Perioperative Care and Operating Room Management最新文献_第8页

Evaluation of the perfusion index as a determinant of the depth of anesthesia; an observational study 评价灌注指数作为麻醉深度的决定因素；观察性研究

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-10-17 DOI: 10.1016/j.pcorm.2025.100577

Sooraj D. Desai, Anju R. Bhalotra, Keshav Gaur, Rahil Singh, Shweta Dhiman

Background

Reliable monitoring of nociception and depth of anesthesia remains limited. Most nociception monitors assess sympathetic and parasympathetic nervous system activity. Minimum Alveolar Concentration (MAC) reflects anesthetic potency, while Bispectral Index (BIS) assesses the level of unconsciousness. Perfusion Index (PI), derived from pulse plethysmography, decreases during sympathetic activation. Light anesthesia and nociceptive stimuli trigger sympathetic responses, leading to reduced PI.

Methods

This double-blinded observational study included 35 adult patients undergoing elective surgery under standardized general anesthesia (GA). PI, MAC, BIS, heart rate (HR), and mean arterial pressure (MAP) were recorded during induction, maintenance, and recovery. The primary objective was to assess changes in PI and its correlation with MAC. Secondary outcomes included correlations of PI with BIS, HR, and MAP.

Results

PI showed significant variation across all time points. It increased after induction of GA and decreased during surgical stimulation and recovery. No significant correlation was found between changes in PI and MAC (r² = 0.394, p = 0.052) or BIS (r² = 0.392, p = 0.053). A strong negative correlation was observed between PI and HR (r = –0.888, r² = 0.789, p < 0.001), and a strong positive correlation between PI and MAP (r = 0.795, r² = 0.631, p = 0.006).

Conclusions

PI was a sensitive early indicator of inadequate anesthesia or analgesia, preceding traditional signs of sympathetic activation. Although not correlated with MAC or BIS, its strong association with HR supports its potential role as a simple, noninvasive adjunct in intraoperative monitoring.

背景：对伤害感觉和麻醉深度的可靠监测仍然有限。大多数伤害感觉监测器评估交感和副交感神经系统的活动。最低肺泡浓度（MAC）反映麻醉效力，而双谱指数（BIS）评估无意识水平。在交感神经激活过程中，由脉搏体积描记得出的灌注指数（PI）下降。轻度麻醉和伤害性刺激触发交感神经反应，导致PI降低。方法采用双盲观察方法，对35例在标准化全身麻醉（GA）下择期手术的成人患者进行研究。在诱导、维持和恢复期间记录PI、MAC、BIS、心率（HR）和平均动脉压（MAP）。主要目的是评估PI的变化及其与MAC的相关性。次要结果包括PI与BIS、HR和MAP的相关性。结果spi在各时间点均有显著差异。它在GA诱导后增加，在手术刺激和恢复期间减少。PI与MAC （r²= 0.394,p = 0.052）、BIS （r²= 0.392,p = 0.053）无显著相关。PI与HR呈显著负相关（r = -0.888, r²= 0.789,p < 0.001）， PI与MAP呈显著正相关（r = 0.795, r²= 0.631,p = 0.006）。结论spi是麻醉或镇痛不充分的早期敏感指标，比传统的交感神经激活迹象更早。虽然与MAC或BIS无关，但其与HR的强相关性支持其在术中监测中作为简单、无创辅助手段的潜在作用。

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引用次数: 0

Comparative efficacy of intrathecal morphine and posterior quadratus lumborum block for post-caesarean analgesia 鞘内吗啡与腰方肌后阻滞用于剖宫产后镇痛的比较疗效

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-09-22 DOI: 10.1016/j.pcorm.2025.100559

Ahmed Omar Mahmoud , Gamal Mohamed Abu Dahab Ibrahim , Mahmoud Alhasan Mohamed Hasan , Waleed Ahmad Ali Hussein Atteia , Ahmed Abdelkader Ahmed , Mostafa Hassanien Hassanien Bakr

Background

Effective pain management after caesarean delivery is essential to promote maternal recovery, facilitate early mobility, and support mother-infant bonding. Traditionally, intrathecal morphine (ITM) has been widely used due to its strong analgesic effects, but concerns about opioid-related side effects have led to growing interest in alternative regional techniques such as the quadratus lumborum block (QLB). Comparative evidence on the efficacy of these approaches in obstetric patients remains limited.

Methods

In a randomized trial, 70 cesarean patients underwent spinal anesthetic at Assiut University Hospital. The study compared bilateral posterior QLB with 0.25 % bupivacaine to 100 μg ITM. Secondary outcomes included pain scores, time to first morphine request, side effects, quality of recovery, and functional outcomes; the primary outcome was 24-hour IV morphine consumption.

Results

Morphine consumption over 24 h was similar between the ITM and QLB groups, averaging 6.4 mg and 8.5 mg, respectively. Pain levels at rest and during movement did not differ significantly between the two groups at any time point. However, a subgroup analysis showed that QLB patients with a BMI of 30 kg/m² or higher required more morphine and reported higher peak pain scores compared to those in the ITM group (10.5 mg vs 7.4 mg, p < 0.05). No such difference was seen in patients with a BMI below 30 kg/m². In a multivariate analysis, BMI emerged as the only significant predictor of 24-hour morphine consumption (p = 0.016).

Conclusion

ITM and posterior QLB provide comparable postoperative analgesia after cesarean delivery for the general population. However, patient factors such as BMI and age may influence postoperative opioid requirements and should be considered when selecting an analgesic technique to optimize recovery and minimize side effects.

背景剖宫产后有效的疼痛管理对于促进产妇康复、促进早期活动和支持母婴关系至关重要。传统上，鞘内吗啡（ITM）因其强大的镇痛作用而被广泛使用，但对阿片类药物相关副作用的担忧导致人们对替代区域性技术（如腰方肌阻滞（QLB））的兴趣日益浓厚。关于这些方法在产科患者中的疗效的比较证据仍然有限。方法对70例剖宫产患者在阿西尤特大学医院行脊髓麻醉进行随机对照试验。该研究将双侧后路QLB与0.25%布比卡因和100 μg ITM进行比较。次要结局包括疼痛评分、到第一次吗啡请求的时间、副作用、恢复质量和功能结局；主要终点为24小时静脉注射吗啡。结果ITM组和QLB组24 h吗啡摄取量相似，平均分别为6.4 mg和8.5 mg。两组在休息和运动时的疼痛水平在任何时间点均无显著差异。然而，亚组分析显示，与ITM组相比，BMI为30 kg/m²或更高的QLB患者需要更多的吗啡，并报告更高的峰值疼痛评分（10.5 mg vs 7.4 mg, p < 0.05）。BMI低于30 kg/m²的患者没有这种差异。在多变量分析中，BMI是24小时吗啡摄入量的唯一显著预测因子（p = 0.016）。结论itm与后路QLB对一般人群剖宫产术后镇痛效果相当。然而，BMI和年龄等患者因素可能会影响术后阿片类药物的需求，在选择镇痛技术时应考虑这些因素，以优化恢复并减少副作用。

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引用次数: 0

Use of gastric ultrasound to identify GLP-1RA users at high risk of aspiration during surgery 使用胃超声识别术中高危误吸GLP-1RA使用者

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-09-26 DOI: 10.1016/j.pcorm.2025.100562

Alessandra T. Ayers , Cindy N. Ho , Nicole Y. Xu , Sergio D. Bergese , Ana Costa , David Kerr , David C. Klonoff

The use of Glucagon Like Peptide-1 Receptor Agonists (GLP-1RAs) has been associated with delayed gastric emptying, which may result in patients scheduled for elective procedures presenting with increased gastric contents in the preoperative stage. Patients with shorter fasting periods, or increased gastric volume, present a concern for the anesthesiologist because of the danger of pulmonary aspiration, which carries a high risk of morbidity and mortality. The use of preoperative point of care (POC) gastric ultrasound (GUS) would be expected to identify patients with increased gastric contents thus requiring postponement or specific anesthetic management practices by an anesthesiologist in the perioperative setting. This article presents reasons for recommending 1) routine GUS for patients at risk to assess for increased gastric contents before elective surgical or endoscopic procedures and 2) specific anesthesia management practices when increased gastric contents are identified.

胰高血糖素样肽-1受体激动剂（GLP-1RAs）的使用与胃排空延迟有关，这可能导致预定择期手术的患者在术前出现胃内容物增加。禁食时间较短或胃容量增加的患者，由于肺误吸的危险，其发病率和死亡率很高，因此引起麻醉师的关注。术前护理点（POC）胃超声（GUS）的使用有望识别胃内容物增加的患者，因此需要在围手术期由麻醉医师推迟或特定的麻醉管理实践。本文提出以下建议的理由：1)在择期手术或内镜手术前，对有胃内容物增加风险的患者进行常规GUS评估；2)当发现胃内容物增加时，采用特定的麻醉管理措施。

引用次数: 0

Comparative efficacy of low-dose prothrombin complex concentrate + fresh frozen plasma combination and fresh frozen plasma in postoperative haemostasis after on-pump and off-pump coronary arterial bypass grafting surgery 低剂量凝血酶原复合物浓缩物+新鲜冷冻血浆联合与新鲜冷冻血浆在有泵和无泵冠状动脉搭桥术术后止血效果的比较

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-10-08 DOI: 10.1016/j.pcorm.2025.100572

Reza Widianto Sudjud, Erwin Pradian, Suwarman, Jenifer Kiem Aviani, Phillipus Andre, Dian Nuryanda

Background

Postoperative bleeding is a major cause of morbidity and mortality in CABG. While FFP is commonly used for bleeding management, high doses may increase the risk of acute lung injury and infection. PCC offers a safer alternative. This study compares low-dose PCC + FFP versus FFP alone in on-pump and off-pump CABG.

Methods

Medical records of CABG patients (2022–2023) were reviewed. Statistical analysis included Independent T-Test, Mann-Whitney U, and Chi-Square Test.

Results

The combination of low-dose PCC (500 IU) and FFP achieved significantly more rapid hemostasis within the first 3 hours postoperatively (277.00 ± 60.48 mL vs. 416.00 ± 34.00 mL; p < 0.0001), without any serious adverse events. However, no significant differences in bleeding volume were observed between the groups beyond the 3-hour mark. On-pump surgery patients had longer ICU stays (mean difference: 0.52 [0.31–0.73], p < 0.00001). In-hospital mortality was higher in the PCC group (RR 2.63 [1.25–5.59], p = 0.0149), particularly in on-pump cases, those with three anastomoses, and male patients, but 30-day mortality was similar between groups (RR 1.53 [0.90–2.63], p = 0.1681).

Conclusion

Low-dose PCC provides rapid hemostasis within 3 hours in CABG but should be used cautiously in male patients, multiple anastomoses, and on-pump surgeries.

背景：术后出血是冠状动脉搭桥术发病和死亡的主要原因。虽然FFP通常用于出血治疗，但高剂量可能会增加急性肺损伤和感染的风险。PCC提供了一个更安全的选择。本研究比较了低剂量PCC + FFP与单独FFP在有泵和无泵CABG中的作用。方法回顾我院2022-2023年冠脉搭桥患者的医疗记录。统计分析采用独立t检验、Mann-Whitney U检验和卡方检验。结果低剂量PCC （500 IU）联合FFP在术后前3小时内止血速度明显加快（277.00±60.48 mL vs. 416.00±34.00 mL; p < 0.0001），无严重不良事件发生。然而，3小时后各组之间的出血量没有显著差异。非泵手术患者的ICU住院时间更长（平均差异：0.52 [0.31-0.73],p < 0.00001）。PCC组住院死亡率较高（RR为2.63 [1.25-5.59],p = 0.0149），特别是非泵送组、三吻合口组和男性患者，但两组间30天死亡率相似（RR为1.53 [0.90-2.63],p = 0.1681）。结论小剂量PCC可在冠脉搭桥术后3小时内快速止血，但在男性患者、多处吻合口及无泵手术中应谨慎使用。

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引用次数: 0

Corrigendum to “A cross-sectional study on dimensions of low back pain in Hamedan Hospitals” [Perioperative Care and Operating Room Management 38 (2025), 100464] “哈马丹医院腰痛维度横断面研究”的勘误[围手术期护理与手术室管理38 (2025),100464]

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-11-19 DOI: 10.1016/j.pcorm.2025.100590

Ashkan karimi , Behzad Imani , Jaber Zabihirad , Reza Feizi , Ali Gharahzade , Reza Tavakkol

引用次数: 0

The effect of professional ethics training on the awareness and attitude of operating room nurses 职业道德培训对手术室护士意识和态度的影响

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-09-30 DOI: 10.1016/j.pcorm.2025.100564

Fardin Amiri , Sina Haghi , Alice Khachian , Seyed Abolfazl Hosseini , Namamali Azadi

Introduction

Adherence to the principles of professional ethics is a fundamental and challenging cornerstone of the nursing profession, particularly in the high-pressure environment of the operating room. Despite the importance of training in this domain, a distinct research gap exists in evaluating the impact of educational interventions on the "awareness" and "attitude" of operating room nurses. The present study was designed and conducted to precisely evaluate the effect of an educational intervention on these two key variables.

Methods

This quasi-experimental study was conducted on 64 operating room nurses employed at the educational-therapeutic centers of Iran University of Medical Sciences, who were selected via simple random sampling. Data were collected using a valid and reliable researcher-developed questionnaire before and 20 days after a CD-based educational intervention. The collected data were analyzed using the Wilcoxon test.

Results

The findings indicated that the educational intervention had a statistically significant effect on enhancing both variables. The mean total scores for awareness (pre: 45.68 ± 6.01, post: 50.15 ± 4.7) and attitude (pre: 49.04 ± 4.5, post: 65.12 ± 3.4) of the nurses increased significantly following the training (P < 0.001).

Discussion and Conclusion

This study demonstrates that targeted education through standardized media, such as an instructional CD, is an effective and practical strategy for strengthening the foundations of professional ethics among operating room nurses. Therefore, the implementation of this educational approach in the retraining and professional development programs for nurses is strongly recommended.

坚持职业道德原则是护理职业的基本和具有挑战性的基石，特别是在手术室的高压环境中。尽管培训在这一领域很重要，但在评估教育干预对手术室护士“意识”和“态度”的影响方面，存在明显的研究空白。本研究旨在准确评估教育干预对这两个关键变量的影响。方法采用简单随机抽样的方法，对伊朗医科大学教育治疗中心的64名手术室护士进行准实验研究。数据收集使用有效和可靠的研究人员开发的问卷调查之前和之后20天的cd为基础的教育干预。收集的数据采用Wilcoxon检验进行分析。结果教育干预对两个变量的增强均有显著的统计学意义。培训后护士的意识（前：45.68±6.01，后：50.15±4.7）和态度（前：49.04±4.5，后：65.12±3.4）的平均总分显著提高（P < 0.001）。讨论与结论本研究表明，通过标准化的媒体，如教学光盘，进行有针对性的教育，是加强手术室护士职业道德基础的有效而实用的策略。因此，强烈建议在护士再培训和专业发展计划中实施这种教育方法。

{"title":"The effect of professional ethics training on the awareness and attitude of operating room nurses","authors":"Fardin Amiri , Sina Haghi , Alice Khachian , Seyed Abolfazl Hosseini , Namamali Azadi","doi":"10.1016/j.pcorm.2025.100564","DOIUrl":"10.1016/j.pcorm.2025.100564","url":null,"abstract":"<div><h3>Introduction</h3><div>Adherence to the principles of professional ethics is a fundamental and challenging cornerstone of the nursing profession, particularly in the high-pressure environment of the operating room. Despite the importance of training in this domain, a distinct research gap exists in evaluating the impact of educational interventions on the \"awareness\" and \"attitude\" of operating room nurses. The present study was designed and conducted to precisely evaluate the effect of an educational intervention on these two key variables.</div></div><div><h3>Methods</h3><div>This quasi-experimental study was conducted on 64 operating room nurses employed at the educational-therapeutic centers of Iran University of Medical Sciences, who were selected via simple random sampling. Data were collected using a valid and reliable researcher-developed questionnaire before and 20 days after a CD-based educational intervention. The collected data were analyzed using the Wilcoxon test.</div></div><div><h3>Results</h3><div>The findings indicated that the educational intervention had a statistically significant effect on enhancing both variables. The mean total scores for awareness (pre: 45.68 ± 6.01, post: 50.15 ± 4.7) and attitude (pre: 49.04 ± 4.5, post: 65.12 ± 3.4) of the nurses increased significantly following the training (<em>P</em> < 0.001).</div></div><div><h3>Discussion and Conclusion</h3><div>This study demonstrates that targeted education through standardized media, such as an instructional CD, is an effective and practical strategy for strengthening the foundations of professional ethics among operating room nurses. Therefore, the implementation of this educational approach in the retraining and professional development programs for nurses is strongly recommended.</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100564"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269386","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}

引用次数: 0

Intravenous Dexmedetomidine vs. Meperidine for managing shivering after spinal anesthesia in cesarean deliveries: a randomized trial 静脉注射右美托咪定与哌哌啶治疗剖宫产脊髓麻醉后的寒战：一项随机试验

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-10-15 DOI: 10.1016/j.pcorm.2025.100575

Nahid Manouchehrian , Alireza Mortazavi , Mohammad Nima Mehrabani

Background

Post-spinal anesthesia shivering is a common complication during cesarean delivery, causing patient discomfort and interfering with vital sign monitoring.

Objectives

This study compared the efficacy and safety of intravenous dexmedetomidine and meperidine for controlling post-spinal anesthesia shivering in cesarean deliveries.

Methods

In this randomized clinical trial, 246 parturients who developed shivering after spinal anesthesia were allocated to two groups. Group A received intravenous meperidine (0.5 mg/kg), and Group B received dexmedetomidine (0.5 µg/kg), both administered over 10 min after umbilical cord clamping. Shivering intensity, vital signs, and adverse effects were recorded and analyzed.

Results

The onset time of shivering was similar between groups (P = 0.081). The time to cessation of shivering was significantly shorter in the meperidine group (7.6 ± 4.6 min) compared to the dexmedetomidine group (9.7 ± 5.5 min) (P = 0.003). Shivering scores at 5- and 10-minute post-injection were significantly lower in the meperidine group (P < 0.05). Blood pressure was lower and heart rate higher in the meperidine group at early time points (P < 0.05), but these changes were transient and not clinically significant. Dexmedetomidine was associated with higher rates of bradycardia and hypertension (P = 0.001 and P = 0.005), while nausea and vomiting were more frequent with meperidine (P = 0.166). Meperidine demonstrated a faster time to shivering cessation, while dexmedetomidine had lower rates of nausea and vomiting.

Conclusion

Both drugs effectively controlled post-spinal anesthesia shivering. Meperidine demonstrated a faster time to shivering cessation, while dexmedetomidine had lower rates of nausea and vomiting. Further studies are needed to optimize dosing and assess long-term outcomes

脊髓麻醉后寒战是剖宫产术中常见的并发症，可引起患者不适并干扰生命体征监测。目的比较右美托咪定和哌哌啶静脉注射控制剖宫产脊髓麻醉后寒战的疗效和安全性。方法将246例脊髓麻醉后出现寒战的产妇随机分为两组。A组静脉滴注哌哌啶（0.5 mg/kg）， B组静脉滴注右美托咪定（0.5µg/kg），均在脐带夹紧后10 min内给药。记录和分析寒战强度、生命体征和不良反应。结果两组患者寒战发作时间相近（P = 0.081）。与右美托咪定组（9.7±5.5 min）相比，哌嗪组（7.6±4.6 min）停止颤抖的时间明显缩短（P = 0.003）。注射后5分钟和10分钟，哌啶组的寒颤评分明显降低（P < 0.05）。哌哌啶组在早期时间点血压较低、心率较高（P < 0.05），但这些变化是短暂的，无临床意义。右美托咪定与较高的心动过缓和高血压发生率相关（P = 0.001和P = 0.005），而恶心和呕吐更频繁使用哌嗪（P = 0.166）。哌嗪能更快地停止颤抖，而右美托咪定的恶心和呕吐率较低。结论两种药物均能有效控制脊髓麻醉后寒战。哌嗪能更快地停止颤抖，而右美托咪定的恶心和呕吐率较低。需要进一步的研究来优化剂量和评估长期结果

{"title":"Intravenous Dexmedetomidine vs. Meperidine for managing shivering after spinal anesthesia in cesarean deliveries: a randomized trial","authors":"Nahid Manouchehrian , Alireza Mortazavi , Mohammad Nima Mehrabani","doi":"10.1016/j.pcorm.2025.100575","DOIUrl":"10.1016/j.pcorm.2025.100575","url":null,"abstract":"<div><h3>Background</h3><div>Post-spinal anesthesia shivering is a common complication during cesarean delivery, causing patient discomfort and interfering with vital sign monitoring.</div></div><div><h3>Objectives</h3><div>This study compared the efficacy and safety of intravenous dexmedetomidine and meperidine for controlling post-spinal anesthesia shivering in cesarean deliveries.</div></div><div><h3>Methods</h3><div>In this randomized clinical trial, 246 parturients who developed shivering after spinal anesthesia were allocated to two groups. Group A received intravenous meperidine (0.5 mg/kg), and Group B received dexmedetomidine (0.5 µg/kg), both administered over 10 min after umbilical cord clamping. Shivering intensity, vital signs, and adverse effects were recorded and analyzed.</div></div><div><h3>Results</h3><div>The onset time of shivering was similar between groups (<em>P</em> = 0.081). The time to cessation of shivering was significantly shorter in the meperidine group (7.6 ± 4.6 min) compared to the dexmedetomidine group (9.7 ± 5.5 min) (<em>P</em> = 0.003). Shivering scores at 5- and 10-minute post-injection were significantly lower in the meperidine group (<em>P</em> < 0.05). Blood pressure was lower and heart rate higher in the meperidine group at early time points (<em>P</em> < 0.05), but these changes were transient and not clinically significant. Dexmedetomidine was associated with higher rates of bradycardia and hypertension (<em>P</em> = 0.001 and <em>P</em> = 0.005), while nausea and vomiting were more frequent with meperidine (<em>P</em> = 0.166). Meperidine demonstrated a faster time to shivering cessation, while dexmedetomidine had lower rates of nausea and vomiting.</div></div><div><h3>Conclusion</h3><div>Both drugs effectively controlled post-spinal anesthesia shivering. Meperidine demonstrated a faster time to shivering cessation, while dexmedetomidine had lower rates of nausea and vomiting. Further studies are needed to optimize dosing and assess long-term outcomes</div></div>","PeriodicalId":53468,"journal":{"name":"Perioperative Care and Operating Room Management","volume":"41 ","pages":"Article 100575"},"PeriodicalIF":1.0,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145363658","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}

引用次数: 0

The future of percutaneous tracheostomy: Is it time to embrace intensivist-led bedside practice? 经皮气管切开术的未来：是时候接受强化医生主导的床边实践了吗？

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-11-01 DOI: 10.1016/j.pcorm.2025.100580

Amr Salah Omar , Mohamed Khalil

The evolution of percutaneous dilatational tracheostomy (PDT) reflects the growing procedural autonomy of intensivists and the shift toward resource-conscious, patient-centered critical care. Bedside PDT performed or led by trained intensivists or dedicated tracheostomy teams has been shown to be safe, cost-effective, and carries an important ethical advantage by avoiding transport-related risks and reducing preventable harm compared with surgical tracheostomy in the operating room. It avoids transport-related risks, enhances care continuity, and optimizes ICU workflow—benefits that proved vital during the COVID-19 pandemic. Broader adoption of intensivist-led bedside PDT should be viewed not merely as a clinical option, but as a professional and institutional imperative.

经皮扩张性气管切开术（PDT）的发展反映了重症医师日益增长的手术自主性，以及向资源意识、以患者为中心的重症监护的转变。由训练有素的重症医师或专门的气管切开术团队执行或领导的床边PDT已被证明是安全的，具有成本效益的，并且与手术室的气管切开术相比，通过避免与运输相关的风险和减少可预防的伤害，具有重要的伦理优势。它避免了运输相关的风险，提高了护理的连续性，并优化了ICU的工作流程——在2019冠状病毒病大流行期间，这些优势被证明至关重要。更广泛地采用强化医生主导的床边PDT不应仅仅被视为一种临床选择，而是一种专业和制度上的必要。

引用次数: 0

Examining the impact of the peer-mentor program on the clinical competence of surgical technology students at shiraz university of medical sciences 考察同伴导师计划对设拉子医科大学外科技术专业学生临床能力的影响

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-10-30 DOI: 10.1016/j.pcorm.2025.100579

Shaghayegh Garmanjani , Somayeh Gheysari , Mehdi Hasanshahi , Reza Tavakkol , Jamshid Eslami

Background

Peer-mentoring-based education is one of the most important educational aspects that constitutes a significant part of developing competent individuals. This study is a quasi-experimental study that investigates the impact of the peer-mentor program on the clinical competence of surgical technology students.

Methods

The present study is a quasi-experimental investigation conducted with 29 undergraduate students in the fourth semester of surgical technology, divided into control and intervention groups, with a pretest and posttest. The data collection tool was the Operating Room Nurses’ Clinical Competence self-assessment questionnaire, which was completed before and after the training. Descriptive statistics and independent-samples t-tests were used for data analysis.

Results

The results of this study indicated a statistically significant difference between the clinical competence scores before and after the intervention, demonstrating an increase in the clinical competence scores of students in both groups after the intervention (p < 0.05). The independent t-test showed that there was no statistically significant difference in the mean clinical competence scores between the two groups after the intervention (p > 0.05).

Conclusions

The results of this research indicated that the clinical competence scores of students who utilized the peer-mentoring educational method were similar to those of the instructor-led group, suggesting that this educational approach can be as effective as instruction by teachers. Therefore, it is essential to develop clinical educational programs that provide a pathway for academic growth and an appropriate environment for acquiring clinical skills in learners.

同伴导师制教育是教育中最重要的方面之一，是培养有能力的个体的重要组成部分。本研究是一项准实验研究，探讨同侪导师计划对外科技术学生临床能力的影响。方法对29名外科技术专业本科四学期学生进行准实验调查，分为对照组和干预组，进行前测和后测。数据收集工具为《手术室护士临床能力自评问卷》，分别于培训前后完成。数据分析采用描述性统计和独立样本t检验。结果本研究结果显示干预前后临床能力得分差异有统计学意义，干预后两组学生临床能力得分均有提高（p < 0.05）。经独立t检验，干预后两组患者的平均临床能力得分比较，差异无统计学意义（p > 0.05）。结论本研究结果显示，采用同侪导师制教育方式的学生临床能力得分与教师导师制教育方式的学生相似，表明同侪导师制教育方式与教师导师制教育方式同样有效。因此，必须发展临床教育计划，为学习者提供学术成长的途径和获得临床技能的适当环境。

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引用次数: 0

Machine learning surgery duration predictions compared to traditional methods: A systematic review 机器学习手术持续时间预测与传统方法的比较：系统综述

IF 1 Q2 Nursing

Perioperative Care and Operating Room Management

Pub Date : 2025-12-01 Epub Date: 2025-11-04 DOI: 10.1016/j.pcorm.2025.100581

Richard T. Park , Christopher H. Stucky , Chandler H. Moser

Introduction: Accurate estimation of surgical case duration is essential for operating room (OR) efficiency. We aimed to evaluate the performance of machine learning (ML) models to predict surgery duration compared to conventional estimation, and to explore the factors affecting ML performance and its practical implementation.

Methods: Following PRISMA guidelines, we searched literature using MEDLINE, Embase, and CINAHL for articles published between January 2019 and October 2024. Studies were eligible if they evaluated an ML-based model, reported performance data, and compared the models to traditional estimation methods. The risk of bias was assessed using the Prediction model Risk Of Bias Assessment Tool.

Results: Eleven studies met the inclusion criteria. Models trained on specific surgical populations generally outperformed broader models. Several studies had methodological issues, such as incomplete handling of missing data and limited validation. ML models typically improved accuracy over traditional estimates. The average improvement was 25.7 %, with the best models reducing error rates by 51 %. We found no correlation (r = −0.01) between the number of predictor variables and the percentage improvement in prediction accuracy.

Discussion: ML-based surgical duration prediction shows promise for improving OR scheduling efficiency. However, challenges remain, including the need for standardized reporting, robust external validation, and practical integration into existing workflows. The risk of bias and inconsistent reporting of validation methods reduces confidence in the generalizability of ML performance. Heterogeneity in study and model designs complicates direct comparisons. Adopting standardized ML model development and testing protocols for surgical duration prediction can better demonstrate its benefits.

准确估计手术病例持续时间对手术室效率至关重要。我们的目的是评估机器学习（ML）模型在预测手术持续时间方面的性能，并与传统估计相比较，探讨影响ML性能的因素及其实际实施。方法：按照PRISMA指南，我们使用MEDLINE、Embase和CINAHL检索2019年1月至2024年10月间发表的文献。如果研究评估了基于ml的模型，报告了性能数据，并将模型与传统估计方法进行了比较，则该研究是合格的。使用预测模型偏倚风险评估工具评估偏倚风险。结果：11项研究符合纳入标准。在特定手术人群上训练的模型通常优于更广泛的模型。一些研究存在方法学上的问题，例如对缺失数据的处理不完整和验证有限。ML模型通常比传统估计提高了准确性。平均改进为25.7%，最好的模型将错误率降低了51%。我们发现预测变量的数量与预测准确度提高百分比之间没有相关性（r = - 0.01）。讨论：基于ml的手术时间预测有望提高手术室调度效率。然而，挑战仍然存在，包括需要标准化的报告、健壮的外部验证，以及与现有工作流的实际集成。验证方法的偏倚和不一致报告的风险降低了对机器学习性能可泛化性的信心。研究和模型设计的异质性使直接比较复杂化。采用标准化的ML模型开发和测试方案进行手术时间预测可以更好地展示其优势。

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引用次数: 0