Intraoperative 70% N(2)O administration significantly reduced postoperative OIH in patients receiving propofol-remifentanil anaesthesia.

Objective In a context of increasingly limited surgical exposition, enhanced by the coronavirus disease 2019 (COVID-19) pandemic context, the objective of this article is to explain the development of a novel low-cost and simple replication animal-based septoplasty training model for otolaryngology residents, to assess its face and construct validity, and to validate a specific rating scale for each task. Study Design Experimental study. Setting Surgical simulation laboratory. Methods Septoplasty experts divided the procedure into key tasks. A simulator model to perform tasks was developed using pig ears to imitate human nasal septum cartilage, and a Specific Rating Scale was constructed. Trainees and faculty performed all tasks in the model. The participants were videotaped, and operative time, hand movements, and path length were recorded using a motion sensor device. Two blinded experts evaluated the videos with Global and Specific Rating Scales. All participants answered a satisfaction survey. Results Fifteen subjects were recruited (7 trainees and 8 faculty). Significantly higher Global Rating Scale score, shorter operative time and path length, and fewer hand movements were observed in the faculty group. The satisfaction survey showed high applicability to a real scenario (mean score of 4.6 out of 5). Specific Rating Scale showed construct and concurrent validity and high reliability. Conclusion This simulation model and its specific rating scale can be accurately used as a validated surgical assessment tool for endonasal septoplasty skills. Its low cost and simple replicability make it a potentially useful tool in any otolaryngology surgical training program.

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El taponamiento nasal es el manejo habitual de la epistaxis que no cede a medidas locales conservadoras. Este procedimiento requiere de conocimientos teóricos y habilidades técnicas, pero se han descrito bajas tasas de entrenamiento. La simulación juega un rol importante a la hora de entrenar habilidades, manteniendo la seguridad del paciente. Se realizó una revisión exhaustiva de la literatura sobre los modelos de simulación disponibles para entrenamiento en el manejo de epistaxis. Se encontraron modelos basados en impresión 3D, cadavéricos, adaptaciones de modelos de reanimación cardiopulmonar y modelos hechos a mano con materiales de bajo costo, que permiten entrenar el taponamiento nasal anterior y/o posterior. En general, se vio un aumento estadísticamente significativo del conocimiento y confianza de los aprendices postentrenamiento. Los simuladores cuentan con valor educativo, pero la mayoría no se encuentran validados, lo cual plantea un desafío a seguir.