Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 1999
Historical ArticleAmbulatory anesthesia and surgery in America: a historical background and recent innovations.
This article describes the history of ambulatory surgery and anesthesia in the United States. The innovations in surgical instrumentation and techniques, newer anesthesia drugs and techniques, as well as insurance provider changes that have led to an increase in the numbers and types of surgeries performed in outpatient settings in the United States, are detailed.
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Sickle cell disease is an inherited hemoglobinopathy that develops from a genetic mutation and the production of a dysfunctional variant of hemoglobin. A number of physiological disturbances encountered during the perioperative period (blood loss, hypotension, acidosis, and hypoxia) may induce "sickling" of the biochemically altered hemoglobin, producing painful microvascular occlusion, hemolytic anemia, and impaired oxygen delivery. The only available curative therapy requires bone marrow transplantation. The purpose of this article is to review the pathophysiology of sickle cell disease and the pertinent preoperative, intraoperative, and postoperative care of patients with the disease.
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J. Perianesth. Nurs. · Aug 1999
ReviewPreoperative diagnosis and postoperative management of adult patients with obstructive sleep apnea syndrome: a review of the literature.
Obstructive sleep apnea syndrome (OSAS) is a common yet potentially fatal disorder. Several reports and clinical studies have established anesthetic-related occurrences of near-fatal respiratory complications in persons with this syndrome, as well as cases of death reported in the medical literature linking OSAS and anesthesia. The postoperative period is a critical time for patients with OSAS recovering from general anesthesia. ⋯ A treatment protocol for the postoperative management of adults with OSAS is also presented. Conclusions are drawn from a summary of the literature review. Future implications for nursing practice and research are drawn from the summary.
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Individuals who abuse illicit drugs have an increased incidence of traumatic injury, medical illness, and drug overdose. Subsequently, many of these drug abusers will require perianesthesia care. The health care professionals responsible for their care must have an understanding of the prevalence, the pharmacology, and medical complications of illicit drug use, including the potential interactions with anesthetic agents.
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The increasing number of critically ill patients requiring prolonged lengths of stay in the surgical intensive care unit has led hospitals to examine ways of using the PACU as a short-term area for critically ill patients. This article identifies common problems associated with this situation, and offers suggestions/guidelines to facilitate a smooth transition and ensure competent care of these patients. This article will not focus on financial issues related to patient charges. The criteria established in this article are based on personal experience.