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.
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J. Perianesth. Nurs. · Oct 2010
Randomized Controlled TrialThe effect of intravenous magnesium sulfate on acute postoperative bleeding in elective coronary artery bypass surgery.
Postoperative blood drainage is a great concern for health care providers when monitoring patients after cardiac surgery. In this study, the effect of intravenous magnesium sulfate infusion on postoperative bleeding in patients undergoing elective coronary artery bypass graft (CABG) surgeries was assessed. ⋯ The magnesium group had less postoperative bleeding (465 ± 130 mL vs 680 ± 190 mL in the placebo group; P = .00) and less packed cell use (2.1 ± 0.6 packs vs 3.2 ± 0.8 packs in the placebo group; P < .05) as compared with placebo. The results demonstrated significantly less postoperative bleeding and packed cell use in the group receiving intravenous magnesium sulfate infusion during elective CABG surgery.
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J. Perianesth. Nurs. · Oct 2010
Incidence of postoperative hypothermia and the relationship to clinical variables.
A prospective, quantitative, correlational study was conducted to determine the incidence of postoperative hypothermia and the relationship of hypothermia to numerous clinical variables previously studied. The study reflects the researchers' interest in updating previous data regarding the incidence of hypothermia. Although hypothermia remains a significant clinical concern, interventions aimed at minimizing hypothermia have evolved over the past 20 years, thus prompting new interest in determining the extent to which hypothermia exists in today's PACU patients. ⋯ Hypothermia (temperature <36°C) was demonstrated in only 4% of the sample (N = 287). Because of the low incidence of hypothermia, correlation statistics were not performed. The study provides a foundation for future research regarding this important clinical phenomenon while offering evidence supporting efforts to avoid hypothermia in today's surgical patients.