Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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Sickle cell disease is an inherited hemoglobinopathy that develops from a genetic mutation and the production of a dysfunctional variant of hemoglobin. A number of physiological disturbances encountered during the perioperative period (blood loss, hypotension, acidosis, and hypoxia) may induce "sickling" of the biochemically altered hemoglobin, producing painful microvascular occlusion, hemolytic anemia, and impaired oxygen delivery. The only available curative therapy requires bone marrow transplantation. The purpose of this article is to review the pathophysiology of sickle cell disease and the pertinent preoperative, intraoperative, and postoperative care of patients with the disease.
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J. Perianesth. Nurs. · Aug 1999
ReviewPreoperative diagnosis and postoperative management of adult patients with obstructive sleep apnea syndrome: a review of the literature.
Obstructive sleep apnea syndrome (OSAS) is a common yet potentially fatal disorder. Several reports and clinical studies have established anesthetic-related occurrences of near-fatal respiratory complications in persons with this syndrome, as well as cases of death reported in the medical literature linking OSAS and anesthesia. The postoperative period is a critical time for patients with OSAS recovering from general anesthesia. ⋯ A treatment protocol for the postoperative management of adults with OSAS is also presented. Conclusions are drawn from a summary of the literature review. Future implications for nursing practice and research are drawn from the summary.