Perioperative Care and Operating Room Management最新文献

{"title":"Intraoperative warming during abdominal surgery with a closed-circuit water sleeve","authors":"Allison McIntosh ,&nbsp;Stephanie Lewis ,&nbsp;Tanjina Jalil ,&nbsp;Gorgio Melloni ,&nbsp;Peter Wu ,&nbsp;Jeffery Weiss ,&nbsp;Enrico Camporesi","doi":"10.1016/j.pcorm.2025.100544","DOIUrl":"10.1016/j.pcorm.2025.100544","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-operative hypothermia is an adverse effect of anesthesia due to widespread inhibition of thermoregulatory processes, which can be mitigated through intraoperative warming. While forced warm-air systems are commonly used, they can pose challenges during procedures. Our study compared an enclosed water-sleeve warming system with a standard forced-air warming system, to compare their efficacy in maintaining normothermia during intrabdominal surgery.</div></div><div><h3>Methods</h3><div>In this controlled trial, 67 patients that underwent elective intrabdominal surgery were assigned to either the water-sleeve warming system (<em>N</em> = 30) or the forced-air warming system (<em>N</em> = 37). Patients gave written consent to the assignment of the warming method (IRB#1814, USF). The water-sleeve system utilized a plastic sleeve circulating warm sterile water at 40 °C on the patient's upper arm, with mild suction (-7 cm H2O) applied to promote venous dilation. The forced-air system used a disposable perforated blanket over the patient's upper body. Operating room temperatures were maintained at 20 °C. Temperatures were recorded preoperatively (sublingual), intraoperatively every 15 min (esophageal), and postoperatively upon arrival in PACU (sublingual).</div></div><div><h3>Results</h3><div>The water-sleeve group maintained a slightly higher median temperature intraoperatively compared to the control group, although the differences were not statistically significant. A Fisher test revealed that the water-sleeve group had fewer patients experiencing at least one intraoperative interval below 36 °C. Both warming methods successfully maintained normothermia upon arrival to the post-anesthesia care unit (PACU).</div></div><div><h3>Conclusions</h3><div>This study demonstrated that the water-sleeve warming system and the forced-air warming system were comparably effective in maintaining normothermia during intrabdominal surgery. No significant differences were observed in intraoperative or postoperative temperatures between the two groups. Given the similar efficacy and utility of the water-sleeve and forced-air warming systems, further research is needed to evaluate the cost-effectiveness of the water-sleeve warming system and to identify clinical scenarios where it may be preferable.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100544"},"PeriodicalIF":1.0,"publicationDate":"2025-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865214","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":"Gender differences in prevalence of musculoskeletal disorders (MSDs) among surgeons","authors":"Layalee Abo-Naser ,&nbsp;Gideon Leibner ,&nbsp;Rotem Givoli Vilenski ,&nbsp;Shai Luria ,&nbsp;Yuval Kriger","doi":"10.1016/j.pcorm.2025.100542","DOIUrl":"10.1016/j.pcorm.2025.100542","url":null,"abstract":"<div><h3>Background</h3><div>work-related musculoskeletal disorders (MSDs) have been studied extensively in different types of occupations. Surgeons are especially prone to MSDs owing to their long working hours, high strain, and abnormal working postures. In this study, we examined the prevalence of MSDs in surgeons, with special regard to gender differences.</div></div><div><h3>Methods</h3><div>we surveyed surgeons at two tertiary referral hospitals, Soroka Medical Center, and Hadassah Medical Center. Participants were asked to complete standardized questionnaires regarding musculoskeletal symptoms using the Standardized Nordic Questionnaire.</div></div><div><h3>Results</h3><div>a total of 105 questionnaires were collected and analyzed. 43 % were filled by females and 57 % by males. Most respondents experienced MSDs in the last twelve months, with a higher proportion in females. females were also more likely to report symptoms in the upper extremity area in comparison to males.</div></div><div><h3>Conclusion</h3><div>the prevalence of MSDs in surgeons is high, females are more prone to MSDs than males. Further research is needed to identify the reasons and to provide a prevention plan.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100542"},"PeriodicalIF":1.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144887327","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":"Laryngospasm in elective pediatric anesthesia: incidence and risk factors","authors":"Saliha Benabdi ,&nbsp;Meriem Amani ,&nbsp;Derouicha Matmour ,&nbsp;Nour eddine Chikh ,&nbsp;Kheira Daho ,&nbsp;Dalila Boumendil","doi":"10.1016/j.pcorm.2025.100543","DOIUrl":"10.1016/j.pcorm.2025.100543","url":null,"abstract":"<div><h3>Background</h3><div>Laryngospasm is a rare but potentially life-threatening critical event. The aim of this study was to identify the incidence and the associated risk factors of laryngospasm in elective pediatric anesthesia.</div></div><div><h3>Methods</h3><div>A prospective single-center cohort study was conducted in the pediatric anesthesia department at Canastel Hospital in Oran (Algeria). It included patients up to 16 years of age who underwent any elective procedure between July 2017 and August 2019. Children undergoing emergency surgery, those with an upper respiratory tract infection (URTI) within two weeks before the procedure, or those who had an asthma attack within 30 days before surgery were not included. Laryngospasm was defined as persistent hypoxemia with oxygen saturation (SpO2) &lt;90 % for ≥30 s, with inspiratory and expiratory stridor.</div></div><div><h3>Results</h3><div>We analyzed 1270 procedures, identifying 12 cases of laryngospasm (incidence 0.9 %). The mean age was 55.41 ± 43.233 months. 7 (58.33 %) of cases of laryngospasm occurred during awakening phase while 5 (41.67 %) were recorded at induction. The major risk factors included: age less than one year (RR: 5.667, 95 % CI: 1.744–17.779, <em>P</em> = 0.05), history of prematurity (RR: 0.161, 95 % CI: 0.0181–1.233, <em>P</em> = 0.042), and maxillofacial surgery (RR: 6.768, 95 % CI: 1.494–33.568, <em>P</em> = 0.045).</div><div>The multivariate analysis determined the following risk factors: age of less than one year (RR: 4.888, 95 % CI: 1.461–16.356, <em>P</em> = 0.01) and anesthesiologist experience of less than one year (RR: 2.324, 95 % CI: 1.014–5.323, <em>P</em> = 0.046). The study also revealed evidence of the beneficial effect of laryngeal mask airway management.</div></div><div><h3>Conclusion</h3><div>The findings highlight increased associations of laryngospasm in elective pediatric anesthesia with multiple factors.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100543"},"PeriodicalIF":1.0,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144888844","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":"Incidence and predictors of post spinal anesthesia-induced hypotension for cesarean section in Ethiopia: A systematic review and meta-analysis","authors":"Sintayehu Samuel Lorato ,&nbsp;Feleke Doyore Agide ,&nbsp;Genanew Kassie Getahun ,&nbsp;Kedir Seid Yesuf ,&nbsp;Yohannes Addisu Wondimagne ,&nbsp;Mitiku Desalegn ,&nbsp;Dawit Tesfaye Rundasa ,&nbsp;Yohannes Godie ,&nbsp;Tolasa Yadate ,&nbsp;Yisehak wolde ,&nbsp;Eyob Ketema Bogale","doi":"10.1016/j.pcorm.2025.100541","DOIUrl":"10.1016/j.pcorm.2025.100541","url":null,"abstract":"<div><h3>Introduction</h3><div>Hypotension is defined as a decrease in mean arterial blood pressure of more than 30% within a 10-minute period after spinal anesthesia. Spinal anesthesia is a subarachnoid block and is the preferred approach for certain surgical procedures, such as cesarean sections. Spinal anesthesia is the most often used neuraxial approach for patients in many institutions because of the superior quality of surgical anesthesia, quick onset of action, excellent patient comfort, and low complication rates. This systematic review and meta-analysis aimed to assess the incidence of SIH and related factors among patients who underwent cesarean sections in Ethiopia.</div></div><div><h3>Methods</h3><div>This systematic review and meta-analysis was conducted using two different methods. The first was an exploration of electronic databases (PubMed, Scopus, Web of Science, MEDLINE, CINAHL, Cochrane Library, Embase, and Google Scholar) for the presence of evidence about the incidence of spinal-induced hypotension and its predictors among pregnant mothers who underwent cesarean section under spinal anesthesia in Ethiopia. Data were extracted using a Microsoft Excel spreadsheet and analyzed using Stata 17. Quality appraisal was conducted using the PRISMA guidelines and Newcastle‒Ottawa assessment scales. Higgins I2 tests were used to assess heterogeneity. Sensitivity and subgroup analyses were performed. Egger's test and funnel plots were employed to identify potential publication bias.</div></div><div><h3>Results</h3><div>The pooled incidence of SIH among pregnant women who underwent cesarean section in Ethiopia was 64.5% (95% CI: 56.2–72.8). The subgroup analysis by region revealed that the pooled incidence of SIH among pregnant mothers in Addis Ababa was 68.6%, and that in the Oromia region was 74%. Baseline systolic blood pressure &lt;120 mmHg (AOR 6, 95% CI 2.878–9.09), newborn weight (AOR 5.4, 95% CI 3.4–7.35), sensory block height (AOR 6.75, 95% CI 4.3–9.201), speed of injection &lt; 10 sec (AOR 4.47, 95% CI 2.348–6.215), and dose of local anesthetics &gt; 2.5 ml (AOR 7.8, 95% CI 6.3–11.56) were significantly associated with SIH.</div></div><div><h3>Conclusion</h3><div>This systematic review and meta-analysis revealed a high pooled incidence of SIH among pregnant women who underwent cesarean section under spinal anesthesia in Ethiopia. Hence, to reduce SIH and other maternal-related complications among pregnant women, much consideration must be given to increasing anesthesia professionals’ knowledge and skills in teaching universities and governmental hospitals in Ethiopia.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100541"},"PeriodicalIF":1.0,"publicationDate":"2025-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144865213","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 randomized controlled trial comparing transversalis fascia plane block and quadratus lumborum block for post-cesarean pain management: Efficacy, execution time, and practicality","authors":"Ayman Mohamady Eldemrdash,&nbsp;Hani Mohammed Ahmed Raslan,&nbsp;Taha Tairy Dardeer Alsawy,&nbsp;Ibrahim Elabd Hassan,&nbsp;Ahmed Khaled Mohamed,&nbsp;Mohammed Ahmed Alazhary","doi":"10.1016/j.pcorm.2025.100536","DOIUrl":"10.1016/j.pcorm.2025.100536","url":null,"abstract":"<div><h3>Background</h3><div>Transversalis Fascia Plane Block (TFPB) and Quadratus Lumborum Block (QLB) provide superior analgesia to Transversus Abdominis Plane Block (TAPB) for post-cesarean pain management. This study evaluates whether TFPB or QLB is preferable when their analgesic efficacy is nearly equal, focusing on ease of performance and execution time.</div></div><div><h3>Methods</h3><div>In this randomized controlled trial, 108 patients scheduled for elective cesarean delivery under spinal anesthesia were randomized into three equal groups to receive either TAPB (control), TFPB, or QLB. Postoperative pain was assessed using the Numeric Pain Rating Scale (NRS) at 6, 12, and 24 hours as the primary outcome. Secondary outcomes included the time to first analgesic request, total opioid consumption within the first 24 hours, the ease of block performance (rated as easy, moderately difficult, or difficult), and the time required for block execution. All blocks were performed bilaterally under ultrasound guidance by a single experienced anesthesiologist to ensure consistency.</div></div><div><h3>Results</h3><div>Both the TFPB and QLB groups demonstrated significantly lower postoperative pain scores compared to the TAPB group at 6, 12, and 24 hours (<em>p</em> &lt; 0.001 for all time points), with no significant difference in analgesic efficacy between TFPB and QLB (<em>p</em> &gt; 0.05). In addition, patients in the TFPB and QLB groups required significantly less opioids within 24 hours and had a longer time before requesting analgesia than those in the TAPB group (<em>p</em> &lt; 0.001). Notably, the TFPB technique required significantly less time for execution and was rated as easier to perform than the QLB technique (<em>p</em> &lt; 0.001). No significant complications or adverse events were observed in any group during the study period.</div></div><div><h3>Conclusions</h3><div>Both TFPB and QLB offer superior postoperative analgesia compared to TAPB, with comparable pain relief between the two techniques. However, TFPB is associated with a shorter execution time and greater ease of performance, making it particularly advantageous in busy clinical settings. These findings suggest that TFPB may be the preferred method for post-cesarean analgesia, especially in high-volume obstetric units where efficiency and simplicity are paramount.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100536"},"PeriodicalIF":1.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144842829","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":"Red cell distribution width as a predictor for post-operative atrial fibrillation after open heart surgeries","authors":"Ashraf Nabil Saleh,&nbsp;Khaled Abdou,&nbsp;Mohamed Dawood,&nbsp;Wail Abdelaal,&nbsp;Marwa Salem","doi":"10.1016/j.pcorm.2025.100539","DOIUrl":"10.1016/j.pcorm.2025.100539","url":null,"abstract":"<div><h3>Background</h3><div>Post operative Atrial Fibrillation _POAF_ is the most common type of arrhythmia after open heart surgeries with incidence 30–50 %. Atrial fibrillation has been a challenging postoperative morbidity, its mechanism is yet to be known, however, a lot of studies have tried to find a predictive biomarker for POAF, in this study we investigated the relationship between Red cell distribution width (RDW)_ and the prediction of POAF</div></div><div><h3>Methodology</h3><div>the eligible patients were 76 patients, the duration of study was 2 months of data collection, Patients enrolled in the study was allocated into two groups according to development of POAF. Group A: patients develop POAF. Group B: patients didn’t develop POAF. Pre operative RDW was compared between the two groups, ROC analysis is done for all patients to predict POAF.</div></div><div><h3>Results</h3><div>there were significant statistical difference between groups preoperative and post operative RDW (p-value 0.023, 0.011, respectively), ROC analysis for RDW in all patient to detect POAF sowed AUC 0.634 with cut off value &gt;15.1 with sensitivity 58.62 % and specificity 78.72 %.</div></div><div><h3>Conclusion</h3><div>We found that RDW was significantly higher in patients who developed POAF in comparison to patients who didn’t develop atrial fibrillation.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100539"},"PeriodicalIF":1.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144893499","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":"Effect of preoperative patient anxiety on post-spinal shivering during non-elective caesarean delivery – A prospective observational study","authors":"Shristee Chudal ,&nbsp;Kajal Jain ,&nbsp;Pulak Priyadarshi Padhi ,&nbsp;Vanita Jain ,&nbsp;Vighnesh Ashok","doi":"10.1016/j.pcorm.2025.100538","DOIUrl":"10.1016/j.pcorm.2025.100538","url":null,"abstract":"<div><h3>Background and aim</h3><div>Shivering is common in patients undergoing caesarean delivery (CD) under spinal anaesthesia, and can have negative perioperative consequences. Preoperative anxiety has been implicated as a potential non-thermogenic risk factor for post-spinal shivering, although data from obstetric patients is only emerging. This study was conducted to ascertain the relationship between preoperative anxiety and post-spinal shivering in obstetric patients.</div></div><div><h3>Methods</h3><div>Patients ≥18 years and undergoing non-elective CD (Royal College of Obstetricians and Gynaecologists Categories 2, 3) under spinal anaesthesia were enrolled in this prospective observational study in a university teaching hospital. Preoperative anxiety was assessed using the visual analogue scale (VAS), correlated with the occurrence of post-spinal shivering and analysed using univariate and multivariate logistic regression models.</div></div><div><h3>Results</h3><div>Of the 150 patients enrolled, 55 (37 %) experienced post-spinal shivering. The relative risk (95 % CI) of post-spinal shivering in patients with high VAS preoperative anxiety was 2.3 (1.4 - 4.0); <em>p</em> = 0.001. VAS anxiety (aOR 1.55; 95 % CI:1.25–1.92; <em>p</em> = 0.001) and history of previous neuraxial anaesthesia for CD (aOR 0.23; 95 % CI: 0.07–0.69; <em>p</em> = 0.009) were independent predictors of shivering after spinal anaesthesia.</div></div><div><h3>Conclusion</h3><div>High preoperative anxiety is an independent risk factor for post-spinal shivering during non-elective CD. A previous history of neuraxial anaesthesia for prior CD is protective for post-spinal shivering in these patients. Specific perioperative interventions to mitigate patients’ preoperative anxiety might reduce the incidence of post-spinal shivering in these patients, potentially improving perceived quality of care being provided.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100538"},"PeriodicalIF":1.0,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144809954","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":"Effect of dexamethasone versus dexmedetomidine on shivering in women undergoing cesarean delivery under spinal anesthesia","authors":"Ayman A. Abouglalah ,&nbsp;Ibrahim Elabd Hassan ,&nbsp;Abdallah Elabd Hassan ,&nbsp;Mohamed Elsayed Mahmoud","doi":"10.1016/j.pcorm.2025.100535","DOIUrl":"10.1016/j.pcorm.2025.100535","url":null,"abstract":"<div><h3>Background and aim</h3><div>Postoperative shivering is a fairly common complication of spinal anesthesia. Management of postoperative shivering encompasses variable pharmacological and non-pharmacological strategies. The aim of the present study is to perform head-to-head comparison between the effects of dexamethasone and dexmedetomidine on shivering after spinal anesthesia in women undergoing elective cesarean delivery.</div></div><div><h3>Patients and methods</h3><div>The study included 382 patients randomized to receive either intravenous dexamethasone 10 µg immediately after delivery (Group 1) or single preoperative dose of dexamethasone 8 mg intravenous infusion in 100 ml normal saline 2 h preoperatively (Group 2). Outcome assessment included the incidence of clinically significant postoperative shivering, postoperative pain, time to use of first rescue analgesia and other side effects e.g. hypotension, bradycardia, sedation grade, and postoperative nausea and vomiting.</div></div><div><h3>Results</h3><div>Comparison between the studied groups regarding the postoperative complications revealed no significantly differences regarding the frequency of shivering (17.8 % versus 12.6 %, <em>p</em> = 0.15), severity of shivering (grades 0/2/3: 82.2/7.9/10.0 % versus 87.4/4.7/7.9, <em>p</em> = 0.61), hypotension (16.2 % versus 23.0 %, <em>p</em> = 0.09), bradycardia (7.9 % versus 12.6 %, <em>p</em> = 0.13) and postoperative nausea and vomiting (8.9 % versus 6.3 %, <em>p</em> = 0.22). Also, no significant differences were found between the studied groups regarding pain assessed by visual analog scale and sedation scores at 0,2,4,6 and 8 h postoperatively.</div></div><div><h3>Conclusions</h3><div>The present study found that both dexmedetomidine and dexamethasone had comparable efficacy and safety profile when used in women undergoing CD under spinal anesthesia.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100535"},"PeriodicalIF":1.0,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144770639","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":"From regional blocks to postoperative outcomes: Exploring the correlation between intraoperative hypotension and short-term postoperative outcomes in thoracic surgery","authors":"Davina Walser ,&nbsp;Roberto Dossi ,&nbsp;Andrea Saporito","doi":"10.1016/j.pcorm.2025.100534","DOIUrl":"10.1016/j.pcorm.2025.100534","url":null,"abstract":"<div><div>Video-assisted thoracic surgery (VATS) provides benefits such as fewer complications and shorter hospital stays, but postoperative pain remains a challenge. While thoracic epidural block (TEB) was once the standard, concerns over risks have shifted interest toward thoracic paravertebral block (TPVB) and erector spinae plane block (ESPB). This study compares ESPB and TPVB, focusing on intraoperative hypotension (IOH), and its impact on hemodynamic stability. In this single-center, prospective, placebo-blinded trial, 50 elective VATS patients were randomized to receive either sham TPVB with active ESPB or sham ESPB with active TPVB at T5. The primary outcome was IOH, defined as a 20 % decrease in systolic blood pressure from induction to incision. Secondary outcomes included norepinephrine use, nausea and vomiting, and procedural duration. Statistical analyses were performed using chi-square and paired <em>t</em>-tests (<em>p</em> &lt; 0.05). Among 47 analyzed patients, IOH occurred in 14 patients in the ESPB group and 12 patients in the TPVB group (<em>p</em> = 0.671). Norepinephrine perfusors were required on only three occasions, indicating a low incidence of severe or refractory intraoperative hypotension. Nausea and vomiting showed no significant differences, while TPVB took significantly longer to perform than ESPB (<em>p</em> = 0.025). ESPB appears to be a viable alternative to TPVB in VATS, offering a technically simpler approach without compromising intraoperative hemodynamic stability. However, further studies with larger sample sizes are necessary to fully understand ESPB’s mechanisms and clinical implications.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100534"},"PeriodicalIF":1.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144757622","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":"Clinical rotation model to foster a positive experience in the operating room","authors":"Christine Reger ,&nbsp;Angellyn Rosario ,&nbsp;Victoria Sherry ,&nbsp;Lynn Dickinson ,&nbsp;Elizabeth Lewis","doi":"10.1016/j.pcorm.2025.100531","DOIUrl":"10.1016/j.pcorm.2025.100531","url":null,"abstract":"<div><div>Operating room (OR) nursing is a subspecialty within nursing that includes the care of patients undergoing surgical procedures. Incorporating students into OR clinical experiences can be challenging as the environment is fast paced, complex, and highly technical. Traditionally, students in the OR spend time shadowing with little to no hand-on care opportunities, which does not allow final semester nursing students to meet the clinical course objectives. Therefore, the course faculty and hospital unit leadership collaborated to develop a clinical experience that met the course objectives.</div><div>The rotation was structured to link OR nursing didactic content to clinical learning, enhance technical skills, and foster critical thinking and teamwork in a high-pressure setting. Feedback was collected from students and preceptors to gain insights into their perspectives on the rotation; both students and preceptors agreed that the rotation was worthwhile and beneficial, recommending its continuation. By integrating student preferences, fostering collaboration with unit leadership, and implementing feedback-driven improvements, this model creates a supportive learning environment that prioritizes patient safety while providing the learner with an experience to develop skills and critical thought necessary for OR nursing roles.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"40 ","pages":"Article 100531"},"PeriodicalIF":1.0,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144739285","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}