Opioids Case Study Essay

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

Postoperative surgical pain can often be moderate to severe leaving the client in a state of discomfort that requires the administration of opioid analgesic medications. Morphine intravenous (IV) patient-controlled analgesia (PCA) is commonly provided through a pump to treat postoperative surgical pain, but with advances in the medication administration field, a fentanyl iontophoretic transdermal system (ITS) has become another popular method (Lindley, Pestano, & Gargiulo, 2009). Morphine and fentanyl are similar medications in that they are both opioid analgesics and are both equally effective to reduce pain, but they offer differences through their administration techniques, comfort for the client, and providing care in a timely manner by the nurse. The nurse must take into consideration these differences to choose the proper medication for their specific client.

The primary outcome of our study was the duration of sensory block, and the secondary outcome was postoperative analgesia. We hypothesized that adding dexmedetomidine will prolong the duration of anesthesia and analgesia with a shorter onset

According to Hah et al. (2017), several studies have shown that nerve blockade of the central nervous system (neuraxial anesthesia) or peripheral nerves (regional anesthesia) reduce the need for opioids in the immediate postoperative phase. There are two mechanisms through which nerve blockade reduces persistent opioid use. First, nerve blockade works by impeding the transmission of pain during the perioperative phase and thereby stopping central sensitization and chronic neuropathic pain. Second, nerve blocks are effective in treating postoperative pain and are good predictor of persistent opioid use. Similarly, studies found that intravenous local anesthetic such as lidocaine reduces perioperative opioid

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).

Currently, one of the critical are an ongoing problem that encountered in the recovery room is regarding the use of patients controlled analgesia (PCA). Momeni (2006) found that PCA is a delivery system controlled by an infusion pump, the patient himself will press the button every time in pain by dose and time specified. PCA is widely now used at the standard protocol for major postoperative surgery such an operation laparotomy, orthopaedic and another major surgery. Expert of evidence clean that, the used of PCA extremities is very useful for pain control during 24-hour. It widely used in clinical practice.

This was done by examining the compound action potentials generated in the rat sciatic nerve. Rats were given injections of morphine. It measured two things: whether the dosage of opioids affected the potency of the local anaesthetic, and whether recovery from opioid-tolerance also affected this potency. The study suggested that opioid-tolerance resulted in a threefold decrease in the local anaesthetic potency.

Multimodal or balanced analgesic techniques involving the use of smaller doses of opioids in combination with non-opioid analgesic drugs (eg, local anesthetics, ketamine, acetaminophen, and NSAIDs) are becoming increasingly popular approaches to preventing pain after surgery [36]. There is evidence showing the benefits of multimodal analgesic techniques, but major surveys have reported that these techniques are underused in clinical practice [37]. Multimodal analgesia is achieved by combining different analgesics that act by different mechanisms at different sites in the nervous system, reducing the incidence of side effects owing to the lower doses of the individual drugs. In our study from all the prescribed analgesics only 23 (19.2%) charts were done according to the multimodal pain management for postoperative pain where as the remaining 97 (80.8%) prescriptions were not in accordance with MAPP (Table

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

In order to determine if Patient Y was having pain, I assessed her pain level using a pain scale. Once she reported a pain score of a 10 out of 10, I reviewed the pain medications that were ordered for her and chose the medication indicated for severe pain. After 30 minutes I reassessed my patient pain score and the rating changed to a 5 out of 10. During this time, I educated Patient Y on other techniques to decrease her pain. I provided Patient Y with an abdominal binder to place over her abdomen and constrict to the incision. I also told Patient Y to hold a folded blanket on her incision if she needs to cough or sneeze to decrease the pain. Finally, I educated Patient Y on breathing techniques to also decrease her pain.

postoperative pain. (6) However, the effects of these drugs on pain control are compared in

A prospective randomized, blinded clinical trial was performed by Schroer W.C. to evaluate the efficacy of liposomal bupivacaine for better pain control against bupivacaine HCL. Patients (n= 111) undergoing TKAs were randomized to receive liposomal bupivacaine vs bupivacaine HCL. 58 patients received 266mg (20cc) liposomal bupivacaine mixed with 75mg (30cc) 0.25% bupivacaine, and 53 patients received 150mg (60cc) 0.25% bupivacaine. A result of the study was generated by accessing visual analog pain (VAS) scores and narcotic use post-operatively. There were no VAS pain score differences between study group patients vs control group. As on POD1: 4.5/4.6 (P=0.73); POD2: 4.4/4.8 (P=0.27); and POD3: 3.5/3.7 (P=0.58). Narcotic use was similar during

After three sets of observation within thirty minutes, Mrs. Bowman’s consciousness level has increased indicated by responding to the vocal stimuli. This might suggest she was just in the process of recovery of the general anaesthesia. The information is consistent with her increased pain sensation. She was tachycardiac at 104 bpm with BP at 151/94 bpm, which were above the normal range. The increased pulse rate and BP could be associated with increased pain ((Jarvis et. al 2012). However, her

According to John Hopkins Medicine (n.d.), pain is an uncomfortable feeling that tells you something may be wrong. It can be fixed, throbbing, stabbing, aching, pinching, or described in many other ways. Pain is categorized as either acute or chronic. Acute pain is usually severe and brief, and is often a signal that your body has been injured. Chronic pain can vary from mild to severe and is there for long periods of time (John Hopkins Medicine, n.d). This paper will discuss a scenario that entails which person is experiencing the most pain, how two people can have the same procedure experience different levels of pain, factors that contribute to each person’s pain level, and two complementary/alternative methods of pain control.

Pain can be categorised as either acute pain or chronic pain. Acute pain is short lasting and will commonly subside once healing has taken place (Mac Lellan 2006). It is often a sudden onset and usually lasts less than 6 months. The main example of acute pain would be the pain experienced post surgery. Chronic pain on the other hand is a prolonged and persistent pain that remains long after the normal healing process of 3- 6 months. A common example of such a pain would be chronic back pain (Mac Lellan 2006). For the purpose of this assignment, the management of acute pain post surgery will be discussed with reference to a particular scenario, which followed the care and pain management given to a patient post appendectomy.