Análise dos registros perioperatórios baseados na sistematização da assistência de enfermagem perioperatória: estudo transversal / Analysis of perioperative records based on the systematization of perioperative nursing care: a cross-sectional study / Análisis de registros perioperatorios a partir de la sistematización de la atención de enfermería perioperatoria: estudio transversal

Objetivo: analisar os registros perioperatórios baseados nas etapas de sistematização da assistência de enfermagem perioperatória em um hospital regional público do agreste de Pernambuco. Método: estudo transversal, descritivo, com abordagem quantitativa, obtido com dados secundários, conduzido em um hospital público. A amostra foi composta por 276 prontuários de indivíduos que se submeteram a procedimentos anestésico-cirúrgicos, durante os meses de janeiro a maio de 2023. Utilizou-se a análise descritiva e inferencial. Resultados: a efetuação dos registros da sistematização da assistência de enfermagem perioperatória foi predominante na maioria do período perioperatório, com respectiva significância principalmente no pré-operatório. Conclusão: as atividades satisfatórias corresponderam à visita pré-operatória de enfermagem, histórico, diagnóstico e prescrição de enfermagem. Já as fragilidades identificadas destacaram-se a ausência de reservas sanguíneas, a verificação de alergia e a colocação de placa de eletrocautério, inserção de sonda vesical, a efetuação do controle de perdas sanguíneas, fisiológicas e secreção gástrica.

Objective: analyzing perioperative records based on the phases of systematization of perioperative nursing care in a public regional hospital in Pernambuco's harsh region. Method: a cross-sectional, descriptive study with a quantitative approach, using secondary data, conducted in a public hospital. The sample consisted of 276 medical records of individuals who underwent anesthetic-surgical procedures between January and May 2023. Descriptive and inferential analysis was used. Results: the recording of the systematization of perioperative nursing care was predominant in the majority of the perioperative period, with significance mainly in the preoperative period. Conclusion: the satisfactory activities corresponded to the preoperative nursing visit, history, diagnosis, and nursing prescription. The weaknesses identified were the lack of blood reserves, checking for allergies and placing the electrocautery plate, inserting a urinary catheter, controlling blood loss, physiological loss, and gastric secretion.

Objetivo: analizar los registros perioperatorios a partir de las etapas de sistematización de la atención de enfermería perioperatoria en un hospital público regional de la zona rural de Pernambuco. Método: estudio descriptivo transversal, con enfoque cuantitativo, a partir de datos secundarios, realizado en un hospital público. La muestra estuvo compuesta por 276 historias clínicas de personas sometidas a procedimientos anestésico-quirúrgicos, de enero a mayo de 2023. Se utilizó análisis descriptivo e inferencial. Resultados: el registro de la sistematización de la atención de enfermería perioperatoria predominó en la mayor parte del periodo perioperatorio, con significación principalmente en el periodo preoperatorio. Conclusión: las actividades satisfactorias correspondieron a la visita de enfermería preoperatoria, registro, diagnóstico y prescripción de enfermería. Las debilidades identificadas incluyeron falta de reservas de sangre, comprobación de alergias y colocación de placa de electrocauterio, inserción de sonda vesical, control de la pérdida de sangre, fisiológica y secreción gástrica.

Gamified Mobile App (MobERAS) for Telemonitoring Patients in the Postoperative Period Based on the Enhanced Recovery after Surgery Program: Development and Validation Study.

BACKGROUND: Digital technology and gamified apps can be useful in the health care context. Gamification uses technology to influence users' actions and motivations through experiences that resemble games. Patient adherence to the enhanced recovery after surgery (ERAS) program is crucial for achieving early recovery after surgery and continuous monitoring is essential for obtaining good results. OBJECTIVE: This study aimed to describe the development and validation of a mobile app for enhanced recovery after surgery (MobERAS), a gamified mobile health app for telemonitoring patients in the postoperative period based on the ERAS program, and to evaluate its functionality and usability and the experience of patients, health care professionals, and computer professionals with its use. METHODS: We developed MobERAS for postoperative telemonitoring, with active participation of patients in the process, and offering availability of real-time information for the health team. The app development process included idealization, interdisciplinary team formation, potential needs assessment, and product deployment. Usability tests were conducted throughout the development process with improvements, technical adjustments, and updates. After finalization, comprehensive verification tests were performed. The parameters evaluated are those that can influence the length of hospital stay, such as nausea, vomiting, pain scales, return to normal gastrointestinal function, and thromboembolic events. MobERAS was designed to be downloaded by users on their phones, tablets, or other mobile devices and to provide postoperative data. The app has a GPS that monitors the patient's walking time and distance and is connected to a virtual database that stores the collected data. RESULTS: Women undergoing medium and major gynecologic oncologic surgeries were included. We included 65 patients with an average age of 53.2 (SD 7.4, range 18-85) years. The time of use ranged from 23.4 to 70 hours (mean 45.1, SD 19.2 hours). Regarding adherence to the use of MobERAS, the mean fill rate was 56.3% (SD 12.1%, range 41.7%-100%), and ambulation data were obtained for 60 (92.3%) of the 65 patients. The researcher had access to the data filled out by the patients in real time. There was good acceptance of the use of MobERAS by the patients, with good evaluation of the app's usability. MobERAS was easy to use and considered attractive because of its gamified design. The app was rated as good or very good in all items by health care professionals (n=20) and professionals specializing in technological innovation (n=10). CONCLUSIONS: MobERAS is easy to use, safe, well accepted by patients, and well evaluated by experts. It can be of great use in clinical surgical practice and an important tool for greater engagement of patients and health care professionals with the ERAS program.

Position paper on perioperative management and surgical risk in the patient with cirrhosis.

INTRODUCTION: Management of the patient with cirrhosis of the liver that requires surgical treatment has been relatively unexplored. In Mexico, there is currently no formal stance or expert recommendations to guide clinical decision-making in this context. AIMS: The present position paper reviews the existing evidence on risks, prognoses, precautions, special care, and specific management or procedures for patients with cirrhosis that require surgical interventions or invasive procedures. Our aim is to provide recommendations by an expert panel, based on the best published evidence, and consequently ensure timely, quality, efficient, and low-risk care for this specific group of patients. RESULTS: Twenty-seven recommendations were developed that address preoperative considerations, intraoperative settings, and postoperative follow-up and care. CONCLUSIONS: The assessment and care of patients with cirrhosis that require major surgical or invasive procedures should be overseen by a multidisciplinary team that includes the anesthesiologist, hepatologist, gastroenterologist, and clinical nutritionist. With respect to decompensated patients, a nephrology specialist may be required, given that kidney function is also a parameter involved in the prognosis of these patients.

Applying enhanced recovery principles to emergency laparotomy in penetrating abdominal trauma: a case-matched study.

PURPOSE: The implementation of enhanced recovery after surgery programs (ERPs) has significantly improved outcomes within various surgical specialties. However, the suitability of ERPs in trauma surgery remains unclear. This study aimed to (1) design and implement an ERP for trauma laparotomy patients; (2) assess its safety, feasibility, and efficacy; and (3) compare the outcomes of the proposed ERP with conventional practices. METHODS: This case-matched study prospectively enrolled hemodynamically stable patients undergoing emergency laparotomy after penetrating trauma. Patients receiving the proposed ERP were compared to historical controls who had received conventional treatment from two to eight years prior to protocol implementation. Cases were matched for age, sex, injury mechanism, extra-abdominal injuries, and trauma scores. Assessment of intervention effects were modelled using regression analysis for outcome measures, including length of hospital stay (LOS), postoperative complications, and functional recovery parameters. RESULTS: Thirty-six consecutive patients were enrolled in the proposed ERP and matched to their 36 historical counterparts, totaling 72 participants. A statistically significant decrease in LOS, representing a 39% improvement in average LOS was observed. There was no difference in the incidence of postoperative complications. Opioid consumption was considerably lower in the ERP group (p < 0.010). Time to resumption of oral liquid and solid intake, as well as to the removal of nasogastric tubes, urinary catheters, and abdominal drains was significantly earlier among ERP patients (p < 0.001). CONCLUSION: The implementation of a standardized ERP for the perioperative care of penetrating abdominal trauma patients yielded a significant reduction in LOS without increasing postoperative complications. These findings demonstrate that ERPs principles can be safely applied to selected trauma patients.

Evaluating the use of laparoscopic gastrostomy in children with congenital heart disease in Colombia: a retrospective analysis.

Introduction: Congenital Heart Disease (CHD) is the most common congenital disorder and a leading cause of infant mortality. Despite improved survival rates, patients with CHD often face malnutrition due to increased metabolic demands, feeding difficulties, and gastrointestinal dysfunction. Malnutrition in CHD is linked to poor short and long-term clinical outcomes. Gastrostomy (GT) is frequently used for long-term enteral support, and laparoscopic GT (LGT) has demonstrated advantages in children without CHD. This study evaluated a modified Georgeson's percutaneous LGT technique and its perioperative complications in children with CHD. Methods: We performed an analytical retrospective cohort study from 2018 to 2022, including patients younger than 24 months with a diagnosis of CHD who underwent LGT. The primary outcome evaluated was the presence of complications during surgery and the first thirty postoperative days. Complications were graded using Clavien-Dindo's (CD) classification. Sociodemographic, clinical, and procedure-related variables were collected. A bivariate analysis was performed using STATA 15, and a p < 0.05 was considered statistically significant. Results: Seventy-eight patients were eligible (male 56.41%, Median age 129.5 days, weight: 4.83 kg). The median surgery time was 35 min. The complication rate was 24.36%. The most frequent complications were GT site infection (10.26%), followed by leakage (8.97%) and granuloma formation (6.41%). Conversion to open surgery was significantly associated with postoperative complications (p = 0.002). Conclusion: This modified technique is well-tolerated in children with CHD, demonstrating a low rate of CD grade 3A/3B complications and no grade 4 or 5 complications.

Preoperative Gabapentin for Pain Control: A Randomized, Placebo-controlled Clinical Trial in Patients Undergoing Inguinal Hernioplasty.

PURPOSE: The perioperative use of gabapentin has been suggested to reduce postoperative pain and opioid consumption. However, there is a variation in clinical practice, the type of surgery and the administration time seem to be distinct between the available studies. We assess whether gabapentin administered before surgery reduces postoperative pain in patients who have undergone inguinal hernioplasty. DESIGN: This is a double-blind, randomized, and placebo-controlled trial. METHODS: Seventy-seven patients scheduled for inguinal hernioplasty were randomized in two groups to receive gabapentin (900 mg) or placebo in the perioperative period. The primary outcome was analgesia measured by visual analog scale up to 30 days after surgery. The secondary outcomes such as morphine consumption, nausea, headache, and sedation have been also described. FINDINGS: Patients who received gabapentin had lower postoperative pain scores compared to the control group, P < .001. The postoperative morphine use was significantly lower in the gabapentin (5.3%) versus placebo group (74.4%), P < .001. No significant difference between groups was observed for the occurrence of adverse events. CONCLUSIONS: The perioperative administration of gabapentin was effective in reducing postoperative pain and had an important effect in decreasing morphine use. Together, our data reveal a long-lasting opioid-sparing effect of gabapentin in patients who underwent inguinal hernioplasty.

Development and validation of the Ex-Care BR model: a multicentre initiative for identifying Brazilian surgical patients at risk of 30-day in-hospital mortality.

BACKGROUND: Surgical risk stratification is crucial for enhancing perioperative assistance and allocating resources efficiently. However, existing models may not capture the complexity of surgical care in Brazil. Using data from various healthcare settings nationwide, we developed a new risk model for 30-day in-hospital mortality (the Ex-Care BR model). METHODS: A retrospective cohort study was conducted in 10 hospitals from different geographic regions in Brazil. Data were analysed using multilevel logistic regression models. Model performance was assessed using the area under the receiver operating characteristic curve (AUROC), Brier score, and calibration plots. Derivation and validation cohorts were randomly assigned. RESULTS: A total of 107,372 patients were included, and 30-day in-hospital mortality was 2.1% (n=2261). The final risk model comprised four predictors related to the patient and surgery (age, ASA physical status classification, surgical urgency, and surgical size), and the random effect related to hospitals. The model showed excellent discrimination (AUROC=0.93, 95% confidence interval [CI], 0.93-0.94), calibration, and overall performance (Brier score=0.017) in the derivation cohort (n=75,094). Similar results were observed in the validation cohort (n=32,278) (AUROC=0.93, 95% CI, 0.92-0.93). CONCLUSIONS: The Ex-Care BR is the first model to consider regional and organisational peculiarities of the Brazilian surgical scene, in addition to patient and surgical factors. It is particularly useful for identifying high-risk surgical patients in situations demanding efficient allocation of limited resources. However, a thorough exploration of mortality variations among hospitals is essential for a comprehensive understanding of risk. CLINICAL TRIAL REGISTRATION: NCT05796024.

Comparison of laparoscopic-guided versus ultrasound-guided TAP block in laparoscopic cholecystectomy.

INTRODUCTION: Transversus abdominis plane (TAP) block is a widely used anesthetic technique of the abdominal wall, where ultrasound guidance is considered the gold standard. In this study, we aimed to compare the effectiveness of laparoscopic-assisted TAP (LTAP) block with ultrasound-assisted TAP (UTAP) block for post-operative pain, nausea, vomiting, duration of the block, and bowel function. MATERIALS AND METHODS: This study included 60 patients who were randomly assigned to two groups to undergo either the LTAP or UTAP block technique after laparoscopic cholecystectomy. The time taken for administering the block, post-operative nausea and vomiting, post-operative pain, respiratory rate, bowel movements, and analgesia requirements were reported. RESULTS: The time taken for the LTAP block was shorter (p < 0.001). Post-operative mean tramadol consumption, paracetamol consumption, and analgesic requirement were comparable between the two groups (p = 0.76, p = 0.513, and p = 0.26, respectively). The visual analog scale at 6, 24, and 48 h was statistically not significant (p = 0.632, p = 0.802, and p = 0.173, respectively). Nausea with vomiting and the necessity of an antiemetic medication was lower in the UTAP group (p = 0.004 and p = 0.009, respectively). CONCLUSION: The LTAP block is an easy and fast technique to perform in patients as an alternative method where ultrasound guidance or an anesthesiologist is not available.

ANTECEDENTES: El bloqueo del plano transverso del abdomen (TAP) es una técnica anestésica de la pared abdominal ampliamente utilizada, en la cual la guía ecográfica se considera el método de referencia. OBJETIVO: Comparar la efectividad del bloqueo TAP asistido por laparoscopia (LTAP) con el bloqueo TAP asistido por ultrasonido (UTAP) para el dolor posoperatorio, las náuseas y los vómitos, y la función intestinal. MÉTODO: El estudio incluyó 60 pacientes que fueron asignados aleatoriamente a dos grupos para someterse a la técnica de bloqueo LTAP o UTAP después de una colecistectomía laparoscópica. Se informaron el tiempo de administración del bloqueo, las náuseas y los vómitos posoperatorios, el dolor posoperatorio, la frecuencia respiratoria, las evacuaciones y los requerimientos de analgesia. RESULTADOS: El tiempo de bloqueo LTAP fue menor (p < 0.001). El consumo medio de tramadol, el consumo de paracetamol y el requerimiento de analgésicos posoperatorios fueron comparables entre los dos grupos (p = 0.76, p = 0.513 y p = 0.26, respectivamente). El dolor en la escala analógica visual a las 6, 24 y 48 horas no fue estadísticamente significativo (p = 0.632, p = 0.802 y p = 0.173, respectivamente). CONCLUSIONES: El bloqueo PATL es una técnica fácil y rápida de realizar en pacientes como método alternativo cuando no se dispone de guía ecográfica o anestesióloga.

Transformação digital na enfermagem perioperatória / Digital transformation in perioperative nursing / Transformación digital en enfermería perioperatoria

Objetivo: Promover a reflexão sobre os efeitos da transformação digital na enfermagem perioperatória. Métodos: Estudo reflexivo baseado em dados da literatura associado a prática do autor na enfermagem perioperatória e no projeto de automação. Resultados: evidenciou-se um misto de competências para enfermagem perioperatória, como atividades relacionadas a busca pelo hospital digital, uso da inteligência artificial e robótica. Conclusão: a reflexão deste tema incentiva o enfermeiro na busca de pesquisa, desenvolvimento digital e novos conhecimentos na área digital associados à sua prática clínica. (AU)

Objective: To promote reflection on the effects of digital transformation in perioperative nursing. Methods: Reflective study based on literature data associated with the author's practice in perioperative nursing and automation project. Results: a mix of skills for perioperative nursing was evidenced, such as activities related to the search for the digital hospital, use of artificial intelligence and robotics. Conclusion: the reflection on this theme encourages nurses to search for research, digital development and new knowledge in the digital area associated with their clinical practice. (AU)

Objetivo: Promover la reflexión sobre los efectos de la transformación digital en la enfermería perioperatoria. Métodos: Estudio reflexivo basado en datos de la literatura asociados a la práctica del autor en enfermería perioperatoria y proyecto de automatización. Resultados: se evidenció una mezcla de habilidades para la enfermería perioperatoria, como actividades relacionadas con la búsqueda del hospital digital, uso de inteligencia artificial y robótica. Conclusión: la reflexión sobre este tema anima al enfermero a buscar investigación, desarrollo digital y nuevos conocimientos en el área digital asociados a su práctica clínica. (AU)

Olanzapine as a prophylactic antiemetic for preventing postoperative nausea and vomiting after general anesthesia: A systematic review and meta-analysis.

BACKGROUND: The antiemetic effectiveness of olanzapine, as a prophylactic off-label antiemetic drug, for Postoperative Nausea and Vomiting (PONV) is unknown. In this systematic review and meta-analysis, the authors evaluate the efficacy and side effects of olanzapine as a prophylactic antiemetic in adult patients who undergo general anesthesia and assess adverse effects. METHODS: A systematic search was done on electronic bibliographic databases in July 2023. Randomized controlled trials of olanzapine as a prophylactic antiemetic for PONV in adults who underwent general anesthesia were included. The authors excluded non-RCTs and retracted studies. The authors set no date of publication or language limits. The outcomes were the incidence of PONV within 24 h postoperatively and the safety of olanzapine. The risk of bias was assessed according to the tool suggested by the National Heart, Lung, and Blood Institute. RESULTS: Meta-analysis included 446 adult patients. Olanzapine reduced on average 38 % the incidence of PONV. The estimated risk ratio (95 % CI) of olanzapine versus control was 0.62 (0.42-0.90), p = 0.010, I2 = 67 %. In the subgroup meta-analysis, doses of olanzapine (10 mg) reduced on average 49 % of the incidence of PONV (RR = 0.51 [0.34-0.77], p = 0.001, I2 = 31 %). CONCLUSIONS: This systematic review with meta-analysis indicated that olanzapine as a prophylactic antiemetic alone or combined with other antiemetic agents reduced the incidence of postoperative nausea and vomiting. However, this conclusion must be presented with some degree of uncertainty due to the small number of studies included. There was a lack of any evidence to draw conclusions on side effects.

Prognostic value of perioperative high sensitivity troponin in patients undergoing hip and knee arthroplasty.

The authors conducted a prospective observational study to investigate the prognostic value of high-sensitivity Troponin I (hs-TnI) in the short- and long-term periods after orthopedic surgery, including Total Hip and Knee Arthroplasty (THA and TKA, respectively), in a tertiary orthopedic center in Brazil. Perioperative Myocardial Injury (PMI) was defined as an absolute increase in hs-TnI of ≥ 26 ng/L above preoperative values. The primary endpoint was all-cause mortality assessed at 30 days and 18 months after surgery. The secondary endpoint consisted of a composite outcome: cardiovascular death, acute myocardial infarction, angina requiring revascularization, and/or stroke. The authors compared Relative Risks (RR) of all-cause mortality and composite outcomes in patients with or without PMI at 30 days and 18 months. A Cox proportional hazards model for long-term outcomes was calculated and adjusted for age > 70 years, gender, and Revised Cardiac Risk Index (RCRI) class ≥ 2. PMI occurred in 3.4 % of all surgeries. At 30-days, 6.6 % of patients with PMI had died versus none without PMI. At 18 months, 20.0 % of PMI versus 4.7 % without PMI had died (RR = 5.0; 95 % Confidence Interval [95 % CI 1.3-19.3]). Based on composite outcomes in short and long-term periods, the RRs were 16.2 (95 % CI 2.7-96.5) and 7.7 (95 % CI 2.2-26.6), respectively. PMI was associated with all-cause mortality after 18 months and increased risk for a composite outcome (Hazard Ratio [HR = 3.97], 95 % CI 1.13-13.89 and HR = 5.80, 95 % CI 1.93-17.45, respectively). Patients with PMI who underwent THA or TKA presented worse short- and long-term prognoses compared to those without PMI.

Pain Predictors in Patients in the Postanesthesia Care Unit.

PURPOSE: To analyze the effects of pain-predicting factors on patients in the postanesthesia care unit (PACU). DESIGN: This is an observational and prospective study. METHODS: This study was conducted at a University Hospital in the state of Minas Gerais (Brazil). To collect data on demographic, clinical, and surgical factors, a collection instrument was devised. The verbal numerical scale was employed to measure pain levels before and after surgery in the PACU. A path analysis was used to assess a predictive model. FINDINGS: A total of 226 patients were included in this study. The incidence of pain in the PACU was 31.9%. A model with demographic, clinical, and surgical variables was tested. The final model, after including modification indices, obtained results that indicated an acceptable data fit (comparative fit index = 0.996; root mean square error of approximation = 0.08). Age (being young), sex (being a woman), oncological diagnosis as an indication for the surgical procedure, type of surgery (surgery of the digestive system), duration of surgery (longer surgeries), and high intraoperative doses of opioids were predictive variables for pain in the PACU. CONCLUSIONS: This study's findings provide support for pain management in the PACU. Furthermore, the results of this research can be used to anticipate the occurrence of acute postoperative pain and personalized perioperative analgesia needs.

Nursing interventions for preventing pressure ulcers in the perioperative period / Intervenciones de enfermería para prevenir lesiones por presión en el periodo perioperatorio / Intervenções de enfermagem para prevenção de lesão por pressão no perioperatório

Objective: To identify risk factors and nursing interventions for preventing pressure ulcers in perioperative patients. Method: This is an integrative literature review, for which data were collected in the following databases: Web of Science, Latin American and Caribbean Health Sciences Literature (LILACS), and National Library of Medicine (Medline). Data collection took place between July and August 2022. Original articles, without language restrictions and related to the research topic, were included. Thematic analysis was used for data processing. Results: Based on the analysis of the 16 publications that composed the corpus of this study, two categories were listed: a) risk factors for developing pressure ulcers in patients in the perioperative period; b) nursing interventions to prevent pressure ulcers. Conclusion: Risk factors for developing pressure ulcers are: being an older adult, malnourished or overweight, and comorbidities such as diabetes mellitus, vasculopathy, neuropathy, among others. Nursing interventions include: asses-sing risks using scales, such as ELPO and Munro, performing appropriate surgical positioning, protecting bone spurs, and planning unique patient care. (AU)

Objetivo: identificar factores de riesgo e intervenciones de enfermería para prevenir lesiones por presión en pacientes perioperatorios. Método: se trata de una revisión integradora, para la cual se recolectaron datos en las siguientes bases de datos: Web of Science, Literatura Latinoamericana y del Caribe en Ciencias de la Salud (LILACS), Biblioteca Nacional de Medicina (MEDLINE). Recopilación realizada entre julio y agosto de 2022. Se incluyeron artículos originales, sin restricción de idioma, relacionados con el tema de investigación. Se utilizó el análisis temático para procesar los datos. Resultados: A partir del análisis de las 16 publicaciones que constituyeron el corpus de este estudio, se enumeraron dos categorías: a) factores de riesgo para el desar-rollo de lesiones por presión en pacientes en el período perioperatorio; b) intervenciones de enfermería para prevenir las lesiones por presión. Conclusión: se consideran factores de riesgo para el desarrollo de lesiones por presión: ser anciano, estar desnutrido o con sobrepeso, comorbilidades como diabetes mellitus, vasculopatía, neuropatía, entre otras. Las intervenciones de enfermería incluyen: evaluación de riesgos mediante escalas como ELPO y Munro, realización de un posicionamiento quirúrgico adecuado, protección de protuberancias óseas y planificación de cuidados únicos al paciente. (AU)

Objetivo: Identificar fatores de risco e as intervenções de enfermagem para a prevenção de lesão por pressão em pacientes no perioperatório. Método: Trata-se de revisão integrativa, para a qual os dados foram coletados nas bases: Web of Science, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS) e National Library of Medicine (Medline). Coleta realizada entre julho e agosto de 2022. Incluídos artigos originais, sem res-trição de idioma, relacionados à temática de investigação. Utilizou-se análise temática para tratamento dos dados. Resultados: Com base na análise das 16 publicações que compuseram o corpus deste estudo, foram elencadas duas categorias: a) fatores de risco para o desenvolvimento de lesão por pressão em pacientes no período perioperatório; b) intervenções de enfermagem para prevenir lesões por pressão. Conclusão: São considerados fatores de risco para o desenvolvimento de lesão por pressão: ser idoso, apresentar desnutrição ou sobrepeso, comorbidades como diabetes mellitus, vasculopatia, neu-ropatia, entre outros. As intervenções de enfermagem compreendem: avaliar os riscos por meio de escalas como a Elpo e a Munro, realizar o posiciona-mento cirúrgico adequado, proteger saliências ósseas e planejar o cuidado singular ao paciente. (AU)

Management of acute compartment syndrome: case report / Manejo del síndrome compartimental agudo: informe de caso / Manejo da síndrome compartimental aguda: relato de caso

Introduction: Acute compartment syndrome (ACS) is defined as any increase in interstitial pressure within the bony-fascial compartment and consists of an adverse event in the intraoperative period, resulting from surgical positioning. Objective: To report a case of fasciotomy in the lower limbs after ACS. Method: Case report registered in a large public teaching hospital, with a highly complex care profile. Results: Patient underwent videolapa-roscopic surgery to remove endometriosis, having remained in the gynecological position for 9 hours, developing ACS in the immediate postoperative period (IPO). The patient underwent decompressive fasciotomy to treat ACS in the second postoperative period, and nine other surgical approaches to continue treatment. She remained hospitalized for 45 days. Conclusion: The training of nursing professionals, knowledge about surgical patient safety and teamwork throughout the anesthetic-surgical procedure are essential for reducing adverse events and quickly identifying and treating complications. (AU)

Introducción: El síndrome compartimental agudo (SCA) se define como cualquier aumento de la presión intersticial dentro del compartimiento óseo-fascial y consiste en un evento adverso en el período intraoperatorio, resultante de la posición quirúrgica. Objetivo: Reportar un caso de fasciotomía en los miembros inferiores después de un SCA. Método: Informe de caso registrado en un gran hospital público de enseñanza, con un perfil de atención de alta complejidad. Resultados: La paciente se sometió a una cirugía videolaparoscópica para extirpar la endometriosis, permaneciendo en posición ginecológica durante 9 horas, desarrollando SCA en el período postoperatorio inmediato (POI). La paciente se sometió a una fasciotomía descompresiva para tratar el SCA en el segundo período postoperatorio, y a otros nueve abordajes quirúrgicos para continuar el tratamiento. Permaneció hospitalizada durante 45 días. Conclusión: La formación de profesionales de enfermería, el conocimiento sobre la seguridad del paciente quirúrgico y el trabajo en equipo durante todo el procedimiento anestésico-quirúrgico son esenciales para reducir los eventos adversos y para identificar y tratar rápidamente las complicaciones. (AU)

Introdução: A síndrome compartimental aguda (SCA) é definida como qualquer elevação na pressão intersticial dentro do compartimento ósseo-fascial, e consiste em um evento adverso no período intraoperatório, decorrente do posicionamento cirúrgico. Objetivo: Relatar um caso de fasciotomia em membros inferio-res após SCA. Método: Relato de caso registrado em um hospital escola público de grande porte, com perfil assistencial de alta complexidade. Resultados: Paciente submetida à cirurgia videolaparoscópica para remoção de endometriose, tendo permanecido 9 horas em posição ginecológica, desenvolvendo SCA, no pós-operató-rio imediato (POI). A paciente foi submetida à fasciotomia descompressiva, para o tratamento da SCA no segundo pós-operatório (PO), e outras nove reabordagens cirúrgicas, para a continuidade do tratamento. Ela permaneceu hospitalizada por 45 dias. Conclusão: O treinamento dos profissionais de Enfermagem, o conhe-cimento acerca da segurança do paciente cirúrgico e o trabalho em equipe durante todo o procedimento anestésico-cirúrgico são essenciais para a diminuição dos eventos adversos e a rápida identificação e tratamento de complicações. (AU)

Physiological parameters of patients in post-anesthetic recovery: cross-sectional study / Parámetros fisiológicos de los pacientes en la recuperación postanestésica: estudio transversal / Parâmetros fisiológicos dos pacientes na recuperação anestésica: estudo transversal

Objective: To map the profile of physiological parameters of patients upon discharge from the Post-Anesthesia Care Unit (PACU) and analyze physiological changes related to the Aldrete and Kroulik Index (AKI) parameters in immediate postoperative patients in anesthesia recovery. Method: Cross-sectional study conducted from May 2021 to April 2022 at the PACUA of a public university hospital, evaluating physiological param-eters and AKI scale. Data collection was prospective, with simultaneous medical record review during patient care in PACU to record variables at five different time points. The sample comprised 88 patients. Results: Predominance of female patients (57.9%), mean age 52.39 (±16.57) years, and average stay in the unit was 91 minutes. At discharge, patients showed average normal blood pressure (121/71 mmHg), heart rate (71 bpm), normal respiratory rate (17 breaths per minute), hypothermia (35.0°C), and adequate oxygen saturation (97%). The overall mean AKI score was 8.5. Conclusion: Patients demonstrated stable physiological parameters consistent with the minimum AKI score for discharge from PACU, although intervention was needed for body warming to maintain temperature. (AU)

Objetivo: Mapear el perfil de los parámetros fisiológicos de los pacientes al recibir el alta de la sala de recuperación postanestésica (SRPA) y analizar las alteraciones fisiológicas en relación con los parámetros del Índice de Aldrete y Kroulik (IAK) en pacientes en el postoperatorio inmediato de la recuperación anestésica. Método: Estudio transversal realizado de mayo de 2021 a abril de 2022 en la SRPA de un hospital universitario público, mediante la evaluación fisiológica de los pacientes y la escala del IAK. La recolección de datos se realizó de manera prospectiva, con consulta simultánea a la historia clínica durante la atención del paciente en la SRPA para registrar las variables analizadas en cinco momentos distintos. La muestra consistió en 88 pacientes. Resultados: Predominio del sexo femenino (57,9%), con una edad promedio de 52,39 (±16,57) años y un tiempo medio de permanen-cia en el sector de 91 minutos. Al momento del alta, los pacientes presentaban una media de presión arterial normal (121x71 mmHg), frecuencia car-díaca normal (71 lpm), respiración eupnoica (17 rpm), hipotermia (35,0°C) y saturación de oxígeno adecuada (97%). La media general del IAK fue de 8,5. Conclusión: Se evidenció que los pacientes tenían parámetros fisiológicos estables, compatibles con la puntuación mínima del IAK para el alta de la SRPA; sin embargo, necesitaban intervención para calentar el cuerpo y mantener la temperatura. (AU)

Objetivo: mapear o perfil dos parâmetros fisiológicos dos pacientes ao receber alta da sala de recuperação pós-anestésica (SRPA) e analisar as alterações fisiológicas em relação aos parâmetros do Índice de Aldrete e Kroulik (IAK) nos pacientes em pós-operatório imediato na recuperação anes-tésica. Método: estudo transversal, realizado de maio de 2021 a abril de 2022 na SRPA de um hospital universitário público, por meio da avaliação fisio-lógica dos pacientes e escala do IAK. A coleta de dados foi realizada de modo prospectivo, com consulta em prontuário simultânea ao atendimento do paciente na SRPA para registrar as variáveis analisadas em cinco tempos distintos. A amostra foi composta por 88 pacientes. Resultados: predominân-cia do sexo feminino (57,9%), idade média de 52,39 (±16,57) e tempo médio de permanência no setor de 91 minutos. No momento da alta, a média dos pacientes estavam normotensos (121x71 mmHg), normocárdicos (71 bpm), eupneicos (17 irpm), hipotérmicos (35,0°C) e com saturação de oxigênio adequada (97%). A média geral do IAK foi de 8,5. Conclusão: evidenciou-se que os pacientes possuíam os parâmetros fisiológicos estáveis, compatíveis com o escore mínimo do IAK para alta da SRPA, no entanto, precisavam de intervenção para o aquecimento corporal a fim de manter a temperatura. (AU)

Tecnologia para educação no serviço e na formação de profissionais de saúde: e-book interativo sobre perioperatório / Technology for in-service education and training of health professionals: interactive e-book on perioperative

Resumo: O presente trabalho de desenvolvimento tecnológico aborda a criação de um e-book que reuniu evidências, informações e orientações para subsidiar o cuidado de Enfermagem ao paciente em período perioperatório. Trata-se de uma pesquisa metodológica desenvolvida em duas fases: (I) exploratória, que constituiu duas etapas: revisão de literatura e busca em manuais e diretrizes; (II) elaboração da tecnologia, com seis etapas: definição do conteúdo, avaliação do e-book, definição do editor de texto, editoração do e-book e seleção de imagens, produção de vídeos e edição final do e-book. Como resultado, obteve-se um e-book intitulado MELHORES PRÁTICAS DE ENFERMAGEM NO ATENDIMENTO A PACIENTES EM PERÍODO PERIOPERATÓRIO, que versa sobre a historicidade e evolução do ato anestésicocirúrgico, o processo de trabalho da Enfermagem e as práticas assistenciais disponibilizadas ao paciente em período perioperatório. Concebido para ser uma ferramenta de educação permanente, tem como característica a alta complexidade, uma vez que é fruto da associação de diferentes atores e interação de múltiplos conhecimentos como os de design, produção de vídeo e editoração de texto. A característica inovatória pauta-se no conteúdo, por ser um compilado de evidências científicas atuais sobre a temática, com a inclusão de vídeos educativos, instrumentos e escalas utilizados no período perioperatório, além de atividades para revisão, fixação e autoavaliação. De abrangência nacional, tem impacto científico, social e na educação por propiciar unidade nas informações para o atendimento ao paciente e excelência nas práticas, com contribuição de novos conhecimentos para a área de Enfermagem.

Abstract: This technological development work addresses the creation of an e-book that brought together evidence, information and guidance to support nursing care for patients in the perioperative period. This is a methodological research developed in two phases (I) exploratory that constituted two stages: literature review; search in manuals and guidelines; (II): elaboration of the technology, with six stages: definition of the content; e-book evaluation; definition of the text editor; e-book publishing and image selection; video production; and final e-book edition. As a result, an e-book entitled MELHORES PRÁTICAS DE ENFERMAGEM NO ATENDIMENTO A PACIENTES EM PERÍODO PERIOPERATÓRIO, was obtained, which deals with the historicity and evolution of the anesthetic-surgical act, the nursing work process and the care practices available to patients during the period. perioperative. Designed to be a permanent education tool, it is characterized by high complexity, as it is the result of the association of different actors and the interaction of multiple knowledge such as design, video production and text editing. The innovative characteristic is based on the content being a compilation of current scientific evidence on the topic, with the inclusion of educational videos, instruments and scales used in the perioperative period, in addition to activities for review, fixation and self-assessment. Of national scope, it has a scientific, social and educational impact, by providing unity in patient care and excellence in practices, with the contribution of new knowledge to the nursing area.

Comparative study of outcomes of surgical patients diagnosed with COVID-19 / Estudio comparativo de resultados de pacientes quirúrgicos diagnosticados con COVID-19 / Estudo comparativo de desfechos de pacientes cirúrgicos diagnosticados com COVID-19

Objective: To compare the outcomes of patients undergoing conventional gastrointestinal surgeries who developed COVID-19 to those who were not infected. Method: Descriptive comparative study. Data were collected from 142 medical records, during the period from March 2020 (begin-ning of the pandemic in Brazil) to December 2021. Study approved by the Research Ethics Committee (CAAE: 29473520.2.0000.5392). Results: The pro-file of the patients was mostly classified as ASA 2 and 3. There was the presence of at least one chronic disease in all patients with COVID-19 and in most patients without COVID-19. The mean BMI for patients with COVID-19 was type I obesity and overweight for the rest of the sample (p=0.043). There was a predominance of females among patients affected by COVID-19. Complications were longer postoperative hospital stay (p=0.015) and need for surgical approach (p=0.034). Conclusions: The profile of surgical patients with COVID-19 was linked to the presence of comorbidities, lon-ger duration of the surgical procedure and high BMI. Complications associated with the presence of COVID-19 were longer postoperative hospital stays and surgical reoperation. (AU)

Objetivo: Comparar os desfechos de pacientes submetidos a cirurgias gastrointestinais convencionais que desenvolveram coronavirus disease(COVID-19) com aqueles que não estavam contaminados. Método: Estudo comparativo descritivo. Foram coletados dados de 142 prontuários desde março de 2020 (início da pandemia no Brasil) até dezembro de 2021. Estudo aprovado pelo Comitê de Ética em Pesquisa (CAAE: 29473520.2.0000.5392). Resultados: O perfil dos pacientes foi, em sua grande maioria, classificação ASA 2 e 3 e presença de ao menos uma doença crônica em todos os pacientes com COVID-19 e na maioria daqueles sem COVID-19. O índice de massa corpórea (IMC) médio para os pacientes com COVID-19 foi obesidade tipo I e sobrepeso para o restante da amostra (p=0,043). Houve predominância do sexo feminino entre os pacientes acometidos por COVID-19. As complicações foram maior tempo de internação pós-operatória (p=0,015) e necessidade de reabordagem cirúrgica (p=0,034). Conclusão: O perfil dos pacientes cirúr-gicos com COVID-19 esteve atrelado à presença de comorbidades, maior duração do procedimento cirúrgico e IMC elevado. As complicações associadas à presença de COVID-19 foram maior tempo de internação pós-operatória e necessidade de reabordagem cirúrgica. (AU)

Objetivo: Comparar los resultados de pacientes sometidos a cirugías gastrointestinales convencionales que desarrollaron la enfermedad por coronavirus (COVID-19) con aquellos que no estaban infectados. Método: Estudio comparativo descriptivo. Se recopilaron datos de 142 historias clínicas, durante el período entre marzo de 2020 (inicio de la pandemia en Brasil) y diciembre de 2021. Estudio aprobado por el Comité de Ética en Investigación (CAAE: 29473520.2.0000.5392). Resultados: El perfil de los pacientes se clasificó en su mayor parte como ASA 2 y 3. Hubo presencia de al menos una enfermedad crónica en todos los pacientes con COVID-19 y en la mayoría de los pacientes sin COVID-19. El índice de masa corporal (IMC) promedio para los pacientes con COVID-19 fue de obesidad tipo I y de sobrepeso para el resto de la muestra (p=0,043). Hubo predominio del sexo femenino entre los pacientes afectados por COVID-19. Las complicaciones incluyeron un mayor tiempo de hospitalización postoperatoria (p=0,015) y la necesidad de reabordaje quirúrgico (p=0,034). Conclusión: El perfil de los pacientes quirúrgicos con COVID-19 se relacionó con la presencia de comorbilidades, mayor duración del procedimiento quirúrgico e IMC elevado. Las complicaciones asociadas con la presencia de COVID-19 fueron una hospitalización postope-ratoria más prolongada y la necesidad de un nuevo abordaje quirúrgico. (AU)

Risk of pressure injury in patients undergoing spine surgery / Risco de lesão por pressão em pacientes submetidos à cirurgia de coluna / Riesgo de lesión por presión en pacientes sometidos a cirugía de columna

Objetivo: Verificar el riesgo de úlceras por presión en pacientes sometidos a cirugía de columna y analizar los factores de riesgo asociados. Método: Investigación de campo descriptiva-exploratoria, transversal, con análisis cuantitativo, realizada en dos etapas (preoperatoria e intraoperatoria), con 55 pacientes sometidos a cirugía de columna, en un hospital privado de São Paulo, mediante la aplicación de un formulario de caracterización del participante y de la cirugía y aplicación de la Escala de Evaluación de Riesgos para el Desarrollo de Lesiones Derivadas del Posicionamiento Quirúrgico (ELPO). Resultados: Según la ELPO, 33 de los 55 pacientes (60,0%) tuvieron una puntuación de riesgo mayor para lesiones por presión. Los pacientes de mayor riesgo tenían una edad promedio de 50,2 años, clasificados como con sobrepeso y obesidad, y un tiempo quirúrgico promedio de 2 horas y 45 minutos. Hubo diferencias estadísticas significativas entre los grupos de mayor y menor riesgo, relacionadas con: edad, peso, índice de masa corporal y tiempo de cirugía. El riesgo del paciente de desarrollar una lesión por presión aumenta proporcionalmente con la edad, el peso, el índice de masa corpo-ral y la duración de la cirugía. A medida que aumentan estos factores, aumenta el riesgo del paciente de desarrollar lesiones por presión. Conclusión: El riesgo de lesiones por presión relacionadas con procedimientos quirúrgicos de columna fue significativo, revelando una realidad en la que corresponde al enfermero perioperatorio planificar medidas preventivas, con el fin de mitigar la aparición de tales lesiones y garantizar la seguridad del paciente. (AU)

Objective: To verify the risk of pressure injury in patients undergoing spine surgery and analyze the associated risk factors. Method: This is a descriptive-exploratory, cross-sectional field research, with quantitative analysis carried out in two stages (pre-operative and intraoperative), with 55 patients undergoing spine surgery, in a private hospital in São Paulo, Brazil, through the application of a characterization form of the participant and the surgery and the application of the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning (ELPO). Results: According to ELPO, 33 of the 55 patients (60.0%) had a higher risk score for pressure injury. Patients at highest risk had an average age of 50.2 years, classified as overweight and obese, and had a mean surgery time of 2 hours and 45 minutes. There were significant statistical differences between the higher and lower risk groups, related to: age, weight, body mass index, and surgery time. The patient's risk of developing a pressure injury increases proportionally with increasing age, weight, body mass index, and surgery duration. As these factors increase, the patient's risk of developing pressure injury increases. Conclusions: The risk of pressure injury related to spinal surgical procedures was significant, evidencing a reality in which the perioperative nurse is res-ponsible for planning preventive measures to mitigate the occurrences of such injuries and ensure patient safety. (AU)

Objetivo: Verificar o risco de lesão por pressão em pacientes submetidos a cirurgias de coluna e analisar os fatores de risco associados. Método:Pesquisa de campo descritivo-exploratória, transversal, com análise quantitativa, realizada em duas etapas (pré-operatório e transoperatório), com 55 pacientes submetidos à cirurgia de coluna, em hospital privado de São Paulo, por meio da aplicação de um formulário de caracterização do participante e da cirurgia e aplicação da Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico (ELPO). Resultados: De acordo com a ELPO, 33 dos 55 pacientes (60,0%) apresentaram escore de maior risco para lesão por pressão. Os pacientes que apresentaram maior risco tinham idade média de 50,2 anos, classificados como sobrepeso e obesidade e tempo médio de cirurgia de 2 horas e 45 minutos. Houve diferenças estatísticas significativas entre os grupos de maior e menor risco, relacionadas com: idade, peso, índice de massa corpórea e tempo de cirurgia. O risco de o paciente desenvolver lesão por pressão aumenta proporcionalmente conforme o aumento da idade, do peso, do índice de massa corpórea e a dura-ção da cirurgia. Com o aumento desses fatores, aumenta o risco de o paciente desenvolver lesão por pressão. Conclusão: O risco de lesão por pressão relacionado ao procedimento cirúrgico de coluna foi significativo, revelando uma realidade na qual cabe ao enfermeiro perioperatório planejar medidas preventivas, no intuito de mitigar as ocorrências de tais lesões e garantir a segurança do paciente. (AU)

Pressure injuries resulting from surgical positions: occurrence and risk factors / Lesiones por presión resultantes del posicionamento quirúrgico: ocurrencia y factores de riesgo / Lesões por pressão decorrentes do posicionamento cirúrgico: ocorrência e fatores de risco

Objective: To verify the occurrence of pressure injuries resulting from surgical positioning and analyze associated risk factors. Method: Observational, cross-sectional, prospective study with a quantitative design conducted at a large hospital in São Paulo, with 128 patients. Results: The occurrence of pressure injuries was observed in 5.47% of the study participants, which was related to: the score of the Surgical Positioning-Related Pressure Injury Risk Assessment Scale, with an odds ratio of 1.54 for each unit increase; surgery time, with an odds ratio of 85.7% for each additional hour; prone surgical position, with an odds ratio of 13.42 compared to other positions; and neurosurgery specialty, with an odds ratio of 10.65 compared to other specialties. Conclusion: Surgical patients exhibit characteristics that put them at risk of developing pressure injuries, and the instrument used in the risk assessment proved to be relevant. (AU)

Objetivo: Verificar la ocurrencia de lesiones por presión resultantes del posicionamiento quirúrgico y analizar los factores de riesgo asociados. Método: Estudio observacional, transversal, prospectivo, con diseño cuantitativo, desarrollado en un hospital de gran tamaño de la ciudad de São Paulo, con 128 pacientes. Resultados: Se observó la ocurrencia de lesiones por presión del 5,47% entre los participantes del estudio, relacionándose con: puntaje en la Escala de Evaluación de Riesgos para el Desarrollo de Lesiones Derivadas del Posicionamiento Quirúrgico, con odds ratio de 1,54 para cada unidad agregada; tiempo de cirugía, con odds ratio del 85,7%, por cada hora agregada; posición quirúrgica prona, con odds ratio de 13,42, en relación a las demás posiciones; especialidad de neurocirugía, con odds ratio de 10,65, en relación con otras especialidades. Conclusión: Se observó que los pacientes quirúrgicos presentan características que los ponen en riesgo de desarrollar lesiones por presión y el instrumento utilizado en la evaluación de riesgos resultó relevante. (AU)

Objetivo: Verificar a ocorrência de lesões por pressão decorrentes do posicionamento cirúrgico e analisar os fatores de risco associados. Método: Estudo observacional, transversal, prospectivo, com delineamento quantitativo, desenvolvido em hospital de extraporte da cidade de São Paulo, com 128 pacientes. Resultados: Observou-se ocorrência de lesão por pressão de 5,47% entre os participantes do estudo, relacionando-se com: escore da Escala de Avaliação de Risco para o Desenvolvimento de Lesões Decorrentes do Posicionamento Cirúrgico, razão de chances de 1,54, para cada uni-dade acrescida; tempo de cirurgia, razão de chances de 85,7%, para cada hora adicionada; posição cirúrgica em prona, razão de chances de 13,42, em relação às demais posições; e especialidade de neurocirurgia, razão de chances de 10,65, em relação às demais especialidades. Conclusão: Observou-se que os pacientes cirúrgicos apresentam características que os colocam em risco de desenvolver lesão por pressão, e o instrumento utilizado na avaliação de risco mostrou-se relevante. (AU)

Ultrasonography for the evaluation of urinary retention in patients in post-anesthesia recovery / Ultrasonografía para evaluación de retención urinaria en pacientes en recuperación anestésica / Ultrassonografia para avaliação de retenção urinária em pacientes em recuperação anestésica

Objective: To describe the results of the investigation of urinary retention in patients in post-anesthesia recovery using ultrasonography. Method: This is a descriptive observational study in which the bladder content of patients in the post-anesthesia recovery room was estimated using ultrasonogra-phy to detect urinary retention. Twenty adult and aged patients with one hour of stay in the post-anesthesia recovery room of a large university hospital in Northeast Brazil were included between June and October 2022. Results: The urinary volume measured through this imaging exam had a mean of 588.3±327.6 mL, ranging from 80 to 1,275.4 mL. Urinary retention was identified in 45% of cases in this series, although only the complaint of pain asso-ciated with the need to urinate was a statistically significant indicative symptom of retention. There was no statistically significant difference between genders, and it was not possible to observe the influence of opioid use on urinary retention. Conclusion: Perioperative nurses should seek training for advanced techniques, including the use of ultrasonography, to assist in their practice. (AU)

Objetivo: Describir los resultados de la investigación sobre retención urinaria en pacientes en recuperación anestésica utilizando ultrasono-grafía. Método: Se trata de un estudio observacional descriptivo, en el cual se estimó el contenido vesical de pacientes en la sala de recuperación posta-nestésica mediante ultrasonografía para detectar retención urinaria. Se incluyeron 20 pacientes adultos y ancianos con una hora de permanencia en la sala de recuperación postanestésica de un hospital universitario de gran tamaño en el noreste de Brasil, entre junio y octubre de 2022. Resultados: El volumen urinario medido mediante este examen de imagen tuvo un promedio de 588,3±327,6 mL, variando de 80 a 1.275,4 mL. La retención urinaria se identificó en el 45% de los casos de esta serie, aunque solo la queja de dolor asociada a la necesidad de micción fue un síntoma indicativo de retención estadísticamente significativo. No hubo diferencias estadísticamente significativas entre los sexos y no se pudo observar la influencia del uso de opioides en la retención urinaria. Conclusión: Los enfermeros perioperatorios deben buscar formación en técnicas avanzadas, incluido el uso de ultrasonogra-fía, como apoyo en su práctica. (AU)

Objetivo: Descrever os resultados da investigação de retenção urinária em pacientes em recuperação anestésica com uso da ultrassonografia. Método: Trata-se de um estudo observacional descritivo, no qual o conteúdo vesical de pacientes em sala de recuperação pós-anestésica foi estimado por meio da ultrassonografia para detectar retenção urinária. Foram incluídos 20 pacientes adultos e idosos com uma hora de permanência na sala de recuperação pós-anestésica de um hospital universitário de grande porte do Nordeste do Brasil, entre junho e outubro de 2022. Resultados: O volume urinário mensurado por meio desse exame de imagem teve média de 588,3±327,6 mL, variando de 80 a 1.275,4 mL. A retenção urinária foi identificada em 45% dos casos desta série, embora apenas a queixa de dor associada à necessidade miccional tenha sido um sintoma indicativo de retenção estatis-ticamente significativo. Não houve diferença estatisticamente significativa entre os sexos e não foi possível observar a influência do uso de opioides na retenção urinária. Conclusão: Os enfermeiros perioperatórios devem buscar formação para técnicas avançadas, incluindo o uso da ultrassonografia, como auxiliar na sua prática. (AU)