Journal of perianesthesia nursing : official journal of the American Society of PeriAnesthesia Nurses
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J. Perianesth. Nurs. · Oct 2020
Meta AnalysisAdverse Outcomes Associated With Intraoperative Anesthesia Handovers: A Systematic Review and Meta-analysis.
Whether intraoperative handover of anesthesia care increases the risk of adverse outcomes in patients undergoing surgery remains unclear. This systematic review aimed to synthesize the evidence on the association of intraoperative anesthesia handover with delivery of patient care and patient outcomes. ⋯ The findings suggested that each additional intraoperative anesthesia handover increased the odds of composite morbidity. It is important to improve the handover quality and avoid handovers when anesthesia providers have high-risk care events, patients having unstable status, or inadequate handover time.
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Postoperative nausea and vomiting (PONV) remains one of the most common adverse effects of anesthesia, affecting up to 80% of high-risk patients within 24 hours after surgery. Patient-related factors, surgical procedure, and perioperative medications such as opioids determine a patient's risk for PONV. To prevent and manage PONV, ondansetron, a 5-hydroxytryptamine type 3 (5-HT3) receptor antagonist, is frequently administered. ⋯ Specifically, the occurrence of the G-allele produced by the OPRM1 A118G appears to be protective against PONV, whereas CYP2D6 ultrarapid metabolism increases the risk for PONV. The Clinical Pharmacogenetics Implementation Consortium guidelines provide CYP2D6-guided therapeutic recommendations for ondansetron. However, further studies are needed to investigate the role of genetic polymorphism in the occurrence of PONV and response to antiemetics.
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J. Perianesth. Nurs. · Apr 2019
ReviewRisk Factors for Perioperative Hypothermia: A Literature Review.
The purpose of this article was to review the literature to identify risk factors for the development of unplanned perioperative hypothermia and to evaluate the strength of the evidence for each risk factor. ⋯ It is crucial to prevention that health care providers are able to identify risk factors and implement interventions. However, vigilance in the perioperative period can only enhance patient safety when we know what to look for. More research is needed to identify risk factors of unplanned perioperative hypothermia and effectively maintain normothermia throughout the perioperative period.