Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Apr 2007
Perianesthesia nurses' pain management after tonsillectomy and adenoidectomy: pediatric patient outcomes.
Tonsillectomy and adenoidectomy (T and A) is a common, painful surgical procedure. The purpose of this descriptive-comparative study was to evaluate the effects of postanesthesia analgesic treatments on self-reported pain intensity, incidence of nausea and vomiting, and amount of oral fluid intake among pediatric patients after T and A. A total of 92 patients, 3 to 18 years old, received one of five analgesic treatments during their postoperative recovery: (1) intravenous fentanyl alone, (2) intravenous fentanyl in combination with an oral analgesic, (3) intravenous morphine alone, (4) intravenous morphine in combination with an oral analgesic, or (5) oral analgesics alone. ⋯ Nurses, however, reported difficulty obtaining pain-intensity scores for many patients, especially in Phase I. These findings suggest that despite variations in analgesics and the amount of analgesics administered, patients received adequate pain control. The findings also support the need for pain medication titration and validate that the amount required to relieve pain differs from child to child.
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Awareness under anesthesia, also known as unintentional intraoperative awareness, occurs when a patient unintentionally becomes aware while under general anesthesia. Although unintentional intraoperative awareness occurs rarely, patients who experience this may develop anxiety disorders of varying severity, including posttraumatic stress disorder. Perianesthesia nurses can play an important role in the prevention and management of unintentional intraoperative awareness in patients.