Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Aug 2002
Phase I collaborative pilot study: Waste anesthetic gas levels in the PACU.
The National Institute of Occupational Safety and Health (NIOSH) recommends that exposure to waste anesthetic gas (WAG) be minimized to the greatest extent possible. Current recommendations include 2 parts per million (ppm) for 1 hour sample to halogenated agents level or 25 ppm based on nitrous oxide level or combination of 0.5 ppm for halogenated agents and 25 ppm nitrous oxide. The Occupational Safety Health Administration requires that work practices and engineering controls be implemented so that occupational exposure to WAG is controlled. ⋯ The methods to detect this exposure were also evaluated. It is recommended that further study be conducted to evaluate PACU staff exposure to WAG. Modifications in some of the measurement methods tested here are also suggested, including the use of procedures to measure the efficacy of air exchange and other engineering controls related to staff exposure.
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J. Perianesth. Nurs. · Jun 2002
ReviewResidual neuromuscular blockade in the immediate postoperative period.
Neuromuscular blocking agents are among the most potent and dangerous drugs administered in the course of a general anesthetic. Their residual actions can have profound effects on a patient's ability to adequately ventilate. Understanding the basics of their actions and the methods of monitoring the level of neuromuscular blockade will assist the PACU nurse in diagnosing the cause of postoperative muscle weakness and hypoventilation. This article will review the mechanisms of action and monitoring of neuromuscular blocking agents, as well as provide a basic overview of postoperative complications involving hypoventilation and motor weakness.
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Postoperative nausea and vomiting (PONV) remains one of the most common complications related to surgery and anesthesia. Referred to as the "big little problem," PONV complications range from minor patient discomfort to gastric aspiration or death. ⋯ Because the causes of PONV are multifactorial, no single antiemetic medication has been 100% effective for its prevention. A thorough understanding of these factors and the pharmacology related to PONV is essential for the effective management of this common postoperative complication.