BackgroundPostoperative pressure ulcers are important indicators of perioperative care quality, and are serious and expensive complications during critical care. This study aimed to identify perioperative risk factors for postoperative pressure ulcers.MethodsThis retrospective case-control study evaluated 2,498 patients who underwent major surgery. Forty-three patients developed postoperative pressure ulcers and were matched to 86 control patients based on age, sex, surgery, and comorbidities.ResultsThe pressure ulcer group had lower baseline hemoglobin and albumin levels, compared to the control group. The pressure ulcer group also had higher values for lactate levels, blood loss, and number of packed red blood cell (pRBC) units. Univariate analysis revealed that pressure ulcer development was associated with preoperative hemoglobin levels, albumin levels, lactate levels, intraoperative blood loss, number of pRBC units, Acute Physiologic and Chronic Health Evaluation II score, Braden scale score, postoperative ventilator care, and patient restraint. In the multiple logistic regression analysis, only preoperative low albumin levels (odds ratio [OR]: 0.21, 95% CI: 0.05–0.82; P < 0.05) and high lactate levels (OR: 1.70, 95% CI: 1.07–2.71; P < 0.05) were independently associated with pressure ulcer development. A receiver operating characteristic curve was used to assess the predictive power of the logistic regression model, and the area under the curve was 0.88 (95% CI: 0.79–0.97; P < 0.001).ConclusionsThe present study revealed that preoperative low albumin levels and high lactate levels were significantly associated with pressure ulcer development after surgery.

Objective: This study was performed to assess the impact of simulation-based training for ultrasound-guided transversus abdominis plane (TAP) block using anesthetized pigs. Methods: In this prospective study, 23 participating residents (10 in their second year, 13 in their third year) underwent simulation-based training for ultrasound-guided TAP block. The residents completed standard questionnaires comprising 10 multiple-choice questions regarding essential general knowledge of abdominal ultrasound and TAP block before and after the training session. On a 5-point Likert scale, they reported their levels of comfort with the use of ultrasound and block equipment, subject/operator positioning, proper block technique, image documentation, needle handling, anxiety, and their overall confidence with the procedure. Results: Compared with those before training, the comfort levels of the residents significantly improved for all measures except needle handling. The participants also indicated significantly reduced anxiety regarding performance of the TAP block technique. Conclusion: The use of anesthetized pigs in simulation-based training for ultrasound-guided TAP block improves procedural knowledge and confidence while reducing the associated anxiety in anesthesiology trainees.

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Background: Anesthetized pigs may be useful for training with regional anesthesia techniques. This model animal was used to assess the impact of simulation-based training for ultrasound-guided transversus abdominis plane (TAP) block. Methods: In this prospective study, 23 participating residents (10 in their second year, 13 in their third year) underwent simulation-based training for ultrasound-guided TAP block. The residents completed standard questionnaires comprising ten multiple-choice questions regarding essential general knowledge of abdominal ultrasound and TAP block before and after the training session. On a five-point Likert scale, they reported their levels of comfort with the use of ultrasound and block equipment, subject/operator positioning, proper block technique, image documentation, needle handling, and anxiety, as well as their overall confidence with the procedure. Results: Compared with those before training, the comfort levels of the residents significantly improved for all measures, except needle handling (all P < 0.05). The participants also indicated significantly reduced anxiety for performing the TAP block technique (P < 0.05). Conclusion: The use of anesthetized pigs in simulation-based training for the ultrasound-guided TAP block procedure improves the procedural knowledge and confidence while reducing the associated anxiety in anesthesiology trainees. Keywords: Porcine; simulation-based training; transversus abdominis plane block

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