Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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Effective treatment of perioperative acute pain requires that information about the patient's goals for pain relief, previous history with analgesics, and type of surgical procedure is used to guide decisions about analgesic regimens. Analgesics are selected based on the location of surgery, degree of anticipated pain, and patient characteristics such as comorbidities, and routes of administration and dosing schedules are determined to maximize the effectiveness and safety of analgesia, while minimizing the potential for adverse events. ⋯ To accomplish this, nurses must have a thorough understanding of the pharmacology of analgesics. This article provides useful information for commonly used analgesics, primarily nonsteroidal antiinflammatory drugs (NSAIDs), opioids, and local anesthetics for control of acute postoperative pain.
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J. Perianesth. Nurs. · Feb 2008
Comparative StudyComparison of temperature measurement devices in post anesthesia patients.
A descriptive correlational study was used to evaluate the correlation/agreement of oral and axillary temperature measurements to patient core temperatures obtained in the OR. Data collectors recorded oral or axillary patient temperature from 752 patients on admission and discharge from the PACU. Results indicated that there was a moderate correlation between each of the current devices and core temperature, but no agreement between core temperature and either device. Recommendations were made to use just one device throughout the organization, or to use the device used on admission throughout the hospitalization.
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New approaches to the management of acute perioperative pain have focused on ways to improve the risk/benefit profile of various analgesics, enhance the consistency of pain control, address interpatient differences in responses to pain and treatments, and avoid periods of ineffective pain relief (analgesic gaps). Although intravenous patient-controlled analgesia has been the "gold standard" for acute pain management, there are now more analgesic options and compelling data to support combinations of analgesics or multimodal therapy, timing of analgesic interventions, and the use of newer drug delivery systems. Maximizing pain control with preemptive analgesia and multimodal therapy, and the availability of transdermal fentanyl by iontophoresis and extended-release epidural morphine have expanded the armamentarium of effective options for perioperative pain control. This article explores emerging trends in acute pain therapy, and discusses their implications for improving patient care.