Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Aug 2009
Randomized Controlled TrialThe effect of needle bevel position on pain for subcutaneous lidocaine injection.
It is a common practice for medical practitioners to use subcutaneous infiltration of lidocaine to alleviate the pain of intravenous cannulation or line insertion. Although previous studies have assessed several factors affecting the pain associated with local anesthetic infiltration, there is a paucity of data on the effects of needle bevel position. ⋯ Significantly higher pain scores were observed when the needle was placed bevel down compared with bevel up (P = .02). No significant differences in pain scores were noted between the groups for age and gender.
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J. Perianesth. Nurs. · Aug 2009
ReviewA review of the incidence, causes, consequences, and management of gastrointestinal effects associated with postoperative opioid administration.
Opioid analgesics are commonly used to manage moderate to severe postoperative pain. Classic mu-opioid receptor agonists, such as morphine, meperidine, and fentanyl, provide excellent analgesia. However, their use in the postoperative setting is often limited by adverse effects such as nausea, vomiting, and reduced gastrointestinal motility. ⋯ If these effects are not managed effectively, opioid-related complications may significantly increase patient morbidity, have a negative impact on patient outcomes, and increase the burden on the nursing staff. Strategies are available to minimize and treat opioid-related adverse effects. Implementation of these strategies should result not only in increased patient comfort and satisfaction, but also in decreases in lengths of stay, more effective nursing care, and decreases in associated hospital costs.
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J. Perianesth. Nurs. · Aug 2009
Randomized Controlled TrialParental presence on emergence: effect on postanesthesia agitation and parent satisfaction.
This prospective, randomized study compared the incidence and duration of postanesthetic agitation in children whose parents were present or absent during emergence from anesthesia. Findings demonstrated that there was no difference in agitation between groups; however, more parents who were present believed they were present at "the right time," in contrast to those reunited later, who more often said they arrived "too late." Furthermore, these parents were comfortable in the setting and reported a high degree of helpfulness in comforting their child. Findings from this study suggest that although parental presence at emergence did not decrease agitation in young children, there was significant psychosocial benefit to the parents. Perioperative and perianesthesia nurses should consider these potential benefits when planning reunion of parents with their children after surgery.
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J. Perianesth. Nurs. · Aug 2009
Pain assessment and management in patients after abdominal surgery from PACU to the postoperative unit.
The aim of this exploratory study was to determine the effectiveness of pain relief for surgical patients (N = 52) in transition from the PACU to the postoperative unit. The study also explored whether there was an association between a verbal numeric pain score (0 to 10) on discharge from the PACU and the duration of time until analgesia was administered in the postoperative unit. ⋯ Most patients were discharged from the PACU with a pain score in the mild range (0 to 4), indicating reasonable pain relief. An association existed between the pain score on discharge from the PACU and the duration of time to the first analgesic dose administered on the postoperative unit.
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Hand washing is one of the oldest methods of reducing infections. Recent evidence based research has re-confirmed the efficacy of proper hand hygiene and recommendations for hand hygiene by the CDC and WHO are outlined. The PACU is a unique environment; patients are in a "cross-road of infection;" many patients are exposed to infections coming from various wards brought to the PACU through the OR. The PACU nurse is not only responsible for observing and monitoring the patient's vital signs but is also responsible for making sure patients are not exposed to an additional risk, e.g. a hand-transmitted infection.