Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Dec 2012
Randomized Controlled Trial Comparative StudyBacteriostatic normal saline compared with buffered 1% lidocaine when injected intradermally as a local anesthetic to reduce pain during intravenous catheter insertion.
Pain associated with intravenous (IV) catheter insertion commonly causes fear and anxiety in presurgical patients. To reduce pain, a common procedure is intradermal injection of a local anesthesia. The aim of this study was to determine whether there is a significant difference in a patient's pain level after intradermal injection and IV catheter insertion when comparing intradermally injected bacteriostatic normal saline with 0.9% benzyl alcohol (a preservative added with an anesthetic component) with buffered 1% lidocaine to numb the IV line site. ⋯ Females reported higher IV pain scores than males only in the buffered 1% lidocaine group (P=.001). No statistically significant differences were found between the two anesthetics with intradermal and IV pain scores for IV placement side, site, IV within 30 days, needle gauge, previous IV experience or problems, vein visibility, or study nurse. This study determined that buffered 1% lidocaine was more effective than bacteriostatic normal saline in reducing pain during IV catheter insertion.
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Discharge of patients from the postanesthesia care unit (PACU) is often delayed for nonclinical reasons. This includes organizational issues such as patient transport, times of heavy workload for the ward and PACU nursing staff, surgical wards being unable to admit the patient, and clerical or administrative delays. We undertook a prospective study to evaluate PACU patient flow and the incidence and reasons behind delayed PACU discharge for nonclinical reasons in a tertiary referral hospital. ⋯ The most common reasons for delayed discharge of the patient to the ward were no bed in the designated postoperative ward for admittance (52%), ward nurses too busy to accept the patient (32%), and ward nurses' meal breaks (10%). Delayed PACU discharge for nonclinical reasons is common and occurs predominantly because of discharge planning and organizational and staffing issues in postoperative surgical wards. Improved discharge planning, restructured staffing, and alterations in operating room scheduling may minimize these nonclinical discharge delays.