Pneumatic tourniquets are widely used in orthopaedic surgery to provide a bloodless operative field and limit blood loss. Although regarded as safe, their use is associated with physiological and clinical complications that may occasionally be severe. We conducted a retrospective review of prospectively collected data over a 5-year period for adverse haemodynamic events during tourniquet use. Five patients (approximate incidence of 0.25%) developed significant haemodynamic complications with tourniquet in situ. The reported complications included acute haemodynamic instability at the time of inflation and deflation, persistent bleeding despite tourniquet application, venous oozing from partial deflation, fat embolism syndrome, and delayed hypotension following release in revision arthroplasty. All patients improved with appropriate supportive management and recovered without long-term sequelae. Awareness of the risks of tourniquet use, with vigilant monitoring, and timely management are essential for patient safety. This series adds to the limited literature on tourniquet-related haemodynamic complications and underlines the importance of careful perioperative vigilance.

This case report describes the anaesthetic management of a 62-year-old female with recurrent papillary carcinoma thyroid presenting with tracheal invasion and significant airway narrowing. This case underscores the implementation of elective tracheostomy and effective retrograde endotracheal intubation following unsuccessful video laryngoscopic attempts due to altered laryngeal anatomy, consequently ensuring safe perioperative airway management.

Prehabilitation has emerged as a promising strategy to optimise outcomes in metabolic and bariatric surgery; however, scientific output in this field remains limited and fragmented. This study aimed to map and characterise international research on prehabilitation for metabolic and bariatric surgery. A systematic search of eight databases and the grey literature (to March 2025) identified studies in English, Spanish, and Portuguese. Bibliometric analyses were used to investigate performance, keyword co-occurrence, and co-citation networks. Thirty-five studies were retrieved, with the number increasing after 2020, predominantly from the United States and Canada, published in 22 journals. Collaboration networks remain incipient. This bibliometric analysis highlights the recent growth of research on prehabilitation in metabolic and bariatric surgery, concentrated in North American institutions, revealing fragmented collaboration and geographical imbalance, while underscoring the need for standardisation, international cooperation, and evaluation of relevant clinical outcomes.

Preoperative anxiety, sleep disturbances and postoperative delirium are common complications among patients undergoing cardiac surgery and are associated with adverse perioperative outcomes. This scoping review aimed to synthesise evidence on the relationship between these factors and identify implications for perianaesthesia nursing practice. A literature search was conducted in PubMed, Scopus and Web of Science for studies published between 2016 and 2026. Twenty-five studies met the inclusion criteria. The findings indicated that preoperative anxiety and poor sleep quality were consistently associated with an increased risk of postoperative delirium. Several studies also reported beneficial effects of educational, psychosocial and sleep-focused nursing interventions on perioperative outcomes. The evidence suggests that anxiety, sleep disturbances and delirium are interrelated and potentially modifiable risk factors. Integrating psychological assessment, sleep evaluation and routine delirium screening may support earlier identification of high-risk patients and improve postoperative recovery.

Operating room nurses increasingly provide shadowing education to nursing students within high-acuity surgical environments, yet little is known about how they experience this educational role. This qualitative descriptive study explored how operating room nurses experience providing shadowing education and the strategies they use to sustain it. Semi-structured interviews were conducted with ten operating room nurses at a national acute care medical centre in Japan and analysed using inductive qualitative content analysis. Four categories were identified: perceived cognitive workload; professional growth and identity reinforcement; organisational and workflow challenges and adaptive instructional strategies. Participants described dividing attention between patient safety, surgical workflow and student supervision, while also experiencing reflective practice and strengthened professional identity. They used deliberate strategies to integrate teaching into surgical flow without compromising safety. Findings were synthesised into a preliminary conceptual model intended to guide future development and evaluation of shadowing education in perioperative practice.

This prospective single-centre pilot study examined whether the double-gloving technique affects fluid accumulation between glove layers and possible bacterial contamination during spinal surgery. Surgical site infections remain a major complication in spine surgery. While double gloving reduces contamination from glove perforations, the microenvironment between glove layers has not previously been studied. A total of 32 spinal procedures were analysed. In the experimental group, the outer glove cuff completely covered the inner glove cuff, whereas in the control group, approximately 1 cm of the inner cuff remained visible. Interglove fluid formation and bacterial contamination were assessed. Fluid accumulation occurred only in the experimental group. Thirty interglove fluid swabs were cultured. Twenty-nine (96.7%) showed no bacterial growth, while one (3.3%) yielded Staphylococcus epidermidis. No fluid formation occurred in the control group. These findings suggest that glove cuff configuration influences wrist moisture dynamics. Larger multicentre studies are needed to determine potential clinical relevance for surgical site infection risk.