AANA journal
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This study was conducted to determine the effects of spinal (n = 113) vs epidural (n = 31) anesthetic techniques on 3 common postoperative complications: pain, urinary retention, and mobility for patients undergoing inguinal herniorrhaphy. The study design was a retrospective chart review. Data were collected on 144 subjects who underwent herniorrhaphy between January 1 and December 31, 1999, had an ASA classification of I to III, and were older than 18 years. ⋯ This study demonstrates that epidural anesthesia results in less urinary retention and earlier mobility than spinal anesthesia in men undergoing inguinal herniorrhaphy. Minimizing postoperative complications is essential in order for the nurse anesthetist to provide a satisfactory anesthetic experience. This study's findings suggest that epidural anesthesia optimizes recovery for the patient undergoing inguinal herniorrhaphy.
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The laparoscopic approach to surgery is being used with greater frequency as our healthcare system continues to strive for shorter hospital stays and improved postoperative patient recovery times. However, laparoscopy is not without potential complications. This article presents 2 patient case studies. ⋯ The second patient's surgery involved an intraperitoneal approach. Massive subcutaneous emphysema developed in both patients. The phenomenon of subcutaneous emphysema associated with laparoscopic surgery will be defined and discussed.
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There is an absence of systematic study regarding the authenticity of the simulation experience in anesthesia except for bias prone "participant perception" assessments. Forty-two senior level graduate nurse anesthesia students were videotaped as they were exposed to short (20-30 minutes) but intense simulated crisis situations. Three observers with intimate knowledge of the operating room (OR) evaluated the films using a pilot-tested authenticity tool. ⋯ There was concern that the brevity of the scenarios did not reflect the realities of patient care during procedures of average length. Simulation is likely of maximal benefit if the participant perceives it as legitimate and authentic. Our study indicates the authenticity of anesthesia simulation is in evolution with much potential for improvement.