Is close monitoring in the intensive care unit necessary after elective liver resection?

Sung Hoon Kim,Jae Gil Lee,So Young Kwon,Jin Hong Lim,Won Oak Kim,Kyung Sik Kim 대한외과학회 2012 Annals of Surgical Treatment and Research(ASRT) Vol.83 No.3

Purpose: Many surgical patients are admitted to the intensive care unit (ICU), resulting in an increased demand, and possible waste, of resources. Patients who undergo liver resection are also transferred postoperatively to the ICU. However, this may not be necessary in all cases. This study was designed to assess the necessity of ICU admission. Methods: The medical records of 313 patients who underwent liver resections, as performed by a single surgeon from March 2000 to December 2010 were retrospectively reviewed. Results: Among 313 patients, 168 patients (53.7%) were treated in the ICU. 148 patients (88.1%) received only observation during the ICU care. The ICU re-admission and intensive medical treatment significantly correlated with major liver resection (odds ratio [OR], 6.481; P = 0.011), and intraoperative transfusions (OR, 7.108; P = 0.016). Patients who underwent major liver resection and intraoperative transfusion were significantly associated with need for mechanical ventilator care, longer postoperative stays in the ICU and the hospital, and hospital mortality. Conclusion: Most patients admitted to the ICU after major liver resection just received close monitoring. Even though patients underwent major liver resection, patients without receipt of intraoperative transfusion could be sent to the general ward. Duration of ICU/hospital stay, ventilator care and mortality significantly correlated with major liver resection and intraoperative transfusion. Major liver resection and receipt of intraoperative transfusions should be considered indicators for ICU admission.

부비동 내시경수술 진료형태에 대한 대한 비과학회 회원 설문결과

정용기,동헌종,박용진 대한비과학회 2015 Journal of rhinology Vol.22 No.2

Background and Objectives: Endoscopic sinus surgery (ESS) has become the standard treatment modality in chronic rhinosinusitis. However there is no uniform treatment protocol regarding preoperative, intraoperative, and postoperative care. The objectives of this study are to identify and report the practice patterns of ESS in South Korea. Materials and Method: A series of eight surveys were sent to the board members of the Korean Rhinologic Society via email between August 2013 and September 2014. Responses to questions regarding detailed practice patterns were recorded anonymously. Results: The average number of replies to each survey was 41.5. Routine antibiotics were prescribed just before computed tomography by 46.9% of the respondents, and the mean duration of antibiotics treatment was 1.90 weeks. A routine preoperative olfactory test was conducted by 64.3% of respondents, and allergy tests were conducted by 82.2%. General anesthesia was preferred by 76.8%, and the mean hospitalization period was 3.12 days. The mean rotation speed used for a microdebrider was 3,054 rpm, and 3,000 rpm was selected by 51.6% of the respondents. In addition, 74.2% of respondents reported that they operate the foot switch themselves. Finally, an absorbable pack was preferred after ESS. Conclusion: The current study was the first nationwide survey on practice patterns in endoscopic sinus surgery in Korea, and the data reflects the opinions of expert sinus surgeons.

Surgical Site Infection Prophylaxis and Wound Management in Spine Surgery

White Alexandra J.,Fiani Brian,Jarrah Ryan,Momin Arbaz A.,Rasouli Jonathan 대한척추외과학회 2022 Asian Spine Journal Vol.16 No.3

Surgical site infection (SSI) is a potentially devastating complication of spinal surgery that increases patient morbidity and healthcare costs. SSIs have complex and multifactorial etiologies; therefore, there are numerous opportunities for prevention and risk mitigation. The aim of this narrative review was to describe the incidence, risk factors, and outcomes of SSIs in spine surgery with an emphasis on postoperative wound care. We list and describe the preoperative, intraoperative, and postoperative evidence-based interventions that can be applied to potentially prevent SSI after spinal surgery.

수술실 간호사의 수술 중 인수인계 실태

김명희 ( Kim Myung Hee ),김성민 ( Kim Sungmin ) 부산대학교 간호과학연구소 2018 글로벌 건강과 간호 Vol.8 No.2

Purpose: Operating room nurses’ hand-off during surgery is inevitable, and it is very important to ensuring continuity of nursing care. This study aimed to identify the status of operating room nurses’ intraoperative hand-off. Methods: This study used a cross-sectional descriptive survey. The data were collected through structured questionnaire from March 12 to April 30, 2018. Participants were 251 operating room nurses from 6 university hospitals. Results: The mean scores of importance and appropriateness of and satisfaction with hand-off were 4.82±0.39, 3.65±0.56, and 3.32±0.50 respectively. During the operation, nurses need to hand-off and assist the surgeon at the same time, which was the important cause of the inappropriate hand-off. The importance of hand-off had a significant positive correlation with appropriateness (r=.17, p=.002) and satisfaction (r=.18, p=.004), and there was significant positive correlation between appropriateness and satisfaction (r=.43, p<.001). In addition, the recipient’s work difficulty had a significant negative correlation with the appropriateness (r=-.14, p=.005) and satisfaction (r=-.35, p<.001). Conclusion: A standardized hand-off method is essential to ensure the continuity of operative nursing and improve the nursing practice. Future research is needed to examine the effectiveness of the intraoperative hand-off protocol.

국소마취에 의한 척추수술 환자가 지각한 수술 중 돌봄과 불안정도

하정숙(Ha, Jung Suck),이은남(Lee, Eun Nam) 대한근관절건강학회 2015 근관절건강학회지 Vol.22 No.2

Purpose: The purpose of this study was to identify the relationship between intraoperative level of caring and anxiety among patients who underwent spinal surgery under local anesthesia. Methods: The study participants included 162 patients who had spinal surgery under local anesthesia at a general hospital in B metropolitan city between July 20 and September 20, 2014. To measure the caring behaviors of patients under local anesthesia, we used the Caring Behavior Measurement, and state anxiety was measured by the State Trait Anxiety Inventory. The collected data were analyzed using a SAS program. The differences in anxiety levels based on participants’ characteristics were analyzed with t-test and an analysis of variance. The correlation between levels of caring and anxiety was tested with Pearson’s correlation coefficient. Results: Education and caring levels showed significant relationship with the anxiety level of patients with spinal surgery under local anesthesia. Conclusion: To decrease the level of anxiety in patients undergoing spinal surgery under local anesthesia, it is necessary to educate and train operating nurses about the intra-operative caring behavior.

The role of intraoperative ultrasonography in the diagnosis and management of focal hepatic lesions

주이진 대한초음파의학회 2015 ULTRASONOGRAPHY Vol.34 No.4

Intraoperative ultrasonography (IOUS) has been widely utilized in hepatic surgery both asa diagnostic technique and in the course of treatment. Since IOUS involves direct-contactimaging of the target organ, it can provide high spatial resolution without interference from thesurrounding structures. Therefore, IOUS may improve the detection, characterization, localization,and local staging of hepatic tumors. IOUS is also a real-time imaging modality capable ofproviding interactive information and valuable guidance in a range of procedures. Recently,contrast-enhanced IOUS, IOUS elastography, and IOUS-guided hepatic surgery have attractedincreasing interest and are expected to lead to the broader implementation of IOUS. Herein,we review the various applications of IOUS in the diagnosis and management of focal hepaticlesions.

The SingHealth Perioperative and Anesthesia Subject Area Registry (PASAR), a large-scale perioperative data mart and registry

Abdullah Hairil Rizal,Lim Daniel Yan Zheng,Ke Yuhe,Salim Nur Nasyitah Mohamed,Lan Xiang,Dong Yizhi,Feng Mengling 대한마취통증의학회 2024 Korean Journal of Anesthesiology Vol.77 No.1

Background: To enhance perioperative outcomes, a perioperative registry that integrates high-quality real-world data throughout the perioperative period is essential. Singapore General Hospital established the Perioperative and Anesthesia Subject Area Registry (PASAR) to unify data from the preoperative, intraoperative, and postoperative stages. This study presents the methodology employed to create this database.Methods: Since 2016, data from surgical patients have been collected from the hospital electronic medical record systems, de-identified, and stored securely in compliance with privacy and data protection laws. As a representative sample, data from initiation in 2016 to December 2022 were collected.Results: As of December 2022, PASAR data comprise 26 tables, encompassing 153,312 patient admissions and 168,977 operation sessions. For this period, the median age of the patients was 60.0 years, sex distribution was balanced, and the majority were Chinese. Hypertension and cardiovascular comorbidities were also prevalent. Information including operation type and time, intensive care unit (ICU) length of stay, and 30-day and 1-year mortality rates were collected. Emergency surgeries resulted in longer ICU stays, but shorter operation times than elective surgeries.Conclusions: The PASAR provides a comprehensive and automated approach to gathering high-quality perioperative patient data.

Anesthetic considerations for lung transplantation

유영철 대한마취통증의학회 2019 Anesthesia and pain medicine Vol.14 No.3

Since the first lung transplantation, developments in surgical techniques, immunosuppressants, preservation solutions, monitoring devices, anesthetic agents, and drugs and devices for hemodynamic support have resulted in improved survival rates after lung transplantation. Lung transplantation is a high-risk procedure and end-stage lung disease is frequently accompanied by compromised cardiopulmonary function. Therefore, a highly trained cardiothoracic anesthesiologist is required during the procedure. As various factors related to anesthesia may have important effects on the prognosis of the patient after the lung transplantation, an anesthesiologist must not only be familiar with the use of various medications and monitoring devices, but also understand the patient’s pathophysiology and the surgical procedure.

부위마취 환자가 지각한 간호사의 수술 중 돌봄행위 측정도구 개발

김미정(Kim, Mi-Jung),이은남(Lee, Eun- Nam) 한국간호과학회 2012 Journal of Korean Academy of Nursing Vol.42 No.5

수술 중 음악요법이 국소마취 수술환자의 불안에 미치는 효과

신효연(Shin Hyoyoun),이명선(Yi Myungsun) 기본간호학회 2005 기본간호학회지 Vol.12 No.1