Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Dec 2010
Randomized Controlled TrialSubarachnoid block with hyperbaric bupivacaine and morphine may shorten PACU stay after cesarean delivery.
Spinal anesthesia for cesarean delivery is a widely used modality. Both hyperbaric and isobaric bupivacaine are in clinical use, with or without the addition of opioids, but the baricity of intrathecal bupivacaine has not been correlated with recovery time after cesarean delivery. One hundred parturients scheduled for elective cesarean delivery were randomly divided into four groups: hyperbaric bupivacaine (10 mg), hyperbaric bupivacaine (10 mg) with morphine (100 mcg), isobaric bupivacaine (10 mg), and isobaric bupivacaine (10 mg) with morphine (100 mcg). ⋯ Parturients receiving hyperbaric bupivacaine recovered from motor block earlier and were less likely to require analgesic supplements, thus meeting PACU discharge criteria sooner. The addition of intrathecal morphine did not significantly delay postoperative recovery or discharge from the PACU and further reduced analgesic requirements. Spinal anesthesia with hyperbaric bupivacaine 10 mg with or without morphine 100 mcg provided faster, less painful recovery compared with either isobaric bupivacaine with or without morphine when added to fentanyl 15 mcg, enabling faster discharge from the PACU.
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J. Perianesth. Nurs. · Dec 2010
Prevention of hypothermia by infusion of warm fluid during abdominal surgery.
Perioperative hypothermia can lead to a number of complications for patients after surgery. The aim of this pilot study was to evaluate the efficacy of warm fluids in maintaining normal core temperature during the intraoperative period. We studied 30 American Society of Anesthesiologists (ASA) physical status I or II adult patients who required general anesthesia for abdominal surgery. ⋯ In the test group, none of the patients reached grade ≥2 (P < .01). Infusion of warm fluid is effective in keeping patients nearly normothermic and preventing postanesthetic shivering. It may provide an easy and effective method for prevention of perioperative hypothermia.
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Emergence delirium (ED) is a postanesthesia phenomenon occurring in both adults and children during recovery from general anesthesia. Although the pediatric population has been an ongoing focus of research and publications regarding ED, a renewed interest in ED has developed among military nurses and anesthesia providers because of its increasing incidence among the US military surgical population. The purpose of this article is to identify potential risk factors for emergence delirium in the US military population. ⋯ Pain and physical and psychological trauma as a result of military duty are identified and linked to ED as potential risk factors. Identification of these risk factors may provide guidance for scientific inquiry into this phenomenon in the military population. Implications for future study are also explored.