Perioperative Care and Operating Room Management最新文献

{"title":"The effect of surgical smoke on operating room workers, attitudes towards risks, and the implementation of preventive measures","authors":"Derya Esenkaya ,&nbsp;Emine İyigün","doi":"10.1016/j.pcorm.2024.100442","DOIUrl":"10.1016/j.pcorm.2024.100442","url":null,"abstract":"<div><div>Amaç: Bu araştırma, cerrahi dumanın ameliyathane sahipleri üzerinde mevcutlukları, risklere karşı tutumlarını ve para harcamanlarını planlama amacıyla tanımlama olarak yapılmıştır. Gereç ve Yöntem: Kesitsel kalitede bu çalışma, Türkiye'de bir hastanenin ameliyathane ünitesinde Nisan-Mayıs 2022′de kayıtlı süre boyunca devam etmektedir. Araştırmanın boyutları, dahil edilme kriterlerini karşılayan 73 ameliyathane çalışanından oluşuyordu. Araştırmanın verileri Kişisel Bilgi Formu, AORN (Peri-Operatif Kayıtlı Hemşireler Derneği) rehberleri ve ilgili kaynaklarla kırsal Cerrahi Dumanın Ameliyathane Çalışanları Üzerindeki Etkileri, Risklere Yönelik Tutumlar ve Önleyici Tedbirlerin Uygulanması Anketi ile toplanmıştır. Bulgular: Ameliyathane çalışanlarının %91,8′i (<em>n</em> = 67) son beş yıl içerisinde cerrahi dumanla ilgili herhangi bir eğitime katılmadığını belirtti. Bunların %75,3′ü cerrahi dumana maruz kaldıklarını bildirdi. Ameliyathane çalışanlarının yaklaşık %50,7′si (<em>n</em> = 37) lazer dumanı tahliyesi için herhangi bir cihazın kullanılmadığını belirtirken, %39,7′si (<em>n</em> = 29) tahliye dumanı için kullanılan cihazlar hakkında bilgisinin olmadığını belirtti. Ameliyathane çalışanlarının %65,8′inin (<em>n</em> = 48) iş yerlerinde cerrahi dumanla ilgili herhangi bir protokolden haber yoktu. Cerrahi dumana maruz kalmanın sağlık üzerindeki etkilerine, maruziyete dayanıklına süt verdiklerini bildirdiler: sızıntı (%65,8), göz tahrişi (%65,8), gözlerde sulanma (%63,0), göz kuruluğu (%65,8)), uyku bozuklukları (%49,3) %), solunum problemleri (%37,0) ve baş ağrısı (%35,6). Araştırmada ameliyathane çalışanlarının elde edebilecekleri cerrahi dumandan korunmak için kişisel koruyucu önlemlerin alınması. Cerrahi maske (%100), aspirasyon sondası (%60,3), önlük (%41,1) ve gözlük (%35,6) belirlendi. Sağlık çalışanlarının cerrahi dumanın potansiyel tehlikelerine karşı tutumları değerlendirildi. Diğer sağlık çalışanlarının ameliyathane çalışanlarına göre daha fazla kaygı yaşadıkları belirlendi. Sonuç: Araştırmanın düzenine göre ameliyathane çalışanlarının sağlıklı duman tehlikelerine yönelik ilerlemeye yönelik tutumlarını geliştirecek yöntemlerin benimsenmesinin esasları. Ayrıca vakum dumanıyla ilgili tamamlayıcıları önlemek için politikalar ve kılavuzlar iletilmeli ve yöneticilerden uygun ekipman ve destek eğitimi.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100442"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662593","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":"Procedure-adjusted incidences of postoperative hospital admissions are not associated with differences in the quality of anesthesiologists’ clinical supervision or nurse anesthetists’ work habits","authors":"Franklin Dexter ,&nbsp;Bradley J. Hindman ,&nbsp;Richard H. Epstein ,&nbsp;Andrea Vannucci ,&nbsp;Rashmi N. Mueller","doi":"10.1016/j.pcorm.2024.100441","DOIUrl":"10.1016/j.pcorm.2024.100441","url":null,"abstract":"<div><h3>Background</h3><div>Anesthesia departments may benefit from automated computerized methods to monitor the clinical performance of individual anesthesia practitioners. Hospital admission (&gt;1 night stay) after ambulatory surgery may be a suitable metric, with higher incidences potentially being associated with poor clinical performance. If valid, there should be a small but statistically significant association of postoperative admission with previously validated measures of quality of intraoperative anesthesia care.</div></div><div><h3>Methods</h3><div>This retrospective cohort study used eight fiscal years of data from one hospital with daily assessments of two different measures of quality of anesthesia clinical care. One variable was anesthesiologists’ clinical supervision evaluated by trainees, principally residents. The second independent variable was nurse anesthetists’ work habits, evaluated by anesthesiologists. These independent variables were binary, the proportions of rater-leniency-adjusted evaluations with maximum performance for all items, calculated annually. The dependent variable was the proportion of ratees’ cases (anesthesiologist or nurse anesthetist) with postoperative length of stay ≤ 1 day, adjusted for surgical suite and procedure category. Thus, for both independent and dependent variables, larger (positive logits) were “good” and smaller (negative logits) were “bad.”</div></div><div><h3>Results</h3><div>There were no significant associations for either supervision (P =0.14, N=561 anesthesiologist-years) or work habits (P =0.74, N=598 nurse anesthetist-years). Estimated signs of the slopes were for increases in the logits of the quality of clinical supervision to be associated with non-significant <u>decreases</u> in the logits of the probabilities of the patients having lengths of stay ≤1 day. Similarly, increases in the logits of nurse anesthetists’ work habits had negative-signed non-significant associations with the logits of the probabilities of the patients having lengths of stay ≤1 day.</div></div><div><h3>Conclusions</h3><div>The results show with substantial certainty that higher-performing anesthesia practitioners do not have briefer lengths of stay. Anesthesiologists and nurse anesthetists should not be compared among one another based on whether their patients have a greater than predicted risk of procedure-adjusted hospital admission after ambulatory surgery.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100441"},"PeriodicalIF":0.0,"publicationDate":"2024-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142578130","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":"Role of Granisetron in preventing hypotension after spinal anaesthesia with Levobupivacaine in rheumatic patients undergoing elective cesarean section: A randomized controlled trial","authors":"Marwa Mahmoud AbdelRady ,&nbsp;Ghada Mohammad AboElfadl ,&nbsp;Mohamed Nassar Ibrahim ,&nbsp;Hany Ahmed Ibraheem El-Morabaa ,&nbsp;Ahmad Mohamed Aboelfadl ,&nbsp;Ahmed Aboulfotouh","doi":"10.1016/j.pcorm.2024.100439","DOIUrl":"10.1016/j.pcorm.2024.100439","url":null,"abstract":"<div><h3>Background</h3><div>Heart disease, which carries a high risk, is the main factor contributing to maternal death and morbidity during pregnancy. In this trial, we examined how well intravenous (IV) granisetron prevented bradycardia and hypotension in rheumatic patients undergoing elective cesarean delivery.</div></div><div><h3>Patients and methods</h3><div>There were 102 patients total in the study, 51 in each of the two groups. Patients in Group G received 1 mg of IV granisetron diluted to 5 ml before the start of spinal anaesthesia, while those in Group S received 5 ml of 0.9 % normal saline. It has been recorded how much atropine and vasopressor were used overall. The Apgar scores at one and five minutes were also examined.</div></div><div><h3>Results</h3><div>In Group S, the prevalence of hypotension was 60.7 %, compared to 33.3 % in Group G (<em>p</em> &lt; 0.05). As a result, patients in Group S needed considerably more ephedrine (<em>p</em> &lt; 0.05). Patients in Group G had their hemodynamic parameters well maintained for the duration of the research. The Apgar score measured the neonatal outcome at 0-, 1-, and 5 min following birth, and it was equivalent between the two study groups.</div></div><div><h3>Conclusion</h3><div>Before spinal anaesthesia, intravenous granisetron 1 mg can lower hypotension in cardiac parturients without negatively affecting the mother or the baby.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100439"},"PeriodicalIF":0.0,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142662554","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":"Countermeasures and management schemes for improving the quality of continuing medical education in hospitals","authors":"Weiwei Zhou ,&nbsp;Fangfang Liang ,&nbsp;Jiajia Qin ,&nbsp;Hui Wei ,&nbsp;Arshad Mehmood ,&nbsp;Yourong Cao ,&nbsp;Qijia Huang ,&nbsp;Zhong Lin ,&nbsp;Yi Mo","doi":"10.1016/j.pcorm.2024.100440","DOIUrl":"10.1016/j.pcorm.2024.100440","url":null,"abstract":"<div><h3>Background</h3><div>This paper analyzes the urgency, importance, and current situation of continuing medical education in hospitals.</div></div><div><h3>Methods</h3><div>To solve the existing problems in continuing medical education, a series of countermeasures and management schemes to improve the quality of continuing medical education were put forward.</div></div><div><h3>Results</h3><div>These solutions include setting up specialized agencies in the field of continuing medical education, strengthening the construction of teaching staff, perfecting the teaching contents and methods, normative training management measures, and improving the participation willingness of the medical staff.</div></div><div><h3>Conclusion</h3><div>These countermeasures and management schemes will help the hospital improve the quality of continuing medical education, promote academic exchanges and cooperation with medical staff, improve the quality of medical services, and promote the healthy development of the medical industry.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100440"},"PeriodicalIF":0.0,"publicationDate":"2024-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535423","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 Acero perioperative skin bundle: An intuitive perioperative pressure injury prevention bundle","authors":"Lilibeth Acero ,&nbsp;Mandy Spitzer","doi":"10.1016/j.pcorm.2024.100436","DOIUrl":"10.1016/j.pcorm.2024.100436","url":null,"abstract":"<div><div>Over 40 million major surgeries are performed each year in the US, and perioperative care areas are a high-risk environment for the development of pressure injuries (PI). A unique set of challenges for the prevention of PI is faced during the perioperative period due to prolonged immobility and positioning on a relatively hard surface. The Acero Perioperative Skin Bundle (APSB) was developed to facilitate risk assessment and application of appropriate interventions at a 500+ bed safety-net, teaching hospital. Prior to the implementation of the bundle, there was a perioperative-acquired incidence of 1.9 %, accounting for 38 % of all hospital-acquired PI. In the 24-months following implementation of the bundle the hospital has maintained a perioperative-acquired PI incidence of 0 % (p = .0001). This quality improvement report demonstrates how the implementation of standardized risk assessment and application of evidence-based interventions was cost effective and significantly reduced PI acquired in perioperative care.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100436"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535424","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":"The role of Clinical Nurse Specialist and the safety management in operating theatre during the COVID-19 pandemic: An integrative scoping review","authors":"Marco Sguanci ,&nbsp;Stefano Mancin ,&nbsp;Sara Morales Palomares ,&nbsp;Giovanni Cangelosi ,&nbsp;Mauro Parozzi ,&nbsp;Michela Piredda ,&nbsp;Maria Grazia De Marinis","doi":"10.1016/j.pcorm.2024.100437","DOIUrl":"10.1016/j.pcorm.2024.100437","url":null,"abstract":"<div><h3>Background</h3><div>The global health crisis caused by the COVID-19 pandemic has prompted discussions regarding the best approach to safely manage COVID-19 positive patients in the operating room.</div></div><div><h3>Objective</h3><div>This study aimed to highlight the importance of \"standardised clinical practice\" and the role of the \"Clinical Nurse Specialist\" in treating COVID-19 positive patients in the operating room. Methods: A scoping review based on Arksey and O'Malley's methodology was conducted. Searches were conducted in Cochrane Library, PubMed, Embase, CINAHL, Scopus, and Web of Science for studies on perioperative management and the Clinical Nurse Specialist's role in COVID-19 surgeries. Manual searches included reference lists and Google Scholar. Two reviewers independently screened, selected, and included articles, assessing the risk of bias and methodological quality.</div></div><div><h3>Results</h3><div>From 278 identified records, 24 studies were included. Two key aspects emerged: clinical safety procedures and the Clinical Nurse Specialist's role in the perioperative setting. Standardised practice in the operating room is crucial, and the Clinical Nurse Specialist has significant potential in managing COVID-19 patients.</div></div><div><h3>Conclusions</h3><div>Healthcare organizations should prioritize standardized practices for surgical assistance of COVID-19 patients. While global implementation of the Clinical Nurse Specialist is limited, their inclusion in perioperative settings could enhance care efficiency.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100437"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416044","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":"The fault in our nature: Error rates in a human observation study on surgical instrument errors in the OR","authors":"Abner M.P. Barbosa ,&nbsp;Mark J. Saari ,&nbsp;Peter F. Nichol","doi":"10.1016/j.pcorm.2024.100438","DOIUrl":"10.1016/j.pcorm.2024.100438","url":null,"abstract":"<div><h3>Background</h3><div>Errors in sterile processing of surgical instruments result in wasted chargeable operating room minutes. Data delineating this problem have been generated primarily through human observation and reporting. Given the inherent error rate in human tasks, we hypothesized that the observed rate of surgical instrument errors per case per day would increase over a six-week longitudinal study as observers became more familiar with their environment and more comfortable identifying errors.</div></div><div><h3>Methods</h3><div>A previously published dataset on surgical instrument errors was analyzed for the average errors per case per day over six weeks. Errors per case per day were compared to the percentage of inpatient cases for each respective date since the error rate in inpatient cases is twice that of outpatient cases.</div></div><div><h3>Results</h3><div>While the average errors per case per day increases from 0.28 to 0.62, indicating a potential increase over time, no statistically significant trend was found (<em>p</em> = 0.157). A positive but modest correlation was observed between inpatient percentage and error rates (Pearson correlation = 0.344), nearing statistical significance (<em>p</em> = 0.068). The inpatient case percentage remained stable over time, with no significant trend detected (<em>p</em> = 0.284).</div></div><div><h3>Conclusions</h3><div>Human observation is a critical tool for defining waste arising from sterile processing errors. While the gradual increase in errors per case per day increases, the variability cannot be attributed to the initial adaptation the observer's environment. Future studies should assess inter-rated reliability and explore alternative automated observation methods to have a more accurate measurement of the number of errors observed.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100438"},"PeriodicalIF":0.0,"publicationDate":"2024-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142416043","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":"Abbreviated in-situ inter-professional debriefing simulation training in peri-operative care environments: Minimizing the impact on clinical care using standardized videos","authors":"Kenneth A Lipshy ,&nbsp;Jessica Feinleib ,&nbsp;Brooke Trainer","doi":"10.1016/j.pcorm.2024.100435","DOIUrl":"10.1016/j.pcorm.2024.100435","url":null,"abstract":"&lt;div&gt;&lt;h3&gt;Introduction&lt;/h3&gt;&lt;div&gt;Our facility leadership posed questions to the perioperative leadership team regarding the presence of collaborative communication during the reconciliation of events occurring in several perioperative care areas (operating rooms {OR}, clinic procedure areas, Intensive Care Unit {ICU}). Our team* collaborated to pilot a rapid cycle performance improvement project focused on improving the effectiveness of debriefings and handoffs that could conceivably lead to more effective after-action reviews following events which were complicated by multiple simultaneous unexpected factors. We proposed we could implement standardized abbreviated low-fidelity point of care (in-situ) inter-professional simulation training across the healthcare system with minimal impact on clinical schedules. We believed this would improve the perception of teamwork and collaboration among surgical team members.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Methods&lt;/h3&gt;&lt;div&gt;Inter-professional in-situ simulation training exercises were designed and performed in perioperative care areas systemwide at our three major facilities (Main hospital and two Healthcare Community Centers [HCC]). Multiple iterations of styles of training were conceived and trialed. In the end, preconstructed videos were used to standardize the processes that framed the simulation role-playing of a debriefing after a complex situation. These videos contain the pre-simulation pre-briefings, the clinical situation that preceded the clinical debriefing and the simulation debriefing. Successful reconciliation of the multiple events required team members to exercise closed-loop communication, mutual trust, reengagement, and de-escalation of disengaged team members. Anonymous institutional review board reviewed, and Association of Federal Government Employees (AFGE) approved retrospective pre/post implementation surveys were made available to participants immediately after and sixty to ninety days following simulation exercises.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Results&lt;/h3&gt;&lt;div&gt;Between July 2023 and March 2024, one hundred and six staff in the perioperative care areas participated in twenty-two inter-professional simulation trainings (eleven OR, eight clinic, and three ICU simulations). Fourteen simulation scenarios in seven surgical disciplines were created. Eleven videos were produced covering cases in the O.R., clinic and ICU. Ultimately, the simulations were completed within twenty minutes in the three perioperative care clinical areas. Seventy-nine staff responded to the initial surveys after the simulation training. Eighty percent of the respondents gave favorable assessments regarding the effectiveness of the training in improving components of teamwork and agreed this program should continue.&lt;/div&gt;&lt;/div&gt;&lt;div&gt;&lt;h3&gt;Conclusions&lt;/h3&gt;&lt;div&gt;The pilot program affirmed that we could implement simulations across the healthcare system in a format that minimally impacted the staffs’ clinical schedule. The process was standardi","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100435"},"PeriodicalIF":0.0,"publicationDate":"2024-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142535422","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":"Length of stay and cost of care differences between postoperative patients who board in PACU and those that proceed directly to inpatient bed","authors":"David F Nelson ,&nbsp;Carla Palomino ,&nbsp;Marc C Torjman ,&nbsp;Gavyn Ooi ,&nbsp;Michael S Green","doi":"10.1016/j.pcorm.2024.100434","DOIUrl":"10.1016/j.pcorm.2024.100434","url":null,"abstract":"<div><h3>Background</h3><div>Bottlenecks in PACU throughput are frequently encountered challenges that OR managers must face. This study seeks to examine the impact of extended PACU stay (e.g. boarding) on both total hospital length of stay and overall cost of care.</div></div><div><h3>Methods</h3><div>A total of 4,740 patients were studied having same-day admit surgeries for seven procedure types including: arthroplasty total knee, arthroplasty total hip, fusion spine transforaminal interbody lumbar, revision arthroplasty total knee, revision arthroplasty total hip, posterior cervical fusion, and anterior cervical fusion. 4,471 were identified as non-PACU boarders and 269 as PACU boarders (&gt;6 h in PACU). Included in the analysis were demographics, date of admission, surgical procedure, PACU and hospital length of stay (HLOS), hospital direct costs, case mix index (CMI), and ASA status.</div></div><div><h3>Results</h3><div>The median (IQR) PACU times in minutes were 57.00 (80) and 488.00 (453.50) minutes for PACU non-boarders and boarders (<em>p</em> &lt; 0.001). HLOS was significantly (<em>p</em> &lt; 0.001) more elevated in PACU Boarders compared to PACU Non-boarders: median (IQR) 2.00 (2.00) and 2.00 (3.00), (mean HLOS 3.16±2.83 vs 2.60±2.71 days). Median direct costs were ≈14.36% higher (<em>p</em> = 0.008) for the PACU boarders compared to Non-boarders. Direct costs were also not significantly different when using a 4-hour criteria for PACU boarders (14.39% higher median direct costs, <em>p</em> = 0.004).</div></div><div><h3>Conclusions</h3><div>PACU boarding (&gt;4 h) is associated with a statistically significant increased length of stay as well as direct costs compared with non-boarders across a variety of elective orthopedic and spine procedures. Thus, when frequent PACU boarding occurs, OR managers should consider the potential impact to patient care and hospital margins.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100434"},"PeriodicalIF":0.0,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142357627","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 double blinded randomized prospective trial of comparison between control and study group, nefopam versus tramadol on shivering scores after spinal anesthesia in patients undergoing Transurethral resection of prostate","authors":"Deepali Valecha ,&nbsp;K K Arora ,&nbsp;Swapnil Kumar Barasker","doi":"10.1016/j.pcorm.2024.100433","DOIUrl":"10.1016/j.pcorm.2024.100433","url":null,"abstract":"<div><h3>Introduction</h3><p>Shivering is a common and distressing complication that can occur after subarachnoid block (SAB) in patients, particularly those undergoing transurethral resection of the prostate (TURP) due to the use of irrigating fluid and older age group. This study aims to compare the effectiveness of nefopam and tramadol in reducing intraoperative shivering compared to a control group, in Indian patients.</p></div><div><h3>Methodology</h3><p>This study is a double-blinded randomized control trial with a total of 99 patients undergoing elective TURP under SAB were enrolled. The patients were randomly divided into three groups (GT, GN, and GC): GT received tramadol (0.5 mg kg^-1) and GN received nefopam (0.15 mg kg^-1). Both tramadol and nefopam were premixed into 100 ml of normal saline (NS) and GC received 100 ml NS, given over 15 min just before SAB. The induction protocol was the same for all groups, and shivering score, hemodynamic parameters, and body temperature (BT) were recorded.</p></div><div><h3>Results</h3><p>The overall incidence of shivering was 29.67 % (27/91), with the lowest incidence being in GN (16.67 %, 5/30), followed by GT (22.58 %, 7/31) and GC (50 %, 15/30). Both nefopam and tramadol resulted in a significant (<em>p</em> &lt; 0.05) decrease in the incidence of shivering compared to control. Among the hemodynamic parameters and BT, no significant difference was seen between GT, GN, and GC (<em>p</em> &gt; 0.05).</p></div><div><h3>Conclusion</h3><p>Both nefopam and tramadol were effective in reducing the incidence but the severity was controlled better with nefopam during TURP under SAB.</p></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"37 ","pages":"Article 100433"},"PeriodicalIF":0.0,"publicationDate":"2024-09-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142168112","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}