Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 1997
Case ReportsRisks and outcomes of perioperative pulmonary aspiration.
A 95 kg, 34-year-old woman undergoes a laparoscopic tubal ligation. Shortly after endotracheal extubation and during transport to the PACU, she attempts to cough, and gags and vomits. ⋯ Concerned that she may have aspirated the vomitus into her trachea, you suction her endotracheal tube and find thick bilious secretions. How important is pulmonary aspiration? What are the risk factors? When does aspiration occur during the perioperative period? How do you treat pulmonary aspiration? What went wrong here?
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Neuromuscular relaxants are commonly used in the provision of general anesthesia for the majority of surgical procedures. After a brief overview of the physiology of the neuromuscular junction, pharmacology of both depolarizing and nondepolarizing muscle relaxants will be discussed. Attention will be given to side effects and factors that influence neuromuscular blockade including reversal agents. This article will provide the PACU nurse with the knowledge necessary to provide safe and effective nursing care.
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J. Perianesth. Nurs. · Jun 1997
Review Case ReportsTotal spinal anesthesia after an interscalene block.
A case study is presented involving a 22-year-old male who developed total spinal anesthesia after interscalene blockade for an arthroscopic procedure of the shoulder. An understanding of the anatomical structures of the brachial plexus, autonomic nervous system function, and side effects of local anesthetics is presented to assist the perianesthetic nurse in assessing and anticipating patient needs and in clinical decision making.
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During the last decade, questions about the length of time patients were required to fast before elective operations, as well as when they should resume oral fluids after an outpatient operation, became important issues in anesthesia and surgical practice. This review analyzes reasons for the traditional fasting guidelines and presents recent evidence that has caused rethinking in the guidelines. Current recommendations regarding both the presurgical fasting guidelines and fluid intake requirements for discharge after outpatient surgery are outlined.