Buddhasothorn Hospital Journal

Nursing care of patient laparoscopic liver resection under general anesthesia: A case study

Potchamat Pechree — 2026-07-06

Laparoscopic surgery is increasingly favored over open surgery due to its benefits, including smaller incision, reduced blood loss, less tissue trauma, decreased postoperative pain, faster recovery, lower rates of surgical site infection, shorter hospital stays, reduced healthcare cost, and fewer complications. Although liver resection is a major surgical procedure, it can be safely performed using minimally invasive laparoscopic techniques. Anesthetic management in patients with complex conditions and high surgical risk is essential. This case aims to contribute to and disseminate clinical knowledge.

Objective

1.To provide safe and effective nursing care for patients undergoing laparoscopic liver resection under general anesthesia, aiming to prevent avoidable complications.

2. To promote appropriate self-care abilities in patients undergoing laparoscopic liver resection under general anesthesia, both preoperatively and postoperatively.

Methodology

This Descriptive study involved of a patient undergoing laparoscopic liver resection under general anesthesia at Buddhasothorn Hospital. Data were collected from a single case over a 3-day period (May 1-3, 2025). Nursing data were obtained from medical records and patient interviews. The nursing process was applied in three phases: pre-anesthesia care, intra-anesthesia care and post-anesthesia care.

Results

The patient undergoing laparoscopic liver resection under general anesthesia received appropriate nursing care, experienced no complications, and demonstrated the ability to perform appropriate self-care both before and after anesthesia.

Summary

Laparoscopic liver resection under general anesthesia can be performed safely without complications. Surgical outcomes depend on thorough patient assessment, multidisciplinary teamwork, and appropriate anesthetic management, particularly in high-risk patients. Nurse Anesthetist should maintain up to date knowledge and skills to enhance the quality of care.

Comparison of the Efficacy of Intravenous Paracetamol and Ondansetron for Prevention of Post-spinal Anesthesia Shivering Following Lower Abdominal and Lower Limb Surgeries in Buddhasothorn Hospital: A Phase II Prospective, Double-blind, Randomized Controlled Trial

Supichaya Chairat — 2026-07-06

Background: Post-spinal anesthesia shivering is a common complication. Severe shivering can significantly increase oxygen consumption and cardiac workload, posing risks to patients with cardiovascular vulnerabilities. Prophylactic administration of anti-shivering agents has been shown to be more effective than symptomatic treatment after the onset of shivering.

Objective: To compare the efficacy of intravenous paracetamol and ondansetron in preventing the incidence of shivering following spinal anesthesia in patients undergoing lower abdominal and lower extremity surgeries.

Methods: This randomized, double-blind clinical trial included 60 patients, divided into two groups of 30. Group P received intravenous paracetamol at a dose of 15 mg/kg or 1,000 mg for patients weighing over 50 kg, while Group O received 8 mg of intravenous ondansetron. Data were collected on the incidence and severity of shivering, body temperature, hemodynamic side effects, and the occurrence of nausea and vomiting both intraoperative and in the post-anesthesia care unit (PACU). Statistical analysis was performed using SPSS version 29.0.1.

Results: The intraoperative incidence of shivering in the paracetamol group and the ondansetron group was 20.0% and 13.3% (p-value=0.729), which was not statistically significant. Similarly, the incidence in the PACU was 6.7% in Group P and 3.3% in Group O (p-value=1.000). No significant differences were found in the severity of shivering between the two groups. However, a statistically significant difference was observed in the incidence of hypotension; the paracetamol group experienced hypotension at a rate of 36.7%, compared to only 10.0% in the ondansetron group (p-value=0.015)

Conclusion: Intravenous paracetamol and ondansetron are equally effective in preventing post-spinal anesthesia shivering. However, the paracetamol group exhibited a significantly higher incidence of intraoperative hypotension, despite limitations in establishing a temporal relationship.

The factors associated with ADHD in children under 15 years old at Phrasamutchedi Sawatyanon Hospital

Pitsinee ๋Jindawatthanawong — 2026-07-06

Background: Attention-deficit/hyperactivity disorder (ADHD) is common among school-aged children and is a major cause of academic difficulties. Its prevalence has been increasing, with symptoms typically emerging in childhood. If left untreated, ADHD can adversely affect educational achievement, occupation, family, and social functioning.

Objective: To identify factors associated with ADHD among children under 15 years of age.

Methods: An analytical retrospective case-control study was conducted among 254 children under 15 years of age, including 127 cases and 127 controls. Data were analyzed using descriptive statistics. Associations between variables were examined using multiple logistic regression analysis, and the results were presented as adjusted odds ratios (OR_adj) with 95% confidence intervals (95% CIs).

Results: Male gender, preterm birth, birth weight <2,500 g, family history of ADHD, parental separation or divorce, not living with parents, and screen time ≥1 hour/day were significantly associated with ADHD (p<0.05). These factors were associated with increased odds of ADHD, including male gender (adjusted OR 4.41; 95% CI 2.22–8.73), preterm birth (adjusted OR 6.95; 95% CI 1.50–32.07), low birth weight (adjusted OR 8.85; 95% CI 1.51–51.77), family history of ADHD (adjusted OR 8.82; 95% CI 1.23–63.03), parental separation or divorce (adjusted OR 4.46; 95% CI 1.99–9.98), not living with parents (adjusted OR 2.76; 95% CI 1.50–5.06), and screen time ≥1 hour/day (adjusted OR 3.63; 95% CI 1.98–6.64).

Conclusions: These findings may inform preventive strategies and early interventions from the prenatal period through childhood, including appropriate child-rearing practices to reduce the long-term risk of ADHD

A Retrospective Cohort Study on the Prevalence and Risk Factors of Preserved Ratio Impaired Spirometry (PRISm) at Pattaya Bhattamakun Hospital

Sarawut Panichaporn — 2026-07-06

Background: Preserved ratio impaired spirometry (PRISm) is defined by a reduced FEV₁ with a preserved FEV₁/FVC ratio and FVC. In practice, this pattern is often interpreted as normal, despite underlying abnormalities. Previous studies have suggested that PRISm may be associated with adverse outcomes, but its prevalence and clinical significance are still not clearly established. This study aimed to determine the prevalence of PRISm and explore its associated risk factors and clinical outcomes at Pattaya Bhattamakun Hospital.

Methods: A retrospective cross-sectional study was conducted including 710 patients who underwent pulmonary function testing between January 2015 and April 2026. PRISm was defined using either lower limit of normal (LLN) or fixed-ratio criteria. Data on demographics, comorbidities, hospitalizations, and mortality were collected from ICD-10 records. Logistic regression was used to identify risk factors, and correlations with outcomes were assessed using Spearman’s rank test.

Results: The prevalence of PRISm was 9.0% (95% CI: 6.9–11.1). When classified separately, prevalence was 3.2% by LLN and 8.9% by fixed-ratio criteria. Female sex, smoking, and obesity were independently associated with PRISm. There was no significant association with all-cause mortality, but PRISm was associated with increased hospitalizations, particularly those related to airway disease.

Conclusions: PRISm was not uncommon in this population and was associated with a higher risk of hospitalization. These findings suggest that PRISm should not be overlooked in clinical practice. Further studies are needed to better understand its long-term outcomes and management.

Outcomes of Home Ward Service on Glycated Hemoglobin(HbA1c) Levels in Patients with Type 2 Diabetes Mellitus at Phra Samut Chedi Sawatyanon

Pitan Jindawattanawong — 2026-07-06

Background: Type 2 diabetes mellitus is a major public health problem. Poor glycemic control and subsequent complications can significantly impair patients’ quality of life. Therefore, developing effective models of care is essential.

Objective: To evaluate the effectiveness of Home Ward care and identify factors associated with changes in HbA1c levels among patients with type 2 diabetes mellitus.

Methods: A retrospective study was conducted among 137 patients who received Home Ward care between January 1, 2024 and August 31, 2025. Data were collected from medical records and analyzed using descriptive statistics paired t-test McNemar–Bowker test Chi-square and multiple logistic regression.

Results: The majority of participants were female, with a mean age of 58 years. Most had a disease duration of 5–10 years and ≥2 comorbidities. The mean HbA1c decreased by 2.46%, which was statistically significant (p < 0.001). Overall, 79.6% of patients showed a good treatment response, and the proportion achieving HbA1c ≤8% increased from 2.2% to 35.8%. Factors significantly associated with treatment response (p < 0.05) included BMI ≥25 kg/m² (OR = 0.06), medication non-adherence (OR = 0.73), alcohol consumption (OR = 0.16), baseline HbA1c 10–13% (OR = 10.38) and >13% (OR = 49.88), and regular exercise (OR = 20.09).

Conclusion: Home Ward care is associated with improved glycemic control in patients with type 2 diabetes mellitus. Factors associated with a lower likelihood of good treatment response include BMI ≥25 kg/m², medication non-adherence, and alcohol consumption. In contrast, higher baseline HbA1c (≥10%) and regular exercise are significantly associated with a greater likelihood of favorable treatment response.