Background: Peripheral nerve injuries (PNI or IPNI) affect approximately 1% (estimates range from 0.02% to 21%) of the general population undergoing surgery, with increased incidence in neurosurgery, cardiac surgery and orthopedic surgery. The onset of this complication affects the brachial plexus and ulnar nerve in 60% of cases. Objective: Analysis of the assessment, monitoring and intraoperative management of the upper limbs (in relation to Supine, Prone, Trendelemburg and Lateral positioning) and the onset of any compromise of the peripheral nerves in the post-operative period. Materials and methods: National and international literature review, through biomedical databases (PubMed and CINHAL) and institutional sites (AGENAS). Observational epidemiological study of a qualitative phenomenological type, using two specially created observation grids following the guidelines of the American Society of Anesthesiologists (ASA) and the Association of PeriOperative Registered Nurses (AORN). The intraoperative observation grid was used within Area Servizi Direzione Medica (Gruppo Operatorio) - Ospedale Alto Vicentino Azienda ULSS 7 Pedemontana. The post-operative observation grid was used within the following surgical wards: U.O. Chirurgia Generale; U.O. Urologia; U.O. Ostetricia e Ginecologia; U.O. Ortopedia e Traumatologia; U.O. Day Surgery-Week Surgery. This survey took place in August 2022. Results: During the data collection activity, 67 surgeries were examined. The incidence of PNI signs and symptoms is 8.96%, in line with the researched data. 50% of patients who presented with signs and symptoms of PNI had at least one risk factor. 100% of patients with signs and symptoms of PNI were female. Conclusions: In 100% of cases, the onset of PNI signs and symptoms is associated with failure to comply with one or more of the preventive positioning interventions. The presence in the sample of some surgical specialties, in particular orthopedics and general surgery, reflects what is reported in the literature. Keywords: Peripheral Nerve Injuries, General Anesthesia, Operating Room, Nurse / Operating Room Nurse / Anesthesia Nurse.
RIASSUNTO Background: Le lesioni dei nervi periferici (PNI o IPNI) interessano circa l’1% (le stime variano dallo 0,02% al 21%) della popolazione generale sottoposta ad interventi chirurgici, con aumenti di incidenza in neurochirurgia, cardiochirurgia e chirurgia ortopedica. L’insorgenza di questa complicanza riguarda nel 60% dei casi il plesso brachiale e il nervo ulnare. Obiettivo: Analisi dell’accertamento, monitoraggio e gestione intraoperatoria degli arti superiori (relativamente al posizionamento Supino, Prono, Trendelemburg e Laterale) e dell’insorgenza di eventuali compromissioni dei nervi nel post-operatorio. Materiali e metodi: Revisione della letteratura nazionale e internazionale, attraverso banche dati biomediche (PubMed e CINHAL) e siti istituzionali (AGENAS). Studio epidemiologico osservazionale di tipo qualitativo fenomenologico, con utilizzo di due griglie di osservazione appositamente create seguendo le linee guida dell’American Society of Anesthesiologists (ASA) e dell’Association of periOperative Registered Nurses (AORN). La griglia di osservazione intraoperatoria è stata impiegata all’interno dell’Area Servizi Direzione Medica (Gruppo Operatorio) dell’Ospedale Alto Vicentino Azienda ULSS 7 Pedemontana. La griglia di osservazione post-operatoria è stata impiegata all’interno dei seguenti reparti chirurgici di degenza: U.O. Chirurgia Generale; U.O. Urologia; U.O. Ostetricia e Ginecologia; U.O. Ortopedia e Traumatologia; U.O. Day Surgery-Week Surgery. Tale rilevazione è avvenuta nel mese di Agosto 2022. Risultati: Durante l’attività di raccolta dati sono stati presi in esame 67 interventi chirurgici. L’incidenza di segni e sintomi di PNI è dell’8,96%, in linea con i dati ricercati. Il 50% dei pazienti che hanno presentato segni e sintomi di PNI presentava almeno un fattore di rischio. Il 100% di pazienti con segni e sintomi di PNI appartenevano al sesso femminile. Conclusioni: Nell’100% dei casi l’insorgenza di segni e sintomi di PNI è associata alla mancata osservanza di uno o più degli interventi preventivi di posizionamento. La presenza nel campione di alcune specialità chirurgiche, in particolare ortopedia e chirurgia, rispecchia quanto riportato in letteratura. Parole chiave: Peripheral Nerve Injuries, General Anesthesia, Operating Room, Nurse / Operating Room Nurse / Anesthesia Nurse.
"Prevenzione delle complicanze agli arti superiori da posizionamento intraoperatorio: uno studio sperimentale"
CAPPOZZO, ALESSANDRO
2021/2022
Abstract
Background: Peripheral nerve injuries (PNI or IPNI) affect approximately 1% (estimates range from 0.02% to 21%) of the general population undergoing surgery, with increased incidence in neurosurgery, cardiac surgery and orthopedic surgery. The onset of this complication affects the brachial plexus and ulnar nerve in 60% of cases. Objective: Analysis of the assessment, monitoring and intraoperative management of the upper limbs (in relation to Supine, Prone, Trendelemburg and Lateral positioning) and the onset of any compromise of the peripheral nerves in the post-operative period. Materials and methods: National and international literature review, through biomedical databases (PubMed and CINHAL) and institutional sites (AGENAS). Observational epidemiological study of a qualitative phenomenological type, using two specially created observation grids following the guidelines of the American Society of Anesthesiologists (ASA) and the Association of PeriOperative Registered Nurses (AORN). The intraoperative observation grid was used within Area Servizi Direzione Medica (Gruppo Operatorio) - Ospedale Alto Vicentino Azienda ULSS 7 Pedemontana. The post-operative observation grid was used within the following surgical wards: U.O. Chirurgia Generale; U.O. Urologia; U.O. Ostetricia e Ginecologia; U.O. Ortopedia e Traumatologia; U.O. Day Surgery-Week Surgery. This survey took place in August 2022. Results: During the data collection activity, 67 surgeries were examined. The incidence of PNI signs and symptoms is 8.96%, in line with the researched data. 50% of patients who presented with signs and symptoms of PNI had at least one risk factor. 100% of patients with signs and symptoms of PNI were female. Conclusions: In 100% of cases, the onset of PNI signs and symptoms is associated with failure to comply with one or more of the preventive positioning interventions. The presence in the sample of some surgical specialties, in particular orthopedics and general surgery, reflects what is reported in the literature. Keywords: Peripheral Nerve Injuries, General Anesthesia, Operating Room, Nurse / Operating Room Nurse / Anesthesia Nurse.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/37849