Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Dec 2014
Review Case ReportsUsing systematic reviews to guide decision making about family-witnessed resuscitation.
Family-witnessed resuscitation (FWR) allows family members to be present while emergency cardiac life support measures are applied. This article describes the use of systematic reviews to inform best clinical policy on FWR. The authors searched Medline and CINAHL for relevant systematic reviews and retrieved four. ⋯ Generally, patients, family, and providers agreed on the benefits of FWR. Barriers to FWR include perceptions of possible performance anxiety and family interruption of care. The authors conclude that institutional settings need to develop a rational policy on FWR, have family support personnel present during FWR, and develop training programs for students and staff on family presence.
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J. Perianesth. Nurs. · Dec 2014
ReviewThe effects of amino acid infusions on core body temperature during the perioperative period: a systematic review.
The aim of this systematic review was to determine the effect of amino acid infusions on core body temperature and shivering. We searched the PubMed, EMBASE, CINAHL, and Cochrane Register of Controlled Trials databases to identify randomized controlled trials that met the inclusion criteria. ⋯ Amino acid infusions were associated with shorter periods of mechanical ventilation and hospitalization and less perioperative shivering, mechanical intubation, and hospitalization in surgical patients without hepatic, renal, or severe metabolic disorders. It is recommended that infusions are warmed before administration to avoid further decrease in core body temperature.
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J. Perianesth. Nurs. · Dec 2014
ReviewA systematic review of the effectiveness of intravenous tranexamic acid administration in managing perioperative blood loss in patients undergoing spine surgery.
This systematic review aimed to identify the effectiveness of intravenous tranexamic acid (TXA) administration in managing perioperative blood loss in patients undergoing spine surgery. The study design was a systematic review and meta-analysis. Quantitative articles were pooled in a statistical meta-analysis using the Joanna Briggs Institute Meta-Analysis of Statistical Assessment and Review Instrument. ⋯ Perioperative blood loss was approaching significance for blood loss in the control group with an overall P = .067. TXA helps reduce perioperative blood loss for patients undergoing spine surgery. TXA should be administered to patients undergoing spine surgery when significant blood loss is anticipated.
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J. Perianesth. Nurs. · Dec 2014
Is dexmedetomidine more effective than remifentanil for neurologic outcomes in patients undergoing CEA surgery using regional anesthesia?
Carotid endarterectomy (CEA) surgery is performed using regional anesthesia and intravenous/sedative drugs, such as dexmedetomidine and remifentanil. It is unclear which drug provides the least amount of hemodynamic variability, sedation, and respiratory depression so cognitive function can be continuously monitored intraoperatively. A search of the literature was conducted to identify the evidence of the effects of dexmedetomidine and remifentanil in patients undergoing awake CEA surgery with regional anesthesia. ⋯ Four randomized control studies and a retrospective study were critically appraised to evaluate the evidence on the effectiveness of dexmedetomidine compared with remifentanil during CEA surgery, using regional anesthesia and dexmedetomidine or remifentanil from 2004 to 2009. These studies found that dexmedetomidine provides adequate sedation with less respiratory depression than remifentanil when used in adjunct with regional anesthesia, allowing the provider to monitor hemodynamic stability and neurologic status continuously during the intraoperative period. Dexmedetomidine was evaluated as the primary agent of choice for sedation when performing an awake CEA with regional anesthesia.