Patients And Methods Of The Department Of Anesthesia

When there is a complication of the regional anesthesia which might include anaphylaxis, overdose, incorrect delivery technique and systemic absorption, the nurse will monitor for systemic toxic reaction which comprises of monitoring the central nervous system (CNS) stimulation along with CNS and cardiac depression. The nurse will also assess the patient for incoherent speech, restlessness, blurred vision, excitement, headache, nausea, vomiting, metallic taste, seizures, tremors, increase blood pressure, respiration and pulse. The patient may become apnea, hypotensive, unconscious, and have a cardiac arrest which may lead to death if the toxic reaction is not treated. Nursing intervention for the complication of regional anesthesia include establishing an open airway, administering oxygen, and notifying the surgeon. Treatment usually comprise of a fast acting barbiturate with epinephrine being administered for cardiac arrest. Edema and inflammation is an early sign of local complication with abscess formation, tissue necrosis and /or gangrene occurring later (Ignatavicius & Workman, 2013). Since general anesthesia was administer in addition to the regional anesthesia, the nurse and anesthesiologist will have to also monitor for complication of general anesthesia which range from a minor sore throat to death. Certain drugs used for general anesthesia may cause an acute, life threatening complication know as malignant hyperthermia (MH). The exposure of these agent to the skeletal muscle causes an increases in serum calcium and potassium level, metabolic rate leading to increased body temperature, acidosis and cardiac dysrhythmias. MH might occur immediately after the administration of the anesthesia, or several hours into the

-Use of indiscriminate sedatives, benzos, and opioid’s, especially in post-op patient who retains Co2, may suppress the ventilator drive and lead to respiratory failure

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)

[of] a decision, policy or practice" that Khajavi reasonably believed, consistent with the standards of his profession, impaired his ability to provide medically appropriate health care to a patient within the meaning of section 2056. Indeed, the trial court had considered the evidence sufficient to go to the jury on this claim before it erroneously narrowed its interpretation of section 2056.

The appropriate assessment of patients prior to surgery to identify coexisting medical problems and to plan peri-operative care is of increasing importance. The goals of peri-operative assessment are to identify important medical issues in order to optimise their treatment, inform the patient of the risks associated with surgery, and ensure care is provided in an appropriate environment secondly to identify important social issues which may have a bearing on the planned procedure and the recovery period and to familiarise the patient with the planned procedure and the hospital processes.(American Society of Anaesthesiologists)

A patient’s journey throughout the surgical process can often be a frightening and unpredictable time in a person’s life (Short & Gordon, 2015). It is therefore vital for nurses to provide holistic and safe patient centred care, in order to meet the needs of each patient through their experience (Short & Gordon, 2015). The following essay will explore the surgical journey and nursing considerations of a patient undergoing a surgical procedure. Firstly, it will address important nursing factors relevant to the preadmission and perioperative stages of care. It will then address relevant nursing factors relevant to the anaesthetic stages of care, during the surgical process.

Several analysis and statistics have been done on Fentanyl. The PLOS ONE did an analysis, their goal was to establish the effect Fentanyl had on children with the presence of emergence agitation (EA) under sevoflurane anesthesia. In all 16 studies were done which included 1362 patients, 737patients were for the Fentanyl group and the rest were for the placebo group, which is an ineffectual treatment for a medical condition. With the presence of Fentanyl, the incidence of EA as well as pain was decreased. However, it increased the frequency of nausea and vomiting denoting the period following the surgical operation. The study concluded that Fentanyl may be associated with a decreased incidence of EA in children and was proven to have a higher

Propofol is a hypnosis which is used to keep the patient sedated during the surgery this also used to keep patients sedated (Stonebridge, 2012). The most common physiological effects of Propofol are the local pain during the injection, eyes rolling back; coughing after anaesthesia, arching body spasms, muscle jerks, muscle twitching, slow heartbeat, hot flushes, increased breathing, hiccups, and periods of not breathing this is when the anaesthetist oxygenates the patient since the patient is sedated. Low blood pressure is also a side effect which shows on the monitor that the blood pressure levels have dropped once the Propofol has been injected (Stonebridge, 2012). Another common side effect is increased levels of fat in the blood, which

Situations in which OLV are indicated can be classified into, either to separate both lungs as in case of hemothorax, massive hemorrhage, bronchopleural fistulae and unilateral pulmonary diseases or to facilitate surgical procedures such as pneumonectomies, lobectomies, thoracoscopies and esophageal resection (4).Intraoperative hypoxemia during OLV is observed in approximately from 1 % up to 27% of patients inspite the use of high inspiratory oxygen fraction (Fio2) (5, 6). The incidence of this hypoxemia is affected by many factors e.g. used ventilator settings, the kind of surgery performed, the patient's position during surgery, and anesthesiologist's experience in OLV thoracic anesthesia (7).

Preoperative examination of the airway is essential. Identification of patients with a potentially difficult airway before anesthesia allows time to plan an appropriate anesthetic technique. Previous anesthetic records should always be consulted. However, a past record of normal tracheal intubation is no guarantee against difficulty on subsequent occasions as airway anatomy can be altered as in trauma affecting the airway. The presence of stridor or hoarse voice is warning sign for the anesthetist. As it is impossible to identify all patients with a difficult airway during preoperative assessment, the anesthetist must be prepared to manage the unexpected difficult laryngoscopy (Alan et al,. 2001).

Background: The field of pediatric pain changed greatly in the past decades. However, the number of children who experience moderate to severe postoperative pain, even with analgesic treatment, remains significant. If an intravenous or inhalational anesthetic would include in itself all the components of general anesthesia, like hypnosis, analgesia, and amnesia, it would represent a really ideal anesthetic. There is a debate on the potential analgesic efficacy of propofol compared with sevoflurane. During comparison of the postoperative analgesic effects of propofol versus sevoflurane in children

As the difficulty of analgesic therapies rises, establishment of the priorities of care must be forced in order to avert or diminish adverse events from occurring and to ensure that high quality and safe care is followed through. Opioid analgesia, in particular, remains to be the main primary pharmacologic intervention for managing pain in hospitalised patients. Although, while opioid use is generally safe for most patients, it may be associated with adverse effects, the most serious and severe opioid-related adverse event being respiratory depression (Davies et al.

Postoperative pulmonary complications are common especially in elderly patients with comorbidities. Nearly 5% of all patients undergoing non-cardiac surgery experience significant pulmonary complications and are a common cause for postoperative morbidity and mortality. They account for up to 40% of all postoperative complications and 20% of potentially preventable deaths.29 The most common pulmonary complications to occur are lung collapse, hypoxemia, hypoventilation, acute respiratory distress syndrome, and pneumonia. Development of these complications can extend the intensive care unit stay and increase mortality. Patients of 70 years of age and above have a higher risk of respiratory complications including bacterial pneumonia, noncardiogenic pulmonary edema, and respiratory failure requiring intubation compared to younger paients.30 Age-related alterations in

described in the literature over the last decade have enabled prehospital clinicians to better understand and manage pre-hospital analgesic practice. In pre-hospital clinical trials, analgesic agents such as morphine and fentanyl, nalbuphine, and tramadol, and a range of nonpharmacologic interventions

The dose of propofol required for induction of anaesthesia, and the continuous rate infusion dose for maintenance of anaesthesia was found significantly lower in the group premedicated with Risperidone and Tramadol orally. The quality of induction of anaesthesia in the non premedicated group was poor while that in group premedicated with risperidone and tramadol orally, was smooth and good. Time taken for recovery, time taken to regain sternal recumbency and time taken for standing