Perioperative Analgesia

Before a procedure begins, the nurse anesthetist will discuss with a patient any medications the patient is taking as well as any allergies or illnesses the patient may have. This must be done so anesthesia can be safely administered. Nurse anesthetists then give a patient general anesthesia to put the patient to sleep so they feel no pain during surgery or they may administer a regional

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.

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 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)

The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety

The pre-operative stage is an important phase in patient’s surgery process. This is the time where the patients is experiencing a lot of anxiety issues and have questions regarding the impending procedure. To help ensure good patient outcomes, it is imperative to provide complete preoperative instructions and discharge instructions (Allison & George, 2014). It is the nurses’ duty to safe guard and protects the patient’s welfare during the surgical experience. Effective preoperative preparation is known to enhance postoperative pain management and recovery. Health professionals need to be cognizant of the contextual factors that influence patients’ preoperative experiences and give context appropriate care (Aziato & Adejumo, 2014).

The major concepts of this theory are defined theoretically since the use of these definitions is from a broader theoretic concept. Therefore, an operational concept could be developed from them. There is consistency in the use of these concepts throughout the theory of acute pain management with examples given using the same language as well as maintaining the integrity of the concepts.

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.

The main functions monitored during general anesthesia include oxygenation, circulation, and temperature, by measuring parameters such as heart pulse and rhythm, blood pressure, oxygen saturation, and temperature level. Breathing volume, rate and pressure are monitored by clinical observation from an anesthesia team member.

Engwall (2009) defined pain as a "symptom and a warning that something is wrong in an organism” (p 370). Rathmell et al., (2006) maintained that fear of uncontrolled pain can be a traumatic situation for a patient undergoing surgery. Moreover, Pellino, et al (2005) sustained that “pain is a multidimensional experience, consisting of not only physical stimuli but also psychological interpretations of pain” (p. 182). Alleviating peri-operative pain is traditionally achieved with the use of pharmacological interventions. analgesia can incur undesirable side-effects like drowsiness, nausea and vomiting. Controlling the pain by complimenting analgesics with the use of non-pharmacological interventions, might ameliorate patients’ response to pain with fewer resultant side-effects. Thus, the need to evaluate the effect of non-pharmacological measures such as music, relaxation, hypnosis and others is highly solicited in the evolving heath system (Pyati & Gan, 2007).

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).

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.

For this reflection of advanced perioperative practice I will be using a case study approach, I will also be using the Gibbs’ reflective cycle. (1988). Gibbs’ reflective cycle (1988) is a model of reflection that I feel allows me to achieve the depth of reflection that is required, I also feel that this model helps me to break the scenario that I have chose to reflect on into manageable sections. This model includes 6 stages of reflection which include description, feelings, evaluation, analysis ,conclusion, action plan.

Patients can benefit from anesthesia and analgesia when needed. Anesthesia can be routine for simple surgeries or used for a lifesaving procedure. Analgesia can offer the patient a state of non-pain along with aiding a better recovery. Surgery doesn’t just consist of anesthesia and analgesia but other areas such as room, machine, instrument, patient, and surgeon preparation. Tiny details really make the larger picture work. Not all veterinary technicians work in the same clinical setting. Some may work in a clinic, specialty hospital, laboratory or research setting. Even if a technician is not directly working with a patient, they need to be understanding of all areas of anesthesia and analgesia as they may need to observe an animal afterwards

As a 2000 graduate of an accredited veterinary college it is of interest to consider the divergent philosophy that persists today regarding the consideration and management of pain in animals. Indeed, accredited veterinary curriculums have included a standard of care for castration in companion animals that requires pre and postoperative pain management since at least the year 2000. However, at the same time, those universities had no such standard of care for animals raised for food such as piglets, and the vast majorities still don’t.