Lumbar Discectomy Lab Report

For the duration of my surgical follow through experience, I had the pleasure of following RF. RF is a 49 year old male with an admitting diagnosis of cervicalgia cervical herniation, and a scheduled surgery for an anterior cervical discectomy and fusion at C4-C5 and C6-C7. According to Sharon Lewis in “Medical Surgical Nursing”, the cause of a cervicalgia cervical herniation is “the result of natural degeneration with age or repeated stress and trauma to the spine.” (Lewis, 2011) The follow through process was observed from when the patient arrived in the pre-op holding area until the

Spinal fusion is categorized into three different categories: cervical, thoracic, and lumbar, in conjunction with the different segments of the spine. Each type of spinal fusion has a different goal depending on the purpose of the surgery. Most surgeries involve fusing vertebrae together to limit its range of motion, thereby hopefully reducing the pain or correcting any physical deformities. Depending on the levels of fusion, spinal fusion surgeries tend to last a few hours. Complications may arise during surgery, and they greatly increase depending the location of the fusion, levels of fusion, and if the surgery crosses any important nerve sites. Levels of spinal fusion are known as the fusion between two different vertebrae. If there is a fusion between L1 and L2, that is known as one level of fusion. If there is another site of fusion at L3 and L4, than there will be two levels of spinal fusion. Lumbar fusion are further complicated when more then one level of performed. By limiting one segment’s range of motion, other segments of the spine will have to compensate and create greater range of motion. With lumbar fusion, most doctors will need to be able to identify why a patient needs lumbar fusion, and being able to identify if lumbar fusion will help alleviate the pain. Most cases of lumbar fusion involve spondylolisthesis, fractures, spinal stenosis, scoliosis, and possibly herniated disk if no other further treatment has proven successful. Most physicians will order an

Anesthesiologists give patients anesthetics in a variety of ways, such as “orally, intravenously, by gas or direct injection to render patients insensible to pain Anesthesiologists typically maintain the same daily schedule a surgeon follows, participating in both scheduled and unscheduled operations. Anesthesiologists are responsible for determining the proper anesthetic and dosage level for each patient. They monitor the patients progress prior to, during, and after surgery.”(“Anesthesiologist” 31)

In the summer of 1969 Dr. Moore, a board-certified obstetrics and gynecology doctor, administered a spinal anesthetic to a patient (Showalter, 2017). However, Dr. Moore did not follow the typical

Use of daily spontaneous breathing trials to assess the patient’s ability to sustain ventilation, oxygenation, and breathing.

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

Although when it happens, there can be a devastating impact on patients as well as to the multidisciplinary theatre team involved. Consequently, the DAS has produced a consensus set of guidelines for managing failed intubations in adult and paediatric patients, but there are as yet no such nationally-agreed guidelines in obstetrics, therefore each obstetric unit should have their own flowchart with regards to management of failed intubation (Brien and Conlon, 2013). Furthermore, in light of the latest DAS guidelines, several aspects of clinical anaesthetic practise have changed over recent years (Frerk at al, 2015). Amongst the changes are the use of new drugs such as rocuronium and suggamadex and using electronic video-laryngoscopes (Frerk et al, 2015). Further work had also looked at extending the period of apnoea without causing desaturation by optimising the preoxygenation process and adequate patient positioning (Frerk et al, 2015). As a result, updated guidelines for difficult intubations in adult patients were published in 2015; these guidelines provide a flowchart to be used when endotracheal intubation proves difficult or impossible and focus on the central importance of oxygenation while reducing the amount of airway interventions in order to minimize trauma to the delicate airway (Frerk et al, 2015). The main message of the revised guidelines is

Could you imagine going through a surgery without anesthetics? You know, an anesthesiologist isn't the only one who gives anesthesia—it's a team effort. Nurse anesthetists have been the primary administers of anesthesia since World War II. Many health care facilities do not have anesthesiologists on staff, but they have a CRNA, or a Certified Registered Nursing Anesthetist. They are the nurses that put IVs (intravenous sedatives) into patients before surgery, as well as a combination of other medicines to relax the patient ("Nurse Anesthetist" Career Articles). The anesthesia promotes a controlled state of unconsciousness, muscular relaxation, and insensitivity to pain. So when you go to the operating room, you will most likely have a nurse

You will be under local or regional anesthesia. This is so that you are able to have higher levels of anesthesia if needed.

Anesthesia was developed in order to block or prevent pain during medical procedures. Anesthesia has been the backbone of the medical world for around 100 years now. Early anesthetics were primitive and many patients simply did not trust anesthetics. Anesthesia is still a risky process even in todays advanced medical world. Anesthesia is not used to treat or diagnose any specific disease; the sole purpose is to aid both the patient and surgeon through procedures. However, anesthesia is used in different ways based on the magnitude of the procedure. There are three levels of anesthesia which include; local, regional, and general anesthesia. An anesthesiologist determines which type of anesthesia will be needed.

My heartrate has to be off the charts. I’m sure the anesthesiologist would know, since I’m hooked up to a monitor. She is doing her damnedest to make this experience seem routine. For her, I’m sure it is. She must do at least a dozen sections a week. I, on the other hand, have never had surgery. Never have I had another life inside me either, counting on me to make all the right decisions. I’m hoping this is the right decision. I am sitting here on this hard cold steel table alone, no loved ones are allowed back until the procedure is underway. My naked back is exposed to a student. There will be a slight pinch as the needle pierces through my lumbar flesh kissing the anesthetic solution into my system. I am here because my daughter, my already

The patients for the endoscopy unit observed were under sedation and any adverse effects from the sedation could occur at any time. To prepare for any possible adverse effects, the perioperative surgical room

The management of postoperative pain has received much interest nowadays. The intensity of postoperative pain depends on many factors such as type and duration of the surgery, type of anesthesia and analgesia used, and the patient’s mental and emotional status (11).

Learning about the potential complications of epidural reinforced my knowledge in being able to choose the right anaesthetic monitoring equipment. Knowing that Spinal and epidural anaesthesia can cause unpredictable and profound arterial hypotension necessitate the use of adequate monitoring like the; Pulse oximetry, ECG and Blood pressure cuff. This knowledge will help me to be able to select appropriate monitoring devices during epidural catheter insertion. Also it goes without saying that an epidural must be performed in a work area that is equipped for airway management and resuscitation.

A review of the literature regarding spinal immobilisation has been undertaken using databases for PubMed, MEDLINE, CINAHL, OVID and Cochrane EBM. Reviews were electronically searched using the subject headings “spinal injuries”, “spinal immobilisation” and “management of spinal injuries”. The results generated by the search were limited to English language articles and reviewed for relevance to the topic. The aim of this literature review is to compare and contrast the views on spinal immobilisation and to achieve a better knowledge of evidence based practice.