Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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Sevoflurane has rapidly replaced halothane as the inhaled anesthetic agent of choice for the pediatric population. Benefits of sevoflurane use include a quick induction and emergence from anesthesia, a nonpungent odor, which allows for mask induction, and decreased airway irritation, which results in a decrease in the incidence of bronchospasm and laryngospasm. Despite the positive aspects of sevoflurane, there are several side effects, including seizures during induction and maintenance, elevations in plasma inorganic fluoride and compound A concentrations, and an increased incidence of emergence delirium when compared to halothane. The purpose of this article is to inform perianesthesia nurses of the common complication of emergence behavioral changes associated with sevoflurane.
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J. Perianesth. Nurs. · Feb 2005
Case ReportsProlonged paralysis related to mivacurium: a case study.
Pseudocholinesterase deficiency is usually identified when an anesthetized patient has prolonged paralysis after receiving neuromuscular blocking agents dependent on pseudocholinesterase enzymes for hydrolysis. This rare complication, most frequently associated with succinylcholine, can occur with the use of mivacurium, one of the newer nondepolarizing muscle relaxants also hydrolyzed by pseudocholinesterase. Prolonged paralysis has occurred 3 times in the past 2 years at this pediatric hospital after administration of mivacurium. The following case study describes causality and interventions for a patient with prolonged paralysis after receiving mivacurium.
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The perianesthesia nurse is continually challenged to provide safe and effective pain management. This task becomes more difficult when working with an aging population. ⋯ To provide quality pain care for geriatric patients, who are at greater risk for developing potentially life-threatening side effects of commonly used analgesics, the perianesthesia nurse must be knowledgeable about factors that affect pain management in this population. Common factors affecting pain control in the older adult patient include misconceptions regarding use and effects of analgesics, preexisting cognitive impairment, impaired communication, cultural differences between the nurse and the patient, and physiologic changes in aging that affect how drugs are metabolized.