Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Jun 1997
Review Case ReportsTotal spinal anesthesia after an interscalene block.
A case study is presented involving a 22-year-old male who developed total spinal anesthesia after interscalene blockade for an arthroscopic procedure of the shoulder. An understanding of the anatomical structures of the brachial plexus, autonomic nervous system function, and side effects of local anesthetics is presented to assist the perianesthetic nurse in assessing and anticipating patient needs and in clinical decision making.
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The incidence of laryngospasm in the PACU after extubation remains low despite the number of extubations that are performed annually. A study of general anesthesia patients conducted by Olsson and Hallen in 1977 & reported by Holmes et al (Am J Sports Med 19:365-371, 1991) showed the incidence of laryngospasm to be 8.7/1,000 patients. ⋯ Its etiology and thus its treatment differs from other forms of noncardiogenic pulmonary edema, such as acute respiratory distress syndrome (ARDS). The PACU nurse must be aware that any patient has the potential for postextubation laryngospasm, and must be prepared to initiate appropriate treatment of noncardiogenic pulmonary edema.
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J. Perianesth. Nurs. · Apr 1997
ReviewThe physiology and pharmacology of pain: a review of opioids.
Patients in the postoperative period are often inadequately medicated for pain. Appropriate nursing assessment and intervention is critical for controlling a patient's pain and preventing associated complications. ⋯ The three classes of opioids-opioid agonists, opioid agonist-antagonists, and opioid antagonists-are examined in detail. Included in the discussion are opioid receptor interaction with the various agents, dosages administration, and side effects.
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J. Perianesth. Nurs. · Feb 1997
ReviewMidazolam as a pediatric premedicant in the ambulatory setting.
In the preoperative setting, the nurse is responsible for the comprehensive evaluation and preparation of the patient. Among these activities, the administration of various premedications to achieve a physiological (eg, raise gastric fluid pH) or psychological (eg, reduce apprehension) effect is commonplace. ⋯ Several studies have evaluated the variety of routes by which midazolam can effectively be administered to the pediatric patient. A review of midazolam as a premedication specific to the pediatric population in the ambulatory setting is presented.