Abdominal Wall Block Analysis

As a clinical requirement for my Adult 1: Medical-Surgical course, I had the opportunity to observe a patient in the Operating Room and in the Post Anesthesia Unit of Advocate Good Samaritan Hospital. The procedure that I observed was a left total knee replacement. The patient needed this surgery because she was experiencing osteoarthritis, and this surgery could alleviate her pain and discomfort. I was with the patient from the end of her stay in the pre-operative holding area to the Operating Room, and then to the Post Anesthesia Care Unit. This paper will include background inquiry, preoperative and operative

The work of Burke, et al (2011) reports that a study with the objective of comparing the "efficacy of intradermal bacteriostatic normal saline with that of intradermal buffered lidocaine in providing local anesthesia to adult patients prior to IV catheterization." (p.1) The study concluded that intradermal buffered lidocaine was superior to intradermal bacteriostatic normal saline in providing local anesthesia prior to IV catheterization in this group of predominately white adults and should be the solution of choice for venipuncture pretreatment." (Burke, et al, 2011, p.1) Burke et al reports that surgery is something that most people fear with the fear of the unknown is combined with "apprehension about such anticipated procedures as insertion of an IV line." (2011, p.1) Burke additionally reports that patients admitted for same-day surgery "require IV access. Any venipuncture, including peripheral IV catheterization with a medium-to-large-gauge catheter, can cause some degree of pain. Using local anesthesia prior to IV catheterization has

Giving birth should be a beautiful experience even though delivery can be terrifying and discomfort. Even though women have the decision to choose between having a natural childbirth or get an epidural majority of women give birth at a hospital get an epidural. Make sure when you base your decision on what’s best for your infant and not base off anyone influencing you. What constitutes a “Natural childbirth”? A natural childbirth is when a woman gives birth without any medication. You can choose between having a mid-wife and having an at home birth or you can give birth at the hospital without any medication either way is consider giving natural childbirth. According to Kristeen, an epidural is drugs called local anesthetics, such as bupivacaine, chloroprocaine, or liocaine it numbs the abdomen or pelvic region during labor. An epidural is given when the women is about 4 or 5 centimeters dilated (Cherney, par.2-6). In order to get an epidural you have to get a shot in your spine (lower back). In 1909, the first caudal anaesthesia was given for labor pains by a German obstetrical, Walter Stoeckel, and he study 141 cases of healthy laboring women with epidurals. In 1931, the first catheter was used in an epidural. By the 1940s, epidural were being used sporadically for labor but did not gain true momentum until the 1970s. This was in large part due to the fact that other

Chest and abdominal wounds were nearly always fatal. Treatment of abdominal wounds often involved pushing in protruding organs and suturing the wound. Food was withheld because fecal material leaking from the intestines caused contamination. Opium was often administered to halt the action of the digestive system. Chest wounds were cleaned and the wound was sutured. Abdominal wounds were fatal in almost 90 percent of the cases reported by Union surgeons.

which in turn inhibits the second order neurons that transmit the nociceptive signals to the

Local anesthesia. This type prevents you from feeling pain in a small area of your body.

Stretch-induced lung injury may not occur if lung compliance is not greatly reduced. However, the benefit of ventilation with a lower tidal volume was independent of the static compliance of the respiratory system at base line, suggesting that the lower tidal volume was advantageous regardless of lung compliance. Variations in chest-wall compliance, which contributes to compliance of the respiratory system and is reduced in many patients with acute lung injury and the acute respiratory distress syndrome,39 may have obscured a true interaction between tidal volume and base-line lung compliance.

This feature also enables the use of this technique into the postoperative period for analgesia, using lower concentrations of local anaesthetic drugs or in combination with different agents.

Overall, the knowledge and expertise an anesthesiologist acquired allows them conduct preoperative procedures and evaluations of patients before undergoing an operation to ensure the best possible operational safety for the patient. The evaluation of patients is important because of numerous factors that can could possibly lower the effectiveness of the anesthetics being used or severely endanger a patient. Before an operation an anesthesiologist must evaluate a healthy patient with a systems approach. This procedure usually evaluates the airway, pulmonary system, neurologic system, cardiovascular system, and endocrine system(Hata p.585-588). Each of the systems that need to be evaluated have different methods or procedures to ensure the best

This study may provide indirect evidence that could be used in future studies investigating the mechanisms responsible for EIH and clinically as another option for production of analgesia.

The compatibility of a LB with other drugs and implanted materials is an important factor impacting drug safety and efficacy. The liposomal formulation of the local anesthetic bupivacaine is designed to provide prolonged postsurgical analgesia. Its compatibility with other drugs and materials depends on the compatibility of the drug itself, along with the integrity of liposomal components.

The use of the preoperative huddle prior to the patient entering the operating room suite improves safety, communication, cost, and the quality of care for the surgical patient by addressing issues and optimizing the patient before he/she is on the operative table and anesthetized. The use of sequential compression device (SCD) therapy on a patient having local sedation for a procedure with a 25-30 minutes duration was brought into question during the huddle process. It was felt by some team members that all patients should have SCDs if they are to have a surgical procedure. That is how it has always been done at this hospital. Other team members felt that this was a waste of hospital resources because it was not general anesthesia and it was

The first task that I needed to do and, that I am still doing, is a literature review. Although it is not my first doing it, it can sometimes feel overwhelming. Its planning is a good starting point.

It block the opioid send signal to your brain which block pain and works as an

My current position is a clinical lead nurse on a surgical/orthopedic floor, we receive a wide variety of patients with a large concentration of them being post-operative knee or hip replacements. Over the last year and a half our surgeons and anesthesiologists have implemented the use of continuous peripheral nerve blocks (CPNB), often referred to as pain pump balls, specifically we use the OnQ balls. “The On-Q infusion device is an elastomeric device with a flow regulator that controls the flow of a local anesthetic agent through a peripheral catheter” (Burnett, 2011). The pain pump balls are intended to decrease post-op pain and maximize patient’s ability to participate in physical therapy. The