1.Development of hypothermia after spinal anesthesia and risk factors
Jing ZHANG ; Shaojie ZONG ; Xinyan ZHU ; Xueyao YU ; Zhengqian LI ; Yi LIU ; Jiechu WANG
Chinese Journal of Anesthesiology 2023;43(2):152-155
Objective:To evaluate the development of hypothermia after spinal anesthesia and risk factors.Methods:Patients undergoing spinal anesthesia in the anesthesia preparation room of our hospital from April 2020 to April 2021 were included. The temperature of the tympanic membrane was measured before spinal anesthesia and immediately after anesthesia and at 5, 10 and 15 min after anesthesia. Patients with tympanic membrane temperature<36 ℃ at any time point were considered as having hypothermia and included in hypothermia group and patients with membrane temperature ≥ 36 ℃ were considered as having no hypothermia and included in non-hypothermia group. The patients′ demographic data, highest anesthesia plane, puncture space of spinal anesthesia, types of anesthetics, preoperative fasting time, and surgical sites were recorded. The multivariate logistic regression analysis was performed to identify the risk factors for hypothermia.Results:A total of 196 patients were finally enrolled. The body temperature was significantly decreased at 5 and 10 min after anesthesia compared with the baseline body temperature before anesthesia and immediately after anesthesia ( P<0.001), and the incidence of hypothermia was 10.2%. The multivariate logistic regression analysis showed that female and high anesthesia plane were independent risk factors for hypothermia, and higher baseline body temperature was an independent protective factor for hypothermia ( P<0.05). Conclusions:Body temperature decreases at 5-10 min after spinal anesthesia, and the occurrence of hypothermia is not a small probability event in the patients undergoing spinal anesthesia; female and higher anesthesia plane are risk factors and higher baseline body temperature is the protective factor.
2.Influencing factors of postoperative nausea and vomiting in patients undergoing egg retrieval with general anesthesia for in vitro fertilization-embryo transfer
Jinlian LIU ; Qin HUANG ; Caifeng HAN ; Luyu WANG ; Yang WANG ; Mingya WANG ; Jiechu WANG
Chinese Journal of Anesthesiology 2024;44(6):662-665
Objective:To identify the influencing factors of postoperative nausea and vomiting (PONV) in the patients undergoing egg retrieval with general anesthesia for in vitro fertilization-embryo transfer (IVF-ET).Methods:This was a case-control study. Medical records from IVF-ET patients undergoing egg retrieval with general anesthesia in the Center for Reproductive Medicine in our hospital from November to December 2020 were retrospectively collected, 52 patients with PONV were identified (group PONV), and 252 patients without PONV were selected as control group (group C). Univariate analysis was performed on the suspicious influencing factors, and the factors with statistically significant differences were included in the logistic regression analysis model to identify the influencing factors of PONV.Results:Compared with group C, statistically significant differences were found in the number of eggs, anesthesia time, and the proportion of PONV history and/or motion sickness history in group PONV ( P<0.05). The results of multivariate logistic regression analysis showed that a large number of eggs, long anesthesia time, and a high proportion of PONV history and/or motion sickness history were independent risk factors for PONV. Conclusions:A large number of eggs, long anesthesia time, and a high proportion of PONV history and/or motion sickness history are independent risk factors for PONV in IVF-ET patients undergoing egg retrieval with general anesthesia.
3.Evaluation of clinical effect of position pillows for neuraxial anesthesia
Jing ZHANG ; Jiechu WANG ; Xinyan ZHU ; Xiaoqing ZHANG ; Dong WANG ; Xueyao YU ; Jinjin HUO ; Zhukai CONG ; Yi LIU ; Wei LIU ; Liyuan HAO ; Li FAN ; Xiaoxiao LI
Chinese Journal of Anesthesiology 2024;44(9):1135-1138
Objective:To evaluate the clinical effect of the position pillows for neuraxial anesthesia.Methods:This was a prospective randomized controlled trial. Four hundred and twelve patients regardless of gender, aged ≥18 yr, of American Society of Anesthesiologists Physical Status classification Ⅰ-Ⅲ, who underwent elective surgery under neuraxial anesthesia at Peking University Third Hospital from February to October 2023, were selected and divided into 2 groups ( n=206 each) using a random number table method: pillow group (P group) and control group (C group). Group C underwent the conventional procedure for neuraxial anesthesia. The patients were placed in a position using the position pillow on the basis of oral education before routine anesthesia in group P. The success rate of puncture at first attempt, puncture time and position placement time were recorded. The adjustment of position, body movement and occurrence of discomfort during the puncture were also recorded. The visual analogue scale score was used to evaluate the level of anxiety before positioning, after positioning and after anesthesia. The visual analogue scale score was used to evaluate the patient′s comfort and the operator′s satisfaction with position after the anesthesia was completed. Results:Compared with group C, the time for positioning was significantly shortened, the anxiety level was decreased after positioning and after anesthesia, the rate of improvement in anxiety was increased, the scores for the patient′s comfort and the operator′s satisfaction with position were increased ( P<0.05), and no significant changes were found in the success rate of puncture at first attempt, puncture time and incidence of body movement during the puncture and incidence of the adjustment of position ( P>0.05). No discomfort was observed in either group during the puncture. Conclusions:This new type of position pillows for the neuraxial anesthesia can not only optimize the effect of position placement, but also improve the patients′ comfort.
4.Investigation and analysis of awareness of malignant hyperthermia among anesthesiology nurses in mainland China
Jing ZHANG ; Jiechu WANG ; Yang ZHOU ; Zhengqian LI ; Xiaoxiao WANG ; Xiaoqing ZHANG ; Xiaona LIN ; Xiangyang GUO
Chinese Journal of Anesthesiology 2022;42(6):661-665
Objective:To investigate and analyze the awareness of malignant hyperthermia (MH) in anesthesiology nurses in mainland China.Methods:From November 2021 to January 2022, anesthesiology nurses of secondary hospitals or above in Chinese mainland were enrolled by convenience sampling and investigated by a self-designed questionnaire on the awareness of MH.The system automatically recorded the situation of questionnaires.Results:A total of 2 058 anesthesiology nurses participated in the survey, distributed in 21 provinces, 2 autonomous regions (Ningxia Hui Autonomous Region, Guangxi Zhuang Autonomous Region) and 4 municipalities directly under the central government, and 2 049 questionnaires were effectively received with effective recovery of 99.56%.The correct answers to questions related to the treatment of MH, characteristics of the disease, classification, susceptible population, screening method of the susceptible population, genetic mode, inducing factors, the first symptoms and the best infusion time of dantrolene, preparation method of domestic dantrolene and the first dose were 86.58%, 82.33%, 58.18%, 50.90%, 50.76%, 50.42%, 45.73%, 32.89%, 51.25%, 48.32% and 46.51%, respectively.Only 27.13% of anesthesiology nurses expressed that dantrolene was available in their hospital.The scores of knowledge about MH among anesthesiology nurses in hospitals of province-level municipalities and provincial capital cities were significantly higher than those in other cities ( P<0.001). The scores of knowledge about MH among the anesthesiology nurses in secondary hospitals were significantly higher than those in tertiary hospitals ( P<0.05). There was no significant difference in the scores of knowledge about MH among anesthesiology nurses with different professional titles, educational backgrounds, and working years ( P>0.05). Conclusions:Anesthesiology nurses in mainland China have insufficient awareness of MH.Popularizing the knowledge about MH and strengthening the awareness of MH in medical staff in the department of anesthesiology throughout the country may be of great significance in improving the diagnosis and treatment of MH in China.
5.Investigation on current situation of core competence of anesthesiology nurses in China
Jing ZHANG ; Shaojie ZONG ; Xinyan ZHU ; Xiaoxiao WANG ; Jiechu WANG ; Baohua LI ; Jun LI
Chinese Journal of Anesthesiology 2022;42(7):854-857
Objective:To investigate the current situation of core competence of anesthesiology nurses in China, and to provide basis for formulating and perfecting the training curriculum of anesthesiology nurses.Methods:The cluster sampling method was used, and 231 nurses in the department of anesthesiology were investigated by using the general data questionnaire and the self-assessment form of core competence of specialized nurses in the department of anesthesiology.Results:Anesthesiology nurses scored (3.7±0.5) points in their core competencies, of which 43.2% and 36.4% had complete mastery of humanistic literacy, and communication and coordination skills, respectively, and only 4.3% of them had mastered scientific research ability.The core competence scores of anesthesiology nurses with the title of head nurse or above positions and deputy chief nurse or above titles were significantly higher than those of other positions and titles ( P<0.05). Conclusions:The self-evaluation of core competence of specialized nurses in anesthesiology department is at a medium level.There are differences in core competencies among nurses in the department of anesthesiology with different positions and titles.It is suggested that the training of specialized nurses should be guided by core competence.