Journal of post anesthesia nursing
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Historical Article
Then and now: a historical development of ambulatory surgery.
The historic origins of ambulatory surgery span prehistoric to modern times. Anesthesia, a pivotal factor, asepsis, advanced technology, and early ambulation are four factors contributing to the development of ambulatory surgery. The recent rapid growth of this specialty resulted from both medical and economic issues. A decrease in the loss of time from the patient's daily life, lower cost to patients and insurers, and more efficient medical and ambulatory procedures resulted.
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The laryngeal mask airway (LMA) is possibly the most significant recent advance in airway management. Designed to be passed into the hypopharynx without a laryngoscope, the LMA was conceived after bioengineering principles were applied to postmortem specimens of the adult larynx. The LMA has gained widespread, worldwide popularity and was approved for use in the United States in 1992. ⋯ Nurses in the PACU may also be involved in management of anesthetized patients who still have an LMA in place. This article acquaints the reader with the LMA; reviews its design, uses, and limitations; and details some of the controversies related to its use in the PACU. Policies about the LMA need to be defined by PACU nurses and anesthesiologists according to the best information available and the particular requirements of the individual PACU.
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Postanesthesia shaking is a common complication occurring after general anesthesia. Although the cause is unknown, some nurses believe that shaking is useful and beneficial for patients because it increases body temperature and that shaking stops when patients are no longer hypothermic. The primary purpose of this study was to examine changes in body temperature among patients who developed and who did not develop shaking. ⋯ Findings also indicated that the administration of intravenous narcotic-analgesic medications to stop shaking does not alter the rate of body temperature change. Suggestions for further research focus on systematically examining nursing interventions currently implemented to stop shaking. Research findings will provide evidence that either supports or fails to support the implementation of therapeutic interventions that effectively stop shaking within 5 minutes.
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The purpose of this article is to provide an overview of completed studies that consider visitors in critical care areas. Studies from coronary care, intensive care, pediatric PACUs, and adult PACUs are reviewed.
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Case Reports
Ketorolac: a new parenteral nonsteroidal anti-inflammatory drug for postoperative pain management.
Providing adequate pain control with minimal side effects in inpatient and ambulatory settings is a continuous challenge to the PACU nurse. Ketorolac tromethamine (Toradol, Syntex, Palo Alto, CA) is a new parenteral nonsteroidal anti-inflammatory drug (NSAID) approved for use in the United States. Ketorolac is useful in the management of short term, moderate to severe postoperative pain. ⋯ A case study presents a healthy ambulatory surgical patient admitted for inguinal hernia repair using epidural anesthesia. Use of ketorolac has shown initial favorable results. More research is needed to further define its role and side effects in postoperative pain management.