Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
-
J. Perianesth. Nurs. · Aug 2004
Review Case ReportsA PACU crisis: a case study on the development and management of methemoglobinemia.
The development of methemoglobinemia requires rapid recognition, confirmation, and treatment. This case study describes the development, diagnosis, and management of a 63-year-old male scheduled for a laparoscopic cholecystectomy with an intraoperative cholangiogram who developed methemoglobinemia after benzocaine was given for intubation.
-
J. Perianesth. Nurs. · Jun 2004
ReviewTreating children for acute agitation in the PACU: differentiating pain and emergence delirium.
Differentiating postoperative pain from emergence delirium in children is challenging for even the most experienced PACU nurse. This article presents a review of the literature and clinical practice experiences that will help guide the PACU nurse in recognizing and differentiating these two conditions that are common in children recovering from anesthesia. ⋯ Treatment with opioids is recommended as the primary strategy for safely recovering the child experiencing acute postanesthesia agitation, whether from pain or emergence delirium. Tools commonly used to assess both pain and postanesthesia agitation in children are reviewed, and an algorithm to facilitate the decision-making process is provided.
-
J. Perianesth. Nurs. · Jun 2004
Clinical evaluation of the ASPAN Pain and Comfort Clinical Guideline.
The ASPAN Pain and Comfort Clinical Guideline was created because of the urgent need for a standardized evidence-based approach to the management of patients' pain and comfort in all perianesthesia settings. The purpose of the research presented here was to test the content of the ASPAN Pain and Comfort Clinical Guideline, which included the domains of assessment, intervention, and outcomes. Each domain was rated on clarity, usability, and feasibility using a Likert scale, which ranged from 1 (strongly disagree) to 4 (strongly agree). ⋯ There were no differences in the clarity, usability, or feasibility of the guideline between perianesthesia settings. The results of this study support that the ASPAN Pain and Comfort Clinical Guideline has practical utility for perianesthesia nurses in all settings. Use of this guideline in perianesthesia settings will standardize pain and comfort management and has the potential to positively impact pain and comfort in perianesthesia patients.
-
Successful ambulatory surgery is dependent on analgesia that is effective, has minimal adverse effects, and can be safely managed by the patient at home after discharge. A number of studies have identified that the provision of effective postoperative analgesia is inadequate for a significant proportion of patients. The following discussion details the current available analgesic options for ambulatory surgery patients and the rationale for their use. ⋯ Consideration should be given to the use of long-acting oral COX-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) and long-acting oral opioids to treat postoperative pain. A standardized multimodal postdischarge analgesic regimen tailored to the patient's expected postoperative pain levels should be prescribed. Patient follow-up by telephone questionnaire will confirm those surgical procedures that result in mild or moderate-to-severe postoperative pain and the effectiveness of treatment plans.