Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 2011
Randomized Controlled TrialRandomized controlled trial to compare effects of pain relief during IV insertion using bacteriostatic normal saline and 1% buffered lidocaine.
A major nursing responsibility is to provide patient care and comfort. Pain reduction is a component of this responsibility to include preanalgesia for peripheral intravenous (IV) insertion. This double-blind randomized controlled trial compared differences in the pain level experienced by 56 nurses during IV cannulation in each arm; one premedicated with bacteriostatic normal saline (BNS) and another with 1% buffered lidocaine (Lido). ⋯ Significant differences were detected between overall BNS and Lido pain scores (2.36±1.45 vs 0.93±1.3; P<0.05). Although blinded to the type of preanalgesia used, 89% of subjects chose the arm premedicated with Lido. Although statistical differences in perceived pain were detected, the pain scores were low and may not be clinically significant.
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J. Perianesth. Nurs. · Dec 2010
Randomized Controlled TrialSubarachnoid block with hyperbaric bupivacaine and morphine may shorten PACU stay after cesarean delivery.
Spinal anesthesia for cesarean delivery is a widely used modality. Both hyperbaric and isobaric bupivacaine are in clinical use, with or without the addition of opioids, but the baricity of intrathecal bupivacaine has not been correlated with recovery time after cesarean delivery. One hundred parturients scheduled for elective cesarean delivery were randomly divided into four groups: hyperbaric bupivacaine (10 mg), hyperbaric bupivacaine (10 mg) with morphine (100 mcg), isobaric bupivacaine (10 mg), and isobaric bupivacaine (10 mg) with morphine (100 mcg). ⋯ Parturients receiving hyperbaric bupivacaine recovered from motor block earlier and were less likely to require analgesic supplements, thus meeting PACU discharge criteria sooner. The addition of intrathecal morphine did not significantly delay postoperative recovery or discharge from the PACU and further reduced analgesic requirements. Spinal anesthesia with hyperbaric bupivacaine 10 mg with or without morphine 100 mcg provided faster, less painful recovery compared with either isobaric bupivacaine with or without morphine when added to fentanyl 15 mcg, enabling faster discharge from the PACU.
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J. Perianesth. Nurs. · Oct 2010
Randomized Controlled TrialThe effect of intravenous magnesium sulfate on acute postoperative bleeding in elective coronary artery bypass surgery.
Postoperative blood drainage is a great concern for health care providers when monitoring patients after cardiac surgery. In this study, the effect of intravenous magnesium sulfate infusion on postoperative bleeding in patients undergoing elective coronary artery bypass graft (CABG) surgeries was assessed. ⋯ The magnesium group had less postoperative bleeding (465 ± 130 mL vs 680 ± 190 mL in the placebo group; P = .00) and less packed cell use (2.1 ± 0.6 packs vs 3.2 ± 0.8 packs in the placebo group; P < .05) as compared with placebo. The results demonstrated significantly less postoperative bleeding and packed cell use in the group receiving intravenous magnesium sulfate infusion during elective CABG surgery.
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J. Perianesth. Nurs. · Jun 2010
Randomized Controlled Trial Comparative StudyNormothermia and patient comfort: a comparative study in an outpatient surgery setting.
ASPAN guidelines for the prevention of unplanned perioperative hypothermia define normothermia as a core temperature between 36 and 38 degrees C and an acceptable level of warmth. Over a six-month period, more than 30% of the same-day surgery patients experienced hypothermic core temperatures on admission to the preoperative unit. The purpose of the study was to compare two preoperative warming methods (forced-air gowns vs traditional warmed cotton blankets) on oral body temperatures, and patients reported "thermal" comfort in ambulatory surgery patients. ⋯ There was no significant difference in postoperative temperature between the subjects warmed with blankets and the warm-air gowns. Subjects warmed with the warm-air gowns reported higher comfort scores after 30 minutes of warming than those warmed with blankets. The change in comfort score from baseline to 30 minutes post warming was greater in the warm-air gown group (P = .001), indicating that warm-air gowns contribute to patients' increased thermal comfort.
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J. Perianesth. Nurs. · Aug 2009
Randomized Controlled TrialThe effect of needle bevel position on pain for subcutaneous lidocaine injection.
It is a common practice for medical practitioners to use subcutaneous infiltration of lidocaine to alleviate the pain of intravenous cannulation or line insertion. Although previous studies have assessed several factors affecting the pain associated with local anesthetic infiltration, there is a paucity of data on the effects of needle bevel position. ⋯ Significantly higher pain scores were observed when the needle was placed bevel down compared with bevel up (P = .02). No significant differences in pain scores were noted between the groups for age and gender.