Impact of rapid rehabilitation surgery on perioperative nursing in patients undergoing cardiac surgery: A meta-analysis

The Impact of the ERAS-MDT-Based Nursing Interventions on Postoperative Recovery, Nutritional Status, and Complications in Patients Undergoing Total Laryngectomy for Laryngeal Cancer

Aims/Background Throat cancer is a common malignant tumor in the head and neck region, with postoperative recovery influenced by various factors. The enhanced recovery after surgery-multidisciplinary team (ERAS-MDT) concept emphasizes the use of multidisciplinary collaboration to optimize preoperative, intraoperative, and postoperative care and treatment, aiming to accelerate patient recovery, reduce complications, and improve treatment outcomes. Therefore, this study aims to explore the impact of the ERAS-MDT-based nursing intervention in postoperative rehabilitation, nutritional status, and complication rates among patients undergoing total resection of laryngeal cancer. Methods This retrospective study recruited 85 of patients who underwent total laryngectomy for laryngeal cancer at the Second Affiliated Hospital of Jiaxing University between April 2020 and February 2024. Among them, 45 patients who received team-based nursing interventions following the ERAS-MDT concept were categorized as the ERAS-MDT group. Another 40 patients who received routine nursing interventions, were randomly included in the conventional group. The study compared nutritional indicators, Patient Health Questionnaire-9 (PHQ-9) scores, Patient-Generated Subjective Global Assessment (PG-SGA) scores, and Generalized Anxiety Disorder-7 (GAD-7) scores before and after nursing intervention. Additionally, gastrointestinal function recovery, total hospitalization costs, patient satisfaction, length of hospital stay, and complication rates were evaluated for both groups. Results There was no statistically significant difference in nutritional status between the two groups before nursing (p > 0.05). The post-nursing hemoglobin, albumin, prealbumin, and total protein levels in the ERAS-MDT group were 125.63 ± 10.77 g/L, 44.14 ± 4.93 g/L, 261.74 ± 28.82 mg/L, and 64.83 ± 5.36 g/L, respectively. In contrast, the post-nursing hemoglobin, albumin, prealbumin, and total protein levels in the conventional group were 114.56 ± 8.96 g/L, 39.01 ± 4.81 g/L, 222.84 ± 26.98 mg/L, and 57.85 ± 5.11 g/L, respectively. All indicators in both groups were higher than before nursing levels, with the ERAS-MDT group exhibiting significantly higher levels than the conventional group (p < 0.05). The time to first mobilization (10.52 ± 2.17 hours), first bowel movement (21.41 ± 4.50 hours), and hospitalization time (11.57 ± 1.91 days) were significantly shorter in the ERAS-MDT group than those in the conventional group (p < 0.05). However, there was no statistically significant difference in total hospitalization costs (p > 0.05). Furthermore, the differences in the PHQ-9, GAD-7, and PG-SGA scores were statistically insignificant between the two groups before nursing (p > 0.05). After nursing, the PHQ-9 score (2.81 ± 0.78), GAD-7 score (6.68 ± 1.05), and PG-SGA score (4.69 ± 1.24) were significantly reduced in the ERAS-MDT group than pre-nursing levels, with the ERAS-MDT group demonstrating substantial decrease than the conventional group (p < 0.05). Moreover, the satisfaction rate was 95.56% (43 cases/45 cases) in the ERAS-MDT group and 80.00% (32 cases/40 cases) in the conventional group. However, the difference was statistically insignificant (p > 0.05). Additionally, the incidence of complications was 8.89% (4 cases/45 cases) in the ERAS-MDT group compared to 17.50% (7 cases/40 cases) in the conventional group, indicating statistically insignificant difference (p > 0.05). Conclusion The ERAS-MDT concept team-based nursing intervention can improve hemoglobin, albumin, prealbumin, and total protein, promote postoperative recovery, and enhance patient satisfaction in those undergoing total laryngectomy for laryngeal cancer.

From surgery to recovery: Measuring success through quality of life and functional improvements after cardiac surgery

Coronary artery disease and aortic valve stenosis are highly prevalent cardiovascular diseases worldwide, resulting in substantial morbidity and mortality. Surgical interventions, such as coronary artery bypass grafting and surgical aortic valve replacement, offer significant therapeutic benefits, including enhanced postoperative quality of life (QoL) and functional capacity, which are key indicators of surgical success. This editorial reviews recent studies on postoperative QoL and functional outcomes in patients undergoing cardiac surgery. Factors such as preoperative health, age, intensive care unit stay duration, surgical risk, and perioperative complications could influence these outcomes. Cardiac rehabilitation is pivotal in enhancing patient function, reducing frailty and improving long-term QoL.

Enhanced recovery after surgery speeds up healing for hip fracture patients

OBJECTIVE

To investigate the effects of enhanced recovery after surgery (ERAS) on the perioperative healing and stress response in patients with hip fractures.

METHODS

A retrospective analysis was conducted on the medical records of 86 patients with hip fractures admitted to the Affiliated Hospital of Southwest Medical University between January 2022 and August 2023. Among them, 48 patients in the research group received ERAS, while 38 patients in the control group received conventional nursing. Hip joint function, pain levels, stress response, fracture healing time, incidence of complications, and nursing satisfaction were compared between the two groups.

RESULTS

After nursing, the Harris scores notably increased in both groups, with the research group showing notably higher scores compared to the control group (P<0.05). The levels of cortisol and epinephrine, as well as the visual analog scale scores significantly decreased in both groups, with the research group showing significantly lower levels (P<0.05). In addition, the research group experienced significantly shorter fracture healing time (P<0.05), higher nursing satisfaction (P=0.014), and lower incidence of complications (P=0.028). Logistic regression analysis revealed that age, underlying diseases, nursing method, emotional disorders, and timing of surgery were independent factors influencing the post-nursing outcomes.

CONCLUSION

The ERAS mode can effectively alleviate pain, improve hip joint function, reduce fracture healing time and complications, mitigate stress response, and accelerate postoperative recovery in patients with hip fractures. It is worthy of application and promotion in clinical practice.

Effect of antibiotics on physical and physiological development of children under 5-A scoping review

The scoping review aimed to investigate and compile the effects of antibiotics on children under the age of five's physiological development. A PubMed, CINAHL, and Medline online database search was conducted, and related studies were included in the databases to carry out a more detailed search of the available literature utilizing keywords like "Antibiotics in children's"; "Children under 5"; and "Physiological Development, Physical Development," as well as Boolean operators to generate papers pertinent which were correlating with the objective of the study. It is imperative to demonstrate that a comprehensive, wide-ranging, and exhaustive search was carried out. MeSH words used for the search. MeSH is an is an effective tool for indexing and classifying literature on biology and health. MeSH terms are affixed to articles to enable precise and effective literature searches, guaranteeing that scholars, medical professionals, and other users can locate pertinent data within the extensive PubMed database. MeSH provides researchers with a standardized and structured method of indexing topics in the field of medicine and related disciplines, which aids in the identification and organization of pertinent articles during scoping reviews. PRISMA checklist was followed while doing the data collection and data extraction. The findings revealed that antibiotics hurt the physical and physiological development of children under 5. The study findings show that after exposure to antibiotics children get obese, it also affects the gut microbiota. Antibiotics also have an impact on the language and behaviors of children under 5. It also shows that children are more prone to get different medical disorders. These results highlight how crucial it is to make well-informed decisions about the use of antibiotics in pediatric care. To sum up, giving antibiotics to kids younger than five can have a big impact on how their bodies develop. This study also provides and implements guidelines that consider the possible long-term effects on the development of children under the age of five when prescribing antibiotics. Encourage healthcare professionals, parents, and other caregivers to learn about the proper use of antibiotics for young children as well as the possible risks of overusing or not using antibiotics at all. Promote funding and research for alternative approaches, such as targeted vaccines or probiotics, to treat and prevent infections in young children.

Effect of rapid rehabilitation surgery nursing on patients undergoing radical thyroidectomy

OBJECTIVE

To determine the effect of rapid rehabilitation surgery nursing on degree of pain and stress response in patients undergoing radical thyroidectomy for thyroid carcinoma.

METHODS

In this retrospective study, the clinical data of 100 patients who received radical thyroidectomy for thyroid carcinoma in Pingkuang General Hospital between November 2020 and October 2022 were analyzed. Among the patients, 56 who received rapid rehabilitation surgery nursing were assigned to the research group, and the other 44 patients who received routine nursing were assigned to the control group. The two groups were compared for thyroid hormone level, degree of pain, stress response, recovery time, hospitalization time, anxiety and depression, nursing satisfaction, and the incidence of complications.

RESULTS

The pain score, recovery time, and hospitalization time in the research group were all lower than those of the control group (all P < 0.05). 48 hours after operation, the thyroid stimulating hormone (TSH) level of the two groups was significantly increased, and was higher in the research group than the control group. Triodothyronine (T3) and thyroxine (T4) were significantly decreased, and was lower in the research group than the control group (all P < 0.05). One day after operation, the levels of plasma cortisol (Cor) and angiotensin II (Ang II) in both groups were increased, with significantly lower levels in the research group than the control group (all P < 0.05). After surgery, the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) scores in both groups decreased (P < 0.05), with significantly lower SAS and SDS scores in the research group than the control group (all P < 0.05). Additionally, the research group expressed higher nursing satisfaction than the control group (P < 0.05), and the research group showed a lower incidence of postoperative complications than the control group (P < 0.05). Age, gender, course of disease, pathologic type, and nursing method were risk factors affecting the prognosis. Logistic regression analysis showed that pathologic type and nursing method were independent risk factors affecting prognosis.

CONCLUSION

For patients undergoing radical thyroidectomy, rapid rehabilitation surgical nursing can effectively reduce postoperative pain and anxiety, shorten recovery time and hospitalization time, decrease incidence of complications and stress response, but promote a fasterrecovery after operation, and improve the quality of life.

Efficacy of Rapid Rehabilitation Nursing in Postoperative Care in China: A Meta-Analysis

BACKGROUND

Rapid rehabilitation nursing (RRN) has been increasingly adopted in China to improve patient outcomes following surgery. This systematic review and meta-analysis aimed to assess the impact of RRN on hospital stays, postoperative complications, postoperative pain, patients' quality of life (QOL), and patient satisfaction with nursing care compared to traditional nursing care.

METHODS

A systematic search of relevant databases, including PubMed, EMBASE, and Cochrane Library, was conducted to identify eligible studies. The standardized mean difference and 95% confidence intervals were calculated for continuous outcomes (hospital stays, postoperative pain, and QOL). Risk ratios (RRs) and 95% confidence intervals were used for dichotomous outcomes (postoperative complications, patient satisfaction with nursing care). Heterogeneity was assessed using the I2 statistic. Fixed-effects and random-effects models were calculated for each outcome measure.

RESULTS

A total of 10 studies including 1,565 patients were included in the meta-analysis. Rapid rehabilitation nursing significantly reduced hospital stays and postoperative complications compared to traditional nursing care. Patients receiving RRN experienced lower postoperative pain scores and improved QOL, although the latter result was not statistically significant. Patient satisfaction with nursing care was significantly higher in the RRN group compared to traditional nursing care.

CONCLUSIONS

Rapid rehabilitation nursing appears to be an effective approach for shortening hospital stays, reducing postoperative complications and postoperative pain, and increasing patient satisfaction with nursing care compared to traditional nursing care. The findings support the integration of RRN into clinical practice to enhance patient outcomes and patients' satisfaction with nursing care. Future research should focus on further investigating the impact of RRN on patients' QOL using larger, well-designed studies.

Regional anesthesia as part of enhanced recovery strategies in pediatric cardiac surgery

PURPOSE OF REVIEW

The purpose of this review article was to highlight the enhanced recovery protocols in pediatric cardiac surgery, including early extubation, rapid mobilization and recovery, reduction of opioid-related side effects, and length of pediatric ICU and hospital stay, resulting in decreased costs and perioperative morbidity, by introducing recent trends in perioperative anesthesia management combined with peripheral nerve blocks.

RECENT FINDINGS

Efficient postoperative pain relief is essential for realizing enhanced recovery strategies, especially in pediatric patients. It has been reported that approaches to perioperative pain management using additional peripheral nerve blocks ensure early extubation and a shorter duration of ICU and hospital stay. This article provides an overview of several feasible musculofascial plane blocks to achieve fast-track anesthesia management for pediatric cardiac surgery.

SUMMARY

Recent remarkable advances in combined ultrasound techniques have made it possible to perform various peripheral nerve blocks. The major strategy underlying fast-track anesthesia management is to achieve good analgesia while reducing perioperative opioid use. Furthermore, it is important to consider early extubation not only as a competition for time to extubation but also as the culmination of a qualitative improvement in the outcome of treatment for each patient.