AORN journal
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The purpose of preemptive analgesia is to reduce postoperative pain, contributing to a more comfortable recovery period and reducing the need for narcotic pain control. The efficacy of preemptive analgesia remains controversial. This systematic review of the literature evaluated the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs), cyclooxygenase-2 (COX-2) inhibitors, and gabapentin as preemptive oral analgesics for surgical patients. ⋯ Research was predominantly conducted outside the United States. Gabapentin and COX-2 inhibitors were found to be the most effective preemptive analgesics for postoperative pain control. As part of a collaborative team, perioperative nurses and certified RN anesthetists are responsible for ongoing pain assessment and management for preemptive analgesic interventions.
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Symptomatic spinal epidural hematoma (SEH) is a rare but serious complication that may occur after lumbar spine surgery. Prompt recognition of this complication depends on the diagnostic skills of perioperative nursing personnel, particularly postanesthesia care unit nurses. ⋯ Clinicians should consider a diagnosis of symptomatic SEH if there is a change in the patient's neurological status during the first several hours after lumbar spine surgery. Suspicion of postoperative symptomatic SEH should prompt clinicians to notify the responsible surgeon without delay.