Effect of intraoperative pressure ulcer preventive nursing on inflammatory markers in patients with high-risk pressure ulcers: A protocol of systematic review and meta-analysis.

BACKGROUND: This study will be designed to appraise the effects of intraoperative pressure ulcer preventive nursing (IPUPN) on inflammatory markers (IMs) in patients with high-risk pressure ulcers (HRPU) based on high quality randomized controlled trials (RCTs). METHODS: In this study, we will perform a rigorous literature search from the following electronic databases: Cochrane Library, MEDLINE, Embase, Cumulative Index to Nursing and Allied Health Literature, Allied and Complementary Medicine Database, and Chinese Biomedical Literature Database. All electronic databases will be retrieved from their initial time to March 1, 2020 without limitations of language and publication status. We will only consider high quality RCTs that explored the effects of IPUPN on IMs in patients with HRPU. Two investigators will identify relevant trials, extract data, and appraise risk of bias in each eligible trial. Data will be pooled by either a fixed-effects model or a random-effects model according to the results of heterogeneity identification. The primary outcomes include IMs, and incidence of new pressure ulcers. The secondary outcomes are time to ulcer development, quality of life, length of hospital stay, and adverse events. Statistical analysis will be undertaken using RevMan 5.3 software. RESULTS: This study will summarize high quality clinical evidence of RCTs to evaluate the effects of IPUPN on IMs in patients with HRPU. CONCLUSION: The expected findings may provide helpful evidence to determine whether IPUPN is an effective intervention on IMs in patients with HRPU. INPLASY REGISTRATION NUMBER: INPLASY202040029.

[Perioperative thermal management in children]. / Kinderanästhesie--Perioperatives Wärmemanagement bei Kindern.

Perioperative temperature monitoring is a pre-requisite for successful prevention of inadvertent hypothermia in children. To achieve this goal, besides of pre-warming, active warming measures have to be intensified the younger and immature infants are. Intraoperatively incubators can be used. Forced-air warming in combination with fluid warming has been proven effective in children. Postoperative shivering should be treated, e.g. with pethidin or clonidine.

Cirugía en el niño y el adolescente / Surgery for children and adolescents. Intra-operative phase

Se expone la segunda fase del proceso quirúrgico, conocida como intraoperatorio, desarrollando un modelo estandarizado de la atención de enfermería al niño y adolescente durante la fase intraoperatoria. Transcurre en la sala de operaciones desde el momento en el que el niño / adolescente llega procedente de la unidad de hospitalización hasta que es trasladado a la unidad de reanimación. Se efectúa una valoración sistemática y holística utilizando los Patrones Funcionales de Salud de Gordon. Se seleccionan los Diagnósticos de Enfermería de la NANDA (North American Nursing Diagnosis Association) que con mayor frecuencia se presentan en esta fase intraoperatoria: riesgo de lesión, riesgo de infección, riesgo de hipotermia y riesgo de asfixia. También se mencionan las complicaciones potenciales que pueden aparecer durante la intervención según la edad del niño, el tipo de anestesia, la técnica quirúrgica y el estado general previo. Finalmente, describimos las intervenciones enfermeras relacionadas con las complicaciones potenciales y los diagnósticos enfermeros reseñados (AU)

The effects of handholding on anxiety in cataract surgery patients under local anaesthesia.

AIM OF THE STUDY: To assess the effectiveness of handholding on the anxiety of patients undergoing planned cataract surgery under local anaesthesia. BACKGROUND: Anxiety concerning anaesthesia, pain, physical injuries, isolation, prognosis, possibilities of deformity, or loss of self-control may be stressful to patients undergoing surgery. Anxiety activates the sympathetic nervous system, characterized by an increase in catecholamine concentration, heart rate and blood pressure and increased glucocorticoid levels; it also affects immune responses. Therefore, there is a need for nursing interventions to reduce the anxiety of patients under local anaesthesia who are conscious. METHODS: An untreated control group design with pre and post-test was used. Among 62 patients, 30 were randomly assigned to the handholding group and 32 to the control group. Handholding was provided to subjects of the handholding group during surgery. Visual analogue scales and interviews were used to measure anxiety, and pulse rate and systolic and diastolic blood pressure were used as physiological measures of stress. Blood was taken for analysis of levels of epinephrine, norepinephrine, cortisol, neutrophils, lymphocytes and natural killer cells. RESULTS: The number of subjects who reported decreased anxiety during operation was significantly higher in the handholding group compared with the control group and most of the subjects reported that handholding during operation was very helpful in reducing anxiety. Epinephrine levels in the handholding group were significantly lower than in the control group. CONCLUSIONS: Results suggest that this noninvasive intervention has potential for reducing anxiety in patients having cataract surgery under local anaesthesia.