Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Aug 2004
Review Case ReportsA PACU crisis: a case study on the development and management of methemoglobinemia.
The development of methemoglobinemia requires rapid recognition, confirmation, and treatment. This case study describes the development, diagnosis, and management of a 63-year-old male scheduled for a laparoscopic cholecystectomy with an intraoperative cholangiogram who developed methemoglobinemia after benzocaine was given for intubation.
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Successful ambulatory surgery is dependent on analgesia that is effective, has minimal adverse effects, and can be safely managed by the patient at home after discharge. A number of studies have identified that the provision of effective postoperative analgesia is inadequate for a significant proportion of patients. The following discussion details the current available analgesic options for ambulatory surgery patients and the rationale for their use. ⋯ Consideration should be given to the use of long-acting oral COX-2 selective nonsteroidal anti-inflammatory drugs (NSAIDs) and long-acting oral opioids to treat postoperative pain. A standardized multimodal postdischarge analgesic regimen tailored to the patient's expected postoperative pain levels should be prescribed. Patient follow-up by telephone questionnaire will confirm those surgical procedures that result in mild or moderate-to-severe postoperative pain and the effectiveness of treatment plans.
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J. Perianesth. Nurs. · Jun 2004
Clinical evaluation of the ASPAN Pain and Comfort Clinical Guideline.
The ASPAN Pain and Comfort Clinical Guideline was created because of the urgent need for a standardized evidence-based approach to the management of patients' pain and comfort in all perianesthesia settings. The purpose of the research presented here was to test the content of the ASPAN Pain and Comfort Clinical Guideline, which included the domains of assessment, intervention, and outcomes. Each domain was rated on clarity, usability, and feasibility using a Likert scale, which ranged from 1 (strongly disagree) to 4 (strongly agree). ⋯ There were no differences in the clarity, usability, or feasibility of the guideline between perianesthesia settings. The results of this study support that the ASPAN Pain and Comfort Clinical Guideline has practical utility for perianesthesia nurses in all settings. Use of this guideline in perianesthesia settings will standardize pain and comfort management and has the potential to positively impact pain and comfort in perianesthesia patients.
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J. Perianesth. Nurs. · Jun 2004
A survey of current perianesthesia nursing practice for pain and comfort management.
Widespread dissemination of information and high-profile press coverage about pain and comfort management has resulted in heightened awareness among health care professionals and the public of the need for improvements in the way pain and comfort are managed. Despite significant advances in treatment options for pain relief and comfort, studies show that both phenomena continue to be poorly managed and undertreated. Providing pain relief and comfort to patients are important fundamental components of good nursing care; however, no studies have been performed to evaluate these responsibilities in perianesthesia nursing practice. ⋯ Inappropriate and inadequate physicians' orders were cited as two of the most common obstacles to managing pain and comfort. Findings of this study can be used to increase awareness of the need to evaluate and improve pain and comfort management education and practices in the perianesthesia settings. ASPAN will also use the results as baseline data as it establishes a strategic plan to address the educational needs of its members.