Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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Epidural, spinal, regional, local, and intravenous administration of local anesthetics (LAs) is a cornerstone of anesthetic practice. LA toxicity is a grave consequence that is of great significance to anesthesia providers. ⋯ Lipid emulsion has emerged as a potential "magic bullet" in treating LA toxicity. This literature review provides background information and proposed mechanisms of action for LAs and lipid emulsion as well as animal experiments and a case report that speak to the effectiveness of lipid emulsion in the face of LA toxicity.
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J. Perianesth. Nurs. · Aug 2015
Observational StudyPostoperative Discomfort After Abdominal Surgery: An Observational Study.
Patients who have surgery may experience distress in the following days. Although postoperative distress is a common experience, few studies have analyzed these patient complaints in-depth. The purpose of the present study was to analyze the potential causes of patients' discomfort after abdominal surgery. ⋯ It was concluded that pain, movement restriction, and dry mouth were the most disturbing causes of discomfort. Therefore, symptoms other than pain should be considered to improve the well-being of patients after abdominal surgery.
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Regional anesthesia as a treatment modality for the control of surgical pain has been in practice since the late 1880s with the introduction of cocaine. The use of lipid emulsion therapy as an emerging treatment for the rare but life-threatening development of local anesthesia systemic toxicity (LAST) has been in the animal literature for approximately 20 years, and case reports have documented successful results with this treatment in humans. The perianesthesia nurse has a significant role in the assessment, communication with the anesthesia care provider, and the emergent management of the patient experiencing LAST. Using a fictitious case study of a patient with LAST, the conduction of sensory information will be reviewed. The pharmacologic characteristics of local anesthetics will be presented, and the evidence-based practice recommendations for the prevention, monitoring, and treatment will be provided.