,&nbsp;Zahra Maleki ,&nbsp;Esmaeil Teymoori","doi":"10.1016/j.pcorm.2024.100395","DOIUrl":"10.1016/j.pcorm.2024.100395","url":null,"abstract":"<div><h3>Background</h3><p>Productivity refers to the maximum use of human resources in service provision. Due to the existence of advanced equipment and instruments for surgery, the operating room is one of the most complex and income-generating sections of a hospital. Since the improvement of operating room nurses’ productivity can lead to enhanced hospital productivity, this study was done to determine the productivity rate of operating room nurses in Iran.</p></div><div><h3>Methods</h3><p>This cross-sectional study was done on 533 operating room nurses from 8 metropolises in Iran in 2022. The sampling method in this research was multistage. The data collection instruments were Hersy &amp; Belanchard &amp; Gold.Smith productivity questionnaire and demographic characteristics. After receiving the ethics code, data collection was done for three months. Descriptive and inferential analyses, including independent <em>t</em>-tests and analysis of variance, were used for data analysis. The collected data were analyzed by SPSS 18. P-value &lt; 0.05 was considered statistically significant.</p></div><div><h3>Results</h3><p>The mean age of the participants was 29.83 ± 5.94 and 421 of the participants were women. The mean and SD for total productivity in operating room nurses was obtained at 60.83 ± 12.78, below average. Data analysis shows that total productivity was significantly associated with marital status (P-value = 0.035) and working experience (P-value = 0.019).</p></div><div><h3>Conclusion</h3><p>Considering the low mean productivity rate of operating room nurses, researchers recommend that hospital managers pay more attention to the productivity of operating room nurses by knowing the influential factors and implementing proper and high-quality management.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100395"},"PeriodicalIF":0.0,"publicationDate":"2024-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141039433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ethical climate and its relationship with attitude to teamwork in operating room nurses: A cross-sectional study","authors":"Mozhgan Rivaz ,&nbsp;Azadeh Amiri ,&nbsp;Zahra Movahednia ,&nbsp;Majid Bagheri ,&nbsp;Yaser Adelmanesh ,&nbsp;Amirali Alizadeh","doi":"10.1016/j.pcorm.2024.100392","DOIUrl":"https://doi.org/10.1016/j.pcorm.2024.100392","url":null,"abstract":"<div><h3>Introduction</h3><p>In the nursing profession, ethical climate is considered to be an important element of the work environment. Nurses are exposed to moral tension due to the volume and high work pressure; on the other hand, the stressful nature of this profession can have many negative effects on nurses and, as a result, the quality of care. Therefore, improving the conditions and ethical climate becomes very important. In the operating room, due to the special working conditions and the variety of available specialties, team work is of great importance among the operating room staff. Improving teamwork in the operating room reduces stress and anxiety, increases work efficiency, improves the quality of care, and increases the patient safety.</p></div><div><h3>Objective</h3><p>This study was conducted with the aim of determining the relationship between the ethical climate and the attitude towards teamwork of operating room nurses in hospitals affiliated with Shiraz University of Medical Sciences.</p></div><div><h3>Method</h3><p>This research was a cross-sectional study conducted in 2022. The study involved a sample of 310 operating room nurses from hospitals affiliated with Shiraz University of Medical Sciences, selected using convenient and purpose-based sampling methods. In order to collect data, the questionnaires of demographic information, Olsan's ethical climate and attitude towards teamwork baker were used. The collected data were analyzed by SPSS V20.</p></div><div><h3>Findings</h3><p>The average score of the operating room staff from the ethical climate was 94.12±14.96, and that of the overall attitude towards teamwork was 121.92±11.74, which indicates a favorable attitude towards teamwork. There was a significant relationship between the scores of the ethical climate and the attitude toward teamwork among the operating room personnel (<em>r</em> = 0.339,<em>p</em> &lt; 0.0001).</p></div><div><h3>Conclusion</h3><p>The results showed that there is a significant relationship between the attitude towards teamwork and the ethical climate of operating room nurses. Managers of hospitals and operating rooms can strengthen the spirit of teamwork and create a suitable atmosphere in the operating room by holding training courses and increase safety and productivity there.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100392"},"PeriodicalIF":0.0,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140844300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The ability of perfusion index and positional perfusion index variation to predict spinal anesthesia-induced hypotension in elderly patients: A prospective observational study","authors":"Amr Abdelkader,&nbsp;Mohamed Elshazly,&nbsp;Maged Elgendy,&nbsp;Ahmed Nabih","doi":"10.1016/j.pcorm.2024.100393","DOIUrl":"10.1016/j.pcorm.2024.100393","url":null,"abstract":"<div><h3>Background</h3><p>Spinal anesthesia (SA) is a popular anesthetic technique for several surgeries; however, it is mostly associated with hypotension. The perfusion index (PI) can predict hypotension after spinal and general anesthesia. We aimed to evaluate the predictability of PI postural change, supine and sitting PI to post-SA hypotension in elderly patients.</p></div><div><h3>Methods</h3><p>This study was conducted on 68 elderly patients aged &gt;65 years, scheduled for elective orthopedic surgical operations under SA in supine position. PI, arterial oxygen saturation, blood pressure, and heart rate were initially recorded at sitting and supine positions then 5, 10, and 20 min after subarachnoid drug injection (in supine position). ΔPI=PI supine−PI sitting. The relative change in PI (rPI) =ΔPI/PI sitting× 100.</p></div><div><h3>Results</h3><p>Hypotension occurred in 33.82 % of patients. The Δ PI was 0.53±0.24, and the r PI was 14.18±6.41 %. Δ PI at cut-off &gt;0.6 and r PI at cut-off &gt; 14 %; could predict SA-induced hypotension with a sensitivity of 82.61 and 86.96 %, respectively, and specificity of 88.89 and 77.78 %, respectively. There was an insignificant difference between Δ PI and r PI and between r PI and baseline supine in predicting SA-induced severe hypotension. The prediction of SA-induced hypotension was higher with Δ PI than baseline sitting and baseline supine (<em>P</em> = 0.002 and 0.027) and between r PI and baseline sitting (<em>P</em> = 0.047).</p></div><div><h3>Conclusions</h3><p>In elderly patients, the Δ PI has a higher predictive value for SA-induced hypotension than baseline sitting and baseline supine with comparable prediction ability between Δ PI and r PI.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"35 ","pages":"Article 100393"},"PeriodicalIF":0.0,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141026666","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}