Journal of perioperative practice
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Review
Acupressure and acupuncture in preventing and managing postoperative nausea and vomiting in adults.
This literature review sets out to investigate the effectiveness of acupressure and acupuncture in preventing and managing postoperative nausea and vomiting (PONV) in adult patients. PONV is problematic, affecting patient satisfaction, delayed discharge and even patient re-admission. Current treatment of PONV constitutes a variety of drug therapies, which are only partially effective. ⋯ Further investigation of the effectiveness of acupressure and acupuncture, combined with current drug therapies, using well designed and adequately powered studies is needed. Published studies predominantly examined the use of P6 as the pressure point. Further studies should examine other 'acupoint' sites, to ascertain whether these are effective dependent upon the operative site.
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The treatment of pain continues to be a major concern in the critically ill patient. Despite advances in pain management, a greater understanding of the mechanisms of pain and advanced methods of analgesic delivery, the treatment of pain is not always a priority on the intensive care unit. Difficulties with pain assessment, in the critically ill ventilated, sedated patient compound the problems of pain management. Physiological signs are difficult to interpret and psychological factors must be considered.
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Paravertebral blockade is a safe and effective technique for intraoperative and postoperative management of acute surgical pain. The block may be performed as a single injection or a catheter may be inserted to allow for the continuous or bolus administration of a long acting local anaesthetic. ⋯ There is little published about the care of patients receiving this form of analgesia. This article provides an overview of the technique of thoracic paravertebral analgesia, the choice of analgesics and side effects together with recommendations for patient care.
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Bedouin women tend to remain quiet and expressionless while giving birth despite reporting high levels of pain and fear (Harrison 1991). Culture undoubtedly influences pain perception and expression but there are dangers in making assumptions about particular groups. This article explores the underlying research and the complex clinical picture highlighting the need for cultural awareness--but ultimately we must care for the individual person in pain.
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Elevated operating theatre noise can be hazardous to patient safety and may cause occupational stress. In a nine-hospital study, background noise and average noise were measured, during operations in different subspecialties, and found to be higher than noise levels recommended by the World Health Organization (WHO) for hospital areas in which patient care takes place. In operations in which nurses had also answered a question about hearing 'quiet', 'normal', and 'loud' talking, speech interference levels were estimated and indicated that nurses and other personnel had to substantially raise their voices to be well understood.