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PURPOSE: This research aims to investigate the role of transformational leadership and organizational culture - encompassing Clan, Adhocracy, Hierarchical and Market Cultures - in the context of work-life balance for healthcare workers. It aims to present a comparison of observations made pre and mid-pandemic. DESIGN/METHODOLOGY/APPROACH: A structured questionnaire was utilized to collect data from a varied sample of 355 employees (258 before and 97 during the pandemic) representing multiple sectors and positions within a hospital. The interpretation of the data was accomplished using Partial Least Squares Structural Equation Modeling (PLS-SEM). FINDINGS: Findings reveal that prior to the pandemic, transformational leadership significantly influenced all forms of organizational culture perceptions, with a strong influence on Clan Culture. Clan Culture displayed a consistent positive correlation with WLB both before and during the pandemic. During the pandemic, Market Culture exhibited a negative effect on WLB and Adhocracy Culture demonstrated a positive effect, impacts which were absent before the pandemic. Transformational leadership had a positive impact on WLB before the pandemic, but no discernible effect during the pandemic was observed. ORIGINALITY/VALUE: The results indicate that the dynamics between transformational leadership, organizational culture and work-life balance are susceptible to alterations in the face of external crisis events. This study offers a unique exploration of these dynamics in the healthcare sector during the ongoing global pandemic.

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BACKGROUND: Tumescent anaesthesia (TA) is a widely used technique in oncologic surgeries necessitating large resection margins. This technique produces transoperative and postoperative analgesia, reduces surgical bleeding, and facilitates tissue divulsion. This prospective, randomised, blind study evaluated the use of TA in bitches submitted to mastectomy and compared the effect of TA with an intravenous fentanyl bolus. A 2.5-mcg/kg intravenous fentanyl bolus (n = 10) was compared with TA using 0.275% lidocaine (n = 10) in bitches submitted to unilateral mastectomy. Sedation was performed by intramuscular (IM) injection of 0.05 mg/kg of acepromazine combined with 2 mg/kg of meperidine. Anaesthesia was induced with 5 mg/kg of intravenous propofol and maintained with isoflurane/O2. Heart and respiratory rates; systolic, mean, and diastolic arterial blood pressures; central venous pressure; SpO2; ETCO2; inspired and expired isoflurane concentrations; and temperature were measured transoperatively. Visual analogue scales for sedation and pain and the Glasgow composite and Melbourne pain scales were used for postoperative assessment. The surgeon investigated the quality of the surgical approach, considering bleeding and resection ability, and the incidence of postoperative wound complications. RESULTS: The heart rate was lower and the end-tidal isoflurane concentration was higher in dogs treated with fentanyl than in dogs treated with TA. A fentanyl bolus was administered to 8 of 10 dogs treated with fentanyl and to none treated with TA. Intraoperative bleeding and the mammary gland excision time were lower in dogs treated with TA. The maximal mean and individual plasma lidocaine concentrations were 1426 ± 502 ng/ml and 2443 ng/ml at 90 minutes after infiltration, respectively. The Glasgow Composite Pain Scale scores were higher in dogs treated with fentanyl than in dogs treated with TA until 2 hours after extubation. CONCLUSIONS: Compared with intravenous fentanyl, TA in bitches: may be easily performed in non-inflamed, ulcerated, adhered mammary tumours; has an isoflurane-sparing effect; improves transoperative and immediate postoperative analgesia; is apparently safe for use in clinical conditions as evidenced by the fact that it did not produce any adverse signs or lidocaine plasma concentrations compatible with toxicity; does not modify the recovery time; and facilitates the surgical procedure without interfering with wound healing.

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A hemipelvectomia é uma técnica cirúrgica usualmente indicada no tratamento de neoplasias ósseas localizadas em pelve de cães e está associada a dor de alta intensidade no pós-operatório, comprometendo a recuperação e o bem-estar do animal. A busca da associação de fármacos que atuem de modo eficaz no controle da dor ainda representa um desafio a ser superado na medicina veterinária e constitui o objetivo deste trabalho. Neste estudo uma fêmea da raça rottweiler, diagnosticada com osteossarcoma em região de fêmur e íleo, foi submetida a hemipelvectomia parcial. Para realizar o procedimento optou-se pelo bloqueio peridural com S(+) cetamina e morfina associada a bupivacaína e fixação do cateter peridural para avaliação rigorosa da analgesia pós-operatória. A associação dos fármacos usados no presente estudo demonstrou ser alternativa promissora na analgesia intra e pós-operatória.(AU)

The hemipelvectomy is a surgical technique usually indicated for the treatment of canine pelvical bone tumors. It is associated with high levels of postoperative pain, which undermines the recovery and well-being of the animal. The search for a drug association that effectively works in controlling pain still represents a challenge to be overcome in veterinary medicine, and is the objective of this work. In this study, a female Rottweiler diagnosed with osteosarcoma in the region of the femur and ileum underwent partial hemipelvectomy. An epidural block with S(+) ketamine and morphine plus bupivacaine and catheter fixation was chosen in order to allow accurate assessment of postoperative analgesia. The combination of drugs used in this study proved to be a promising alternative for intra- and postoperative analgesia.(AU)

La hemipelvectomía es una técnica quirúrgica comúnmente indicada para el tratamiento de neoplasias óseas localizadas en la pelvis de los perros, que está relacionada con dolor de alta intensidad durante el postoperatorio, comprometiendo la recuperación y el bien estar del animal. Es así que la búsqueda de una combinación de fármacos que actúen de una manera eficiente en el control del dolor representa un desafío a ser superado en medicina veterinaria, siendo este el objetivo del presente trabajo. En este relato, se realizó una hemipelvectomía parcial en una hembra Rottweiler, en la que se había diagnosticado un osteosarcoma en la región de fémur e ileon. Para la cirugía se utilizó un bloqueo peridural con S(+) ketamina, morfina y bupivacaína, a través de un catéter epidural, con el fin de poder evaluar rigurosamente la analgesia postoperatoria. La asociación de los fármacos utilizados en este estudio mostró ser una alternativa promisoria para la analgesia intra y postoperatoria.(AU)

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A hemipelvectomia é uma técnica cirúrgica usualmente indicada no tratamento de neoplasias ósseas localizadas em pelve de cães e está associada a dor de alta intensidade no pós-operatório, comprometendo a recuperação e o bem-estar do animal. A busca da associação de fármacos que atuem de modo eficaz no controle da dor ainda representa um desafio a ser superado na medicina veterinária e constitui o objetivo deste trabalho. Neste estudo uma fêmea da raça rottweiler, diagnosticada com osteossarcoma em região de fêmur e íleo, foi submetida a hemipelvectomia parcial. Para realizar o procedimento optou-se pelo bloqueio peridural com S(+) cetamina e morfina associada a bupivacaína e fixação do cateter peridural para avaliação rigorosa da analgesia pós-operatória. A associação dos fármacos usados no presente estudo demonstrou ser alternativa promissora na analgesia intra e pós-operatória.

The hemipelvectomy is a surgical technique usually indicated for the treatment of canine pelvical bone tumors. It is associated with high levels of postoperative pain, which undermines the recovery and well-being of the animal. The search for a drug association that effectively works in controlling pain still represents a challenge to be overcome in veterinary medicine, and is the objective of this work. In this study, a female Rottweiler diagnosed with osteosarcoma in the region of the femur and ileum underwent partial hemipelvectomy. An epidural block with S(+) ketamine and morphine plus bupivacaine and catheter fixation was chosen in order to allow accurate assessment of postoperative analgesia. The combination of drugs used in this study proved to be a promising alternative for intra- and postoperative analgesia.

La hemipelvectomía es una técnica quirúrgica comúnmente indicada para el tratamiento de neoplasias óseas localizadas en la pelvis de los perros, que está relacionada con dolor de alta intensidad durante el postoperatorio, comprometiendo la recuperación y el bien estar del animal. Es así que la búsqueda de una combinación de fármacos que actúen de una manera eficiente en el control del dolor representa un desafío a ser superado en medicina veterinaria, siendo este el objetivo del presente trabajo. En este relato, se realizó una hemipelvectomía parcial en una hembra Rottweiler, en la que se había diagnosticado un osteosarcoma en la región de fémur e ileon. Para la cirugía se utilizó un bloqueo peridural con S(+) ketamina, morfina y bupivacaína, a través de un catéter epidural, con el fin de poder evaluar rigurosamente la analgesia postoperatoria. La asociación de los fármacos utilizados en este estudio mostró ser una alternativa promisoria para la analgesia intra y postoperatoria.

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