Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 2018
Case ReportsSugammadex Rescue in Avoiding Intensive Care Unit Admission in an Octogenarian Undergoing Emergency Laparotomy.
Postlaparotomy management for elderly patients with underlying comorbidities is always a challenge because of poor cardiorespiratory reserves and prolonged effect of anesthetic drugs. For these reasons, such patients usually require intensive care unit (ICU) admission in the postoperative period. We report a case of an 85-year-old chronic smoker with controlled diabetes mellitus who needed an emergency laparotomy for a perforated gastric ulcer. ⋯ With the successful conduct of an early surgery using combined general and regional anesthesia, the use of sugammadex (Bridion, Merck Sharp & Dohme Corp, Oss, the Netherlands) as a reversal agent, a skilled surgeon, and good postanesthesia care, the patient did not require ICU admission. He recovered fast and was discharged home 4 days after surgery. This case study aims to contribute to the literature on experience of a successful conduct of anesthesia in a high-risk geriatric patient when ICU facilities are limited.
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J. Perianesth. Nurs. · Oct 2018
ReviewPreventing Opioid-Induced Respiratory Depression in the Hospitalized Patient With Obstructive Sleep Apnea.
To enhance the role of nursing interventions in the management of perioperative opioid-induced respiratory depression (OIRD) in patients with obstructive sleep apnea (OSA). ⋯ Nursing interventions are essential to improving outcome and reduce cost in the management of postsurgical OIRD in OSA patients.
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J. Perianesth. Nurs. · Oct 2018
Review Comparative StudyPostoperative Cognitive Dysfunction in the Elderly: A Review Comparing the Effects of Desflurane and Sevflurane.
The incidence of postoperative cognitive dysfunction (POCD) remains a relatively common complication in the elderly following surgery. Use of anesthesia for surgery might precipitate certain cognitive alterations. The purpose of this review is to address the impact of two volatile anesthetic agents, desflurane and sevoflurane, on POCD. ⋯ No definitive conclusion can be drawn about the type of anesthetic used and its relation to occurrence of POCD. However, the information presented is crucial, which can help to improve anesthetic usage and patient safety.