Risk Factors For Sudden Agitations For Adults After Being Applied Anesthesia For Urological Surgery

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

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).

A general anaesthetic always involves hypnotic agent, usually an analgesic and may also include muscle relaxation. This combination is referred to as “triad of anaesthesia”. The relative importance of each component depends on surgical and patient factors: the intervention planned, site, surgical access requirement and the degree of pain or stimulation anticipated. The technique is tailored to the individual

At the beginning of the literature search, PubMed database were searched by applying the keywords: “Paediatric OR Pediatric AND Preoperative anxiety AND Induction OR Induce* AND Non Pharmacological OR Parents OR Father OR Mather Intervention” yielded 21 hits, “Paediatric Anaesthesia OR Pediatric Anesthesia AND Anxiety OR Anxious AND Pharmacological OR sedation OR premedication Intervention” yielded 86, “Distraction OR Clown Interference AND Preoperative Anxiety AND Children*” yielded 11 hits. “Parental presence OR premedication OR Distraction AND Preoperative Anxiety “yielded 54 hits.

The investigation of how anesthesia effects cognitive functioning has had a long history. Overtime, it has been suggested that there is an association between anesthesia, surgery, delirium, dementia and postoperative cognitive dysfunction (Inan & Ozkose Satirlar, 2015). The theory of anesthesia’s impact on cognitive functioning was derived in 1887, by Savage, who began to observe the “insanity” that follows the use of anesthesia. He suggested that “Any cause which will give rise to delirium may set up a more chronic form of mental disorder quite apart from any febrile disturbance” (Savage, 1887, p. 1199). Delirium can be defined as an altered level of consciousness that may cause a sudden decline in attention and focus perception (Isik, 2015). Postoperative delirium was reevaluated in 1955 when Bedford used a series of case studies collected over a 50 year span to describe a connection between anesthesia and dementia. The results suggest that 10% of the patients had postoperative cognitive dysfunction (Bedford, 1955). Since these initial studies, research has persisted using a variety of methods, in an attempt to determine: both long- and short-term effects of anesthesia on cognitive functioning and memory; whether the anesthesia administration technique will change the outcome of postoperative cognitive dysfunction; and other risk factors that may be associated to AD.

Ketamine can be used for sedation before minor procedures, although this use is not approved by the FDA

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

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

Some major components of postoperative pain investigations are often asked and recognizing that most patients, who suffer from postoperative pain, relieve it by verbal grievances or nonverbal behaviors after surgery. IV Ketorolac (Toradol) and IV Acetaminophen (Tylenol) are two non-opioid medications, whose administration combined with analgesics addresses multimodal therapy. By understanding what their pharmacologic profiles are, analgesic potentials, combinations with opioids, their limitations and the considerations such as the ease of administrations postoperative pain relief outcomes can be effective and controlled.

Noise induced higher environmental stimuli and sleep disturbance was identified as a risk factor of developing agitation (Stefen etl al., 2016).During day time patients are less engaged, additionally higher visitors flow leads to develop agitation in afternoon than in night shift (Nott, Chapparo, Heard, & Baguley, 2010). Continuous direction, frequent interaction, changes in an environment (p < 0.029), norepinephrine-dopamine- serotonin agonist stimulants (Bogner, 2015) were also predicted as risk factor of agitation. A study on use of tramadol for pain management, agitation was observed in around 35 % cases who received tramadol (Mahmood, Al-thani, El-menyar, Alani, & Al-hassani, 2015). Use of restrain for controlling agitated behavior were also assumed as an associated cause of developing agittaion in reltaion to treatment modalities ( p< 0.0001) (Mcnett, Sarver, & Wilczewski,

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

It is also imperative to reevaluate the purpose of the research and its methods of how to go about doing it. The fact that there was no consideration of the patient as another party in the research was big loophole in the research. Moreover, I think the results were biased because the clinical staffs were briefed on the purpose before the observation. It left rooms for the participant to circumvent its screening approach to fit the study. Evaluating this research opened my mind to understanding researches results just by looking at the approached being used. In which helps me to answer my practice-based question.

Renal protection is a critical concept for both anesthesiologists and urologists since anesthesia and renal function are highly interconnected and can potentially interfere with one another. Therefore, a comprehensive understanding of anesthetic drugs and their effects on renal function remains fundamental to the success of renal surgeries specifically transplant procedures. Some studies have shown some anesthetics provide protection against renal ischemia/reperfusion injury experimentally, but there are limited clinical evidence.

Before anesthesia was invented, surgeons had many different ways to make surgery less painful. They used things including medicine from plants, marijuana, or large amounts of alcohol. When surgeons used alcohol, people commonly had side effects including vomiting, nausea, or even death instead of sleep. Another method was to knock a patient unconscious by hitting them in the jaw. Some surgeries were completed with the patient

We also reported medication consumption before and after the procedure, accounting for all medications used for treating pain, anxiety and sleep. We found that there was no significant change in medication use for the following medications before and after the procedure: acetaminophen, alprazolam, aspirin, baclofen, buspirone, celecoxib, clonazepam, cyclobenzaprine, diazepam, duloxetine, hyoscyamine, hydrocodone, hydromorphone, ibuprofen,