Effectiveness of a Structured Nursing Care Pathway Integrated with Standard Pharmacological Management on Biophysiological and Psychological Outcomes in Patients Undergoing Spinal Anesthesia: A Pilot Quasi-Experimental Study.

BACKGROUND

Spinal anesthesia is a common technique for lower abdominal and limb surgeries, offering advantages such as rapid onset, and fewer systemic complications compared to general anesthesia. However, postoperative challenges including delayed wound healing, pain, impaired gastric motility, anxiety, and sleep disturbances remain prevalent. Standard pharmacological regimens (e.g., bupivacaine, paracetamol, tramadol, ondansetron, and pantoprazole) address these issues, but integrating structured nursing care pathways may optimize recovery.

AIM: This pilot study aimed to evaluate the effectiveness of a structured nursing care pathway combined with standard pharmacological management on biophysiological (wound healing, pain, gastric motility) and psychological (anxiety, sleep quality) outcomes in patients undergoing spinal anesthesia.

METHODS

A quasi-experimental pre-test-post-test control group study was conducted among 20 patients undergoing spinal anesthesia (control = 10, experimental = 10). Both groups received standard pharmacological therapy, while the experimental group additionally received a structured nursing care pathway. Outcomes including wound healing, pain, gastric motility, anxiety, and sleep quality were assessed using validated scales and analyzed using descriptive statistics, t-tests, and Chi-square tests (P < 0.05).

RESULTS

The experimental group showed significant improvements in all outcomes post-intervention (P < 0.05), with between-group post-test differences favoring the experimental group (t-values ranging from 8.25 to 10.12; P < 0.05). For instance, wound healing scores improved from 7.12 ± 0.88 to 17.1 ± 1.24 in the experimental group, compared to minimal changes in controls.

CONCLUSION

Integrating structured nursing care pathways with pharmacological management enhances postoperative recovery, reducing complications, and improving patient well-being. Larger randomized trials are recommended to confirm these findings.