AANA journal
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A sore throat is the most frequent adverse side effect of general anesthesia. The purpose of this study was to determine the relationship between intravenous lidocaine given during induction of general endotracheal anesthesia and postanesthesia sore throat. In addition, the study examined selected variables (bucking; gender; smoking; type of laryngoscope blade; and use of succinylcholine, condenser-humidifiers, or analgesic medication during the previous hour) in relation to the occurrence of postoperative sore throat. ⋯ The researcher administered the visual analogue scale to 139 subjects at 21 to 27 hours following termination of the anesthetic in order to rate sore throat. A retrospective chart review provided data on the variables selected for study and those that were controlled. Chi-square and independent t-tests revealed that a decrease in the severity of the sore throat, as recorded on the visual analogue scale, was significantly related to use of intravenous lidocaine and condenser-humidifiers.
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Developmental strides in cardiopulmonary resuscitation were paralleled by acquired knowledge of pulmonary and cardiac physiology. The evolution of the current recommendations for cardiopulmonary resuscitation have evolved over the past 40 years as a result of human trial and error and have been authenticated through laboratory research and clinical experience. Current research efforts in cardiopulmonary resuscitation are examining the mechanisms of blood flow during external cardiac massage and techniques to optimize myocardial and cerebral perfusion during the resuscitative period. ⋯ Prior to the 1950s, the occurrence of cardiac arrest was associated with the conduct of anesthesia and surgery. Although infrequent today by comparison, cardiac arrest continues to occur with the conduct of regional and general anesthesia. This course will review the etiology of cardiac arrest during anesthesia, detail the mechanisms of blood flow during resuscitation, and review the pharmacological importance of epinephrine for the preservation of myocardial and neurologic function.
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Comparative Study
Side effects of morphine patient-controlled analgesia and meperidine patient-controlled analgesia: a follow-up of 500 patients.
Many physicians, Certified Registered Nurse Anesthetists (CRNAs), and registered nurses have the clinical impression that either morphine sulfate or meperidine hydrochloride is a better drug to control postoperative pain. In this study, we evaluated pain relief and side effects for these two drugs to assess their potential differences. CRNAs conducted a structured interview of 500 female patients 24 hours after major gynecologic, urologic, or breast surgery. ⋯ Patients vomited more often after vaginal hysterectomy than patients having laparotomy, major oncology, or tuboplasty surgeries (P less than .05), and vaginal repair patients reported more vomiting than patients having major oncology or tuboplasty surgeries. Clinical impressions that either morphine or meperidine should be the preferred treatment for patients following gynecologic operations was not found by a 24-hour review of 500 patients for pain relief and side effects. Although mild itchiness occurred more frequently in the morphine PCA group, treatment was rarely necessary.
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Randomized Controlled Trial Clinical Trial
The effect of pH-adjusted 2-chloroprocaine on the duration and quality of pain relief with a subsequent continuous epidural bupivacaine infusion.
A randomized, double-blind true experimental design with a post-test only was chosen to determine if the addition of sodium bicarbonate to 2-chloroprocaine would result in a longer duration of epidural analgesia, as well as increase the quality of pain relief in stage I parturients receiving a continuous bupivacaine epidural infusion. The experimental group (number (N) = 16) received sodium bicarbonate and 2-chloroprocaine followed by a continuous bupivacaine epidural infusion. The control group (N = 15) received normal saline and 2-chloroprocaine followed by a continuous bupivacaine epidural infusion. ⋯ Additional bolus injections occurred nine times in the control group and six times in the experimental group. The differences were not found to be significant (P > .106). The differences in time and amount of local anesthetic delivered were also found to be trivial (P > .80).(ABSTRACT TRUNCATED AT 250 WORDS)