Perioperative Care and Operating Room Management最新文献

{"title":"A comparative study between the impact of ultrasound guided Pericapsular Nerve Group Block (PENG) versus Fascia Iliaca Compartment Block (FICB) on the quality of postoperative analgesia and ambulation in hip arthroplasty","authors":"Tamer Nabil Abdelrahman,&nbsp;Moustafa Mahmoud Abdelsattar,&nbsp;Mohamed Abdelmoneim Fouly,&nbsp;Mohsen Abdelghany Bassiouny,&nbsp;Sahar Mohamed Talaat","doi":"10.1016/j.pcorm.2025.100469","DOIUrl":"10.1016/j.pcorm.2025.100469","url":null,"abstract":"<div><h3>Background</h3><div>Hip surgeries are one of the common orthopedic surgeries, especially in the geriatricnpopulation following trauma, postoperative pain control and early ambulation are the main concerns for decreasing hospital stay and postoperative complications. We aimed to analyze the ultrasound-guided pericapsular nerve group block (PENG) effect versus fascia iliaca compartment block (FICB) on the time needed for unaided mobilization and postoperative analgesics consumption in hip arthroplasty.</div></div><div><h3>Methods</h3><div>The study was a randomized, prospective, comparative study carried out at Ain Shams University Hospital where 44 patients subjected to hip arthroplasty were randomized into two equal groups; Group (F) in which patients received FICB under ultrasound guidance and Group (P) in which patients received PENG under ultrasound guidance. Both blocks were performed by injecting 20 mL of 0.25 % bupivacaine immediately after spinal anesthesia. The time needed for unaided mobilization was assessed by the time up and go test (TUG) and postoperative pain was assessed by visual analogue scale (VAS) in the first 24 h postoperatively.</div></div><div><h3>Results</h3><div>Regarding ambulation data over the first 24 h following surgery, the time needed for unaided mobilization was significantly shorter in the PENG group than FICB group. No statistically significant differences were determined between both groups as regards postoperative complications, total narcotic consumption, and VAS score. Conclusions: The Pericapsular nerve group (PENG) block demonstrated earlier unaided ambulation and delayed first rescue analgesia in hip arthroplasty compared to those who were administered Facia iliaca compartment blocks)FICB(in hip arthroplasty. Both blocks offered efficient postoperative pain control without difference in total opioid requirements.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100469"},"PeriodicalIF":0.0,"publicationDate":"2025-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139170","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":"Employing lean six sigma strategies to improve operating room first case on-time starts: A case report","authors":"Christy V. Mitchell ,&nbsp;Alex R. Anderson ,&nbsp;Kenneth Romito ,&nbsp;Wesley M. Abadie ,&nbsp;Angela K. Phillips","doi":"10.1016/j.pcorm.2025.100473","DOIUrl":"10.1016/j.pcorm.2025.100473","url":null,"abstract":"<div><h3>Background</h3><div>The operating room is a key driver of hospital revenue, making the monitoring of performance metrics crucial for cost reduction. Perioperative leaders often struggle to pinpoint the causes of delays. This article describes how an ambulatory surgical center implemented Lean Six Sigma methodology to identify barriers and implement targeted interventions to improve first-case on-time starts.</div></div><div><h3>Methods</h3><div>A multidisciplinary committee employed the standard process improvement methodology known as define-measure-analyze-improve-control (DMAIC) to assess workflow, identify the root causes of delays, and implement five targeted interventions to improve workflow.</div></div><div><h3>Results</h3><div>Data from 888 cases were examined over a 20-month period in the perioperative department, 180 cases before and 708 cases during and after implementation. First case on-time starts increased from 30 % to 79 % 12 months after the interventions were implemented. Additionally, delays in OR minutes decreased by approximately 49 % during this time frame.</div></div><div><h3>Conclusion</h3><div>A multidisciplinary committee's use of Lean Six Sigma strategies, particularly the DMAIC framework, has effectively identified barriers to on-time first case starts in the OR. This approach established a solid foundation for developing targeted problem-solving interventions. By applying this methodology, the committee improved operational efficiency and reduced delays in the surgical workflow.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100473"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138826","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":"Cardiac monitoring and cardiovascular event incidence in patients over 50 with ICU needs undergoing abdominal/vascular surgery: Insights from a tertiary care facility","authors":"Sendhil Kumar,&nbsp;Zareen Fatema,&nbsp;Vikneswaran G,&nbsp;Alben Sigamani,&nbsp;Delitia Manuel","doi":"10.1016/j.pcorm.2025.100472","DOIUrl":"10.1016/j.pcorm.2025.100472","url":null,"abstract":"<div><h3>Background</h3><div>As the global population ages, the vulnerability of older adults (≥50 years) undergoing major non-cardiac surgeries increases significantly, posing greater risks and challenges. This study aims to address the gap in understanding postoperative cardiac complications and associated risk factors in this demographic.</div></div><div><h3>Methods</h3><div>A retrospective observational study was conducted to identify 100 patients aged 50 or older who underwent major abdominal or vascular surgeries requiring ICU admission for more than 24 h. MACE incidence, including myocardial infarction, unstable angina, heart failure, arrhythmias, stroke, and cardiac death, was assessed. Logistic regression analyzed preoperative risk factors.</div></div><div><h3>Results</h3><div>Postoperatively, 18 % experienced MACE events, including acute coronary syndrome, unstable angina, and cardiac death. Vascular surgeries correlated with increased mortality risk (<em>p</em> &lt; 0.001). Hypertension emerged as a significant risk factor (OR 10.88, <em>p</em> &lt; 0.02), alongside abnormal echocardiogram findings (<em>p</em> &lt; 0.05).</div></div><div><h3>Discussion</h3><div>The study highlights the significant association of advanced age, hypertension, and echocardiographic abnormalities with MACE in elderly patients undergoing major abdominal/vascular surgeries requiring ICU care. The findings emphasize the importance of perioperative risk stratification, particularly in high-risk groups, to guide surgical planning and improve outcomes. Developing predictive tools, such as MACE risk calculators, could support clinical decision-making.</div></div><div><h3>Conclusion</h3><div>Age, hypertension, and echocardiographic findings are key MACE predictors in elderly surgical patients requiring ICU care. Future studies should focus on validating risk calculators and optimizing perioperative strategies to improve patient outcomes.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100472"},"PeriodicalIF":0.0,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139135","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":"Turkish validity and reliability study of the person-centered perioperative nursing scale","authors":"Tugba ALBAYRAM ,&nbsp;Sukriye Ilkay GUNER","doi":"10.1016/j.pcorm.2025.100468","DOIUrl":"10.1016/j.pcorm.2025.100468","url":null,"abstract":"<div><h3>Background</h3><div>Patient satisfaction and health status improve with person-centered care. It also reduces hospital stays and medical costs.</div></div><div><h3>Aim</h3><div>The purpose of this methodological study was to assess the validity and reliability of the \"Person-Centered Perioperative Nursing Scale\" in Turkey.</div></div><div><h3>Methods</h3><div>This online study was conducted between March and September 2021, and 185 nurses worked in the operating rooms of fourteen private hospitals, five state hospitals, and one university hospital in Gaziantep, Turkey. Scale validity analysis, language equivalence, content validity, exploratory and confirmatory factor analysis, reliability analysis, internal consistency, item-total correlations, and retest method were used. The STARD checklist organized the study setting.</div></div><div><h3>Results</h3><div>The scale's item-total correlation values were 0.519–0.804, and the Cronbach's alpha coefficient was 0.939. The scale has a five-factor structure, and according to the confirmatory factor analysis, the fit indices were χ2 (Cmin/df) 2.065; CFI 0.957; IFI: 0.958; Excellent agreement with TLI: 0.944; and RMR: 0.051, RMSEA 0.076; and it was found to be in acceptable agreement with NFI 0.921 and AGFI 0.836 (<em>p</em> = 0.000). The scale's discriminant validity was AVE: 0.59, CR: 0.88, and there were high congruent validity correlations.</div></div><div><h3>Conclusion</h3><div>The Person-Centered Preoperative Nursing Scale, which can be used to evaluate the quality of perioperative care, has enough validity and reliability indicators to be considered a measurement tool.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100468"},"PeriodicalIF":0.0,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139140","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":"Efficacy of massage therapy in alleviating pain and anxiety post-cardiac surgery: A systematic review and meta-analysis","authors":"Esra Özkan ,&nbsp;Nurten Gülsüm Bayrak","doi":"10.1016/j.pcorm.2025.100465","DOIUrl":"10.1016/j.pcorm.2025.100465","url":null,"abstract":"<div><h3>Background</h3><div>Despite the existence of controlled trials (CTs) and a handful of meta-analyses investigating the effects of massage on postoperative pain and anxiety, recent comprehensive reviews in this area are scarce.</div></div><div><h3>Aim</h3><div>This study seeks to fill this gap by quantifying the impact of massage therapy on pain and anxiety levels in patients who have undergone cardiac surgery, thereby enriching the existing body of literature.</div></div><div><h3>Design</h3><div>A systematic review and meta-analysis.</div></div><div><h3>Review methods</h3><div>The random effect model was applied to estimate the effects since the heterogeneity between results was high.</div></div><div><h3>Data Sources</h3><div>Five databases (Scopus, Clinical Key, Web of Science, Pubmed, Science-Direct) were searched for CTs from July to October 2023.</div></div><div><h3>Results</h3><div>The analysis included 19 control trials and showed that massage therapy is effective in reducing postoperative pain (95 % CI, <em>g</em> = 0.899, <em>p</em> &lt; .000) and anxiety (95 % CI, <em>g</em> = 0.705, <em>p</em> &lt; .000). In our study significant variations in effect sizes based on the person applying the massage, and the type of massage used (<em>p</em> &lt; .05 for all), suggesting these factors significantly moderate the effect of massage therapy on pain and anxiety reduction.</div></div><div><h3>Conclusion</h3><div>The results advocate for the integration of massage therapy into the postoperative recovery plans of patients undergoing cardiac surgery, highlighting its potential to alleviate pain and anxiety effectively. As such, massage therapy represents a valuable complementary approach to traditional care methods.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100465"},"PeriodicalIF":0.0,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138812","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":"Adductor canal block versus intra-articular analgesia for postoperative pain after arthroscopic anterior cruciate ligament reconstruction: A randomized trial","authors":"Seham M. Moeen ,&nbsp;Shaymaa R. Zarea ,&nbsp;Mohamed H. Bakri ,&nbsp;Hesham A. Elkady ,&nbsp;Mohamed T. Mohamed ,&nbsp;Mohamed A. Abdelsalam","doi":"10.1016/j.pcorm.2025.100466","DOIUrl":"10.1016/j.pcorm.2025.100466","url":null,"abstract":"<div><h3>Objectives</h3><div>Optimal analgesia is crucial for promoting early rehabilitation and enhances functional recovery after arthroscopic anterior cruciate ligament reconstruction (ACLR). Our main objective was to compare the analgesic effectiveness of bupivacaine and dexamethasone administered in an adductor canal block (ACB) versus intra-articularly (IA) after ACLR. We hypothesized that the two approaches might have equal efficacy.</div></div><div><h3>Methods</h3><div>Seventy-two adult patients, ASA I–II, aged 18–65 years, undergoing elective ACLR under spinal anesthesia, were included in this randomized, double-blind, sham-controlled trial. Patients were randomly assigned to receive 18 ml of bupivacaine 0.25 % and 8 mg of dexamethasone either in ACB 30 min before spinal anesthesia or intra-articularly at the end of the surgery. Pain scores, both at rest and during movement, were assessed at 6, 12, 18, and 24 h after surgery. The time until the first analgesic request and the total analgesic consumption were recorded. Quadriceps muscle strength at 6 and 24 h after surgery, patient satisfaction, and any side effects were also recorded.</div></div><div><h3>Results</h3><div>The pain scores were significantly lower in the IA group at 12, 18, and 24 hrs after surgery, both at rest and during movement, with no patients requiring analgesia up to the first 17 hrs postoperatively. The times to the first ketorolac (1342.5 ± 132.7 versus 1167.5 ± 297.36 min, P= 0.029) and morphine (1412.5 ± 87.94 versus 1278.33 ± 274.04 min, P= 0.025) doses were significantly longer in the IA group compared to the ACB group. Kaplan-Meier curves for times to the first ketorolac and morphine doses showed significant differences (Breslow test) between the groups (P= 0.028 and P= 0.025, respectively). The total analgesic consumption was insignificantly lower in the IA group compared to the ACB group. Both groups had similar quadriceps muscle strength and patient satisfaction post-surgery, with no perioperative side effects observed.</div></div><div><h3>Conclusions</h3><div>The administration of bupivacaine plus dexamethasone for IA analgesia, compared to ACB, provided superior pain relief for up to 17 h following ACLR, both at rest and during movement.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100466"},"PeriodicalIF":0.0,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139138","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":"Potential role of intravenous lidocaine versus intravenous ketamine for pain management in fibromyalgia patients","authors":"Maha Sadek El Derh ,&nbsp;Sherif Essam Shabaan ,&nbsp;Sally Saber AbdelAziz ,&nbsp;Reham M. Hashim","doi":"10.1016/j.pcorm.2025.100462","DOIUrl":"10.1016/j.pcorm.2025.100462","url":null,"abstract":"<div><h3>Introduction</h3><div>Fibromyalgia syndrome (FMS) is a disease characterized by chronic, pain associated with impaired physical function and overall quality of life (QOL). Pain can be controlled by IV lidocaine which is considered a topical anesthetic drug. Also, ketamine is used as a potent anesthetic agent reducing the induction of synaptic plasticity and maintenance of chronic pain states.</div></div><div><h3>This study aimed</h3><div>to assess the efficacy of intravenous (IV) lidocaine versus IV ketamine in pain management and improvement in the QOL in FM patients.</div></div><div><h3>Patients &amp;methods</h3><div>75 patients were divided equally into 3 groups in which group A received 5 mg/Kg lidocaine, group B received 0.5 mg/Kg ketamine sulphate and group C received a placebo of normal saline. This procedure was done weekly for 3 weeks.</div></div><div><h3>Result</h3><div>As regards pain perception using VAS group A&amp;B showed a marked reduction in VAS with no difference between them, with no change in group C. Changes in the fibromyalgia impact questionnaire (FIQ) were analyzed and showed the mental part of the health score decreased significantly in all groups while the physical and overall parts of the health score decreased significantly only in the lidocaine and ketamine group and non-significantly changed in the placebo group. Overall QOL significantly improved in groups A&amp;B assessed by Health-related quality of life (HrQOL) SF-12 questionnaire 4 weeks post-procedure.</div></div><div><h3>Conclusion</h3><div>IV lidocaine and ketamine are efficient not only in pain relief among patients with FM but also in improving physical function and QOL.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100462"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143139139","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":"Knowledge levels of surgical nurses regarding surgical site infections: A cross-sectional evaluation","authors":"Şeyma Yurtseven ,&nbsp;Hamide Şişman","doi":"10.1016/j.pcorm.2025.100461","DOIUrl":"10.1016/j.pcorm.2025.100461","url":null,"abstract":"<div><h3>Introduction</h3><div>Surgical site infections (SSI) are an important health problem that develop after surgical interventions and can have serious negative effects on patient health. Surgical nurses play a critical role in the prevention of these infections.</div></div><div><h3>Objective</h3><div>This study was conducted to determine the level of knowledge of nurses working in surgical clinics about SSI.</div></div><div><h3>Method</h3><div>The population of this descriptive and cross-sectional study consisted of 170 nurses working in the surgical units of Çukurova University Faculty of Medicine Balcalı Hospital. The sample of the study consisted of 142 (83 %) nurses who met the inclusion criteria in April-June 2024. The data were collected using a questionnaire form designed to test the socio-demographic characteristics of the participants and their level of knowledge about surgical site infection. In addition to descriptive statistics, ANOVA and Student t-test were used to analyse the data.</div></div><div><h3>Results</h3><div>Of the nurses who participated in the study, 78.9 % were female and 72.5 % received training on SSI in the institution. The mean number of correct answers given by the nurses to the questions about SSI was 20±2.4 and the mean number of incorrect answers was 8 ± 2.4. It was found that there was a statistically significant relationship between the number of correct answers given by the nurses and gender, age groups, education, working time in surgical units and in the institution, working style, and SSI training status (<em>p</em> &lt; 0.05).</div></div><div><h3>Conclusion</h3><div>The results of the study suggest that increasing the level of knowledge of surgical nurses about SSI is of great importance in terms of preventing infections and ensuring patient safety. In this context, it is recommended that health institutions should organise continuous education programmes and nurses should actively participate in these programmes. In addition, it is recommended to improve the working conditions of nurses to increase the applicability of infection control measures.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100461"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138823","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 cross-sectional study on dimensions of low back pain in Hamedan Hospitals","authors":"Ashkan karimi ,&nbsp;Behzad Imani ,&nbsp;Jaber Zabihirad ,&nbsp;Reza Feizi ,&nbsp;Ali Gharahzade ,&nbsp;Reza Tavakkol","doi":"10.1016/j.pcorm.2025.100464","DOIUrl":"10.1016/j.pcorm.2025.100464","url":null,"abstract":"<div><h3>Background</h3><div>Low-back pain (LBP) is the most common musculoskeletal disorder, which is considered one of the most debilitating chronic conditions worldwide. The operating room personnel are at higher risk of LBP due to the different working environment. Therefore, the aim of present study was to investigate the prevalence, dimensions and risk factors of LBP among operating room personnel of Hamedan hospitals.</div></div><div><h3>Methods</h3><div>This descriptive-cross-sectional study was conducted on 350 operating room personnel of teaching hospitals affiliated to Hamedan University of Medical Sciences in 2023. The sample size was estimated by census method. Data analysis was also carried out using descriptive statistics, frequency distribution, mean and standard deviation, chi-square test, <em>t</em>-test and ANOVA in SPSS ver. 22.</div></div><div><h3>Results</h3><div>Most of the participants (78.3 %) had LBP. Among the studied operating rooms, the highest and the lowest LBP rate belonged to the maxillofacial operating room and the plastic and reconstructive surgery operating rooms, respectively. The most prevalent LBP included acute LBP (40.6 %) and the regional type in which the pain did not radiate into the legs. Most people with LBP in this study complained of sharp pain (28.3 %) and mild transient pain that subsided without painkillers or rest.<span><span>²⁹</span></span> The results also revealed a significant relationship between age, years of work experience and type of hospital with LBP prevalence.</div></div><div><h3>Conclusions</h3><div>The results of the present study showed high prevalence for LBP among operating room personnel, and unfortunately, many of these people develop this condition within the first few years of their work. Therefore, it is recommended that operating room personnel are regularly screened and evaluated for musculoskeletal disorders (MSDs) and LBP, and adequate information about this complication is given to them.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100464"},"PeriodicalIF":0.0,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138811","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":"Predictive criteria for difficult tracheal intubation in a Moroccan population: A prospective observational study","authors":"Soumaya Touzani ,&nbsp;Adel Elmekkaoui ,&nbsp;Fatima Bouyarmane ,&nbsp;Nawfal Houari ,&nbsp;Abderrahim El Bouazzaoui ,&nbsp;Brahim Boukatta ,&nbsp;Nabil Kanjaa","doi":"10.1016/j.pcorm.2025.100463","DOIUrl":"10.1016/j.pcorm.2025.100463","url":null,"abstract":"<div><h3>Background</h3><div>Difficult tracheal intubation (DTI) may be a major cause of morbidity and mortality if not anticipated. Pre-anesthesia airway risk assessment is a must for safety reasons. The aim of this study is to analyze the clinical predictive criteria for DTI with particular focus on the Mallampati score in the supine and sitting positions.</div></div><div><h3>Methods</h3><div>This is a 6-month prospective observational study including all surgical adult patients requiring oro-tracheal intubation and not relevant to an indication for fibroscopic intubation nor urgent surgery (N = 500). DTI predictive criteria, composite scores, mask ventilation, laryngoscopy, and glottic catheterization were collected. Primary outcome was the ability of the collected criteria to predict DTI. Secondary outcome was the comparison of the Mallampatti score in the sitting vs. supine position to predict DTI using Cohen's kappa non-parametric test.</div></div><div><h3>Results</h3><div>Mean age was 46.5 years. 10 % had diabetes. The incidence of DTI was 26 %. Six predictive factors for DTI were identified in multivariate analysis (<em>p</em> &lt; 0.05): body mass index greater than 30 kg/m², mouth opening &lt;3.5 cm, thyromental distance &lt;6.5 cm, grades III and IV of Mallampati sitting and supine scores and Cormack and Lehane score IV. Mallampati supine score outperformed Mallampati sitting score in predicting the risk of difficult intubation, with respective ROCs at 0.898 (IC95 % 0.857–0.938) vs 0.751 (IC95 % 0.678–0.824).</div></div><div><h3>Conclusions</h3><div>Incidence of DTI was higher in our population, probably related to our specific context of care. Predictive factors of DTI are consistent with previous studies while composite scores are not conclusive. The supine Mallampati performed better than sitting Mallampati in predicting DTI and may be reliable pre-operatively to assess the airway in patients unable to sit.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"38 ","pages":"Article 100463"},"PeriodicalIF":0.0,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143138825","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}