Comparative Study Of Intubation : Fentanyl Versus Nalbuphine Essay

METHODS: One hundred and fifty ASA physical status I or II patients undergoing elective, non-cardiac procedures were randomised, to one of the three treatments such as either normal saline or lignocaine 2mg/kg or fentanyl 2mcg/kg. Intubation was carried out 3 minutes after administration of these study drugs. Patients received Midazolam before induction, and Thiopental, Rocuronium during anaesthesia. The heart rate, blood pressure and SPO2 were recorded a day before (B),

Lack of enough trained staff in conscious sedation available at the time of the procedure

Original research related to sedation management occurred in the year 2000 by Kress, Pohlman, O ' Connor, and Hall. Their findings served as a landmark study and initiated the impetus related to improving our sedation practices. According to Kress et al. (2000), daily interruption of sedation led to a decrease in the number of days on the ventilator in the intensive care unit. Several studies since this time have focused on the influence of sedation protocols, and outcomes. This paper will review the synthesis of the discovered studies and highlight the noted contraindications and inconsistencies. Also, explanations including a preliminary conclusion will be discussed.

This Anaesthetic case study would describes and discussed the scenario of a patient through the anaesthetic role of their surgical procedure. It will include and discuss the anaesthetic safety procedures equipment and drug interventions used to ensure this particular patients maximum safety and comfort before and during the procedure. The case study will include pre and peri-operative assessment in order to describe the involvement contribution of various specialties in the holistic care of the critical care patient. This assignment will focus only on the anaesthetics side of the procedure but will also highlight the importance of the triad of anaesthesia and discuss the administration, maintenance and reversal of

On arrival to UKMC the patient received a Glasgow Coma Score of 3, which is an indication that intubation is needed. Bipap therapy was attempted but failed, due to respiratory failure. This was confirmed by arterial blood gases. After being assessed by the team at UKMC, the patient was intubated for respiratory failure, as well as shock of an unclear etiology. Rapid sequence intubation drugs, Etomidate and Succinylcholine where administered prior to intubation. A 7.5 endotracheal tube was used

These procedures are not reported alone but as add-on codes used to identify extraordinary conditions of patients and their unusual risk factors. There are four kinds of certain codes used for particular circumstances which are: 1) Anesthesia for the age younger than one year and over the age of seventy (99100), 2) Anesthesia complicated by the utilization of total body hypothermia (99116), 3) Anesthesia complicated by the utilization of controlled hypotension (99135) and 4)Anesthesia complicated by emergency circumstances

The values such as communication, innovation, quality, and collaboration is key to the growing field of perioperative nursing (AORN, 2015). During surgery communication is important between surgeons, anesthesia and nursing. Surgeons are focused on surgery, anesthesia takes care of breathing and vital signs, nurses are at the bedside or circulating and can assess the OR and what is happening during the procedure. The ARON believes that every patient has the right to receive the highest quality of perioperative nursing care of every surgical or invasive setting; all health care providers must collaborate and strive to create an environment of patient safety; and every patient experiencing a surgical or invasive

Propofol was administered to put the patient to sleep initially. The patient was kept asleep with anesthesia gases. These gases are fluorinated ethers combined with nitrous oxide. A paralytic was also administered to keep the patient’s muscles from moving during the procedure. During the procedure, the CRNA monitored the patient’s vitals, especially the blood pressure. The blood pressure decreases prior to the initial incision and will increase after the cut is made. The CRNA was monitoring that the patient’s blood pressure did not get too low before the incision was made. The CRNA also made sure the patient was positioned to prevent injury such as pulled muscles and pinched nerves.

In cardiothoracic surgical patients, an incidence of as high as 16-46% has been reported8. This is related to a number of factors that can be encountered during surgery. Mechanical factors like manipulating the heart, pain and sympathetic stimulation can all induce POAF. It can also be related to systemic inflammatory processes, hypotension, hypoxia, anemia and metabolic alterations. These situations can all be expected during anaesthesia. Volatile agents used during anaesthesia may also have antifibrillatory action8.

During the intraoperative phase, identifying outcomes related to patient care during surgery is paramount due to the fact the patient is under anesthesia and completely dependent on the surgical team, and the nurse acting as their advocate. Examples of identifying outcomes prior to surgery would include; the prevention of electrical burns from cautery equipment, proper positioning during the procedure to prevent nerve or skin damage. Collaborating with other members of the surgical team regarding this information, and utilizing evidence-based nursing knowledge is necessary for the surgical plan. My responsibility as a nurse is to alleviate suffering during the intraoperative phase and as the patient’s advocate ensuring no further injury occurs.

The research behind this technique includes several small studies, all of which have shown that patients receiving non-opioid analgesia, such as that of the MuliMix, fare better than those treated with opioid anesthesia.

While numbers from the study may appear to show a positive improvement, the account of out-of-hospital neurological and physical deficits arising from the event are not shown throughout the study and need to be taken into consideration. The American Heart Association acknowledges the study and also acknowledges that there is not enough evidence to support they use or the lack of ACLS medications during a cardiac arrest.

Cardiac surgery is among the most frequently performed surgical procedures in the United States. According to the American Heart Association, over 575,000 open heart surgeries were performed in 2005. Until relatively recently, sedation and prolonged ventilatory support through the first twelve to eighteen hours post operatively have been standard. This allowed adequate time for the patient’s hemodynamic, respiratory and coagulation physiological

From a quantitative point of view cardiac arrests after an ambulatory surgery unit are a rare emergency, but why is this problem important? This problem is important because about 234 million person wordwide have major noncardiac surgeries every year (3),and even if a really small percentage of these people have cardiac arrest during or post-surgery, it is still a lot of people that can be saved by implementing appropriate measurements in order to prevent and respond to cardiac arrest. According to the article “Intraoperative Cardiac Arrest in Adults Undergoing Noncardiac Surgery: Incidence, Risk Factors, and Survival,(3)” post-operative cardiac arrest occurs at a rate of approximately 7 per 10000 noncardiac surgeries (2). From a qualitative

The positive impact of anesthesia advancements over the last 100 years have made the care that patient receives more effective and less life threatening. These innovations have brought about a transformation in the care of the patient. It has improved how the healthcare institutions operate and the patient has benefited from the advancements and so have the medical staff. The anesthesia used today, and the anesthesia used a century ago is similar because it was created for the welfare of the patient. It was produced to help numb or put the patient to sleep during a surgical procedure. However, the difference today is that research and advancements in the medical field have improved and designed more superior drugs over the years and made them