Nurse anesthesia
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Randomized Controlled Trial Comparative Study Clinical Trial
Comparison of the effect of insulated and noninsulated head covers on heat loss during abdominal surgery.
Hypothermia is experienced by all patients undergoing major surgical procedures. Hypothermia can lead to postoperative complications affecting oxygenation with neurologic, immunologic, and metabolic consequences. Current methods of heat conservation used in the operating room include blanket warmers, fluid warmers, and anesthesia circuit warmers. ⋯ All subjects had routine heat conservation measures (blanket warmers, fluid warmers, and anesthesia circuit humidifiers). Following induction of anesthesia, subjects' temperatures were measured using an esophageal stethoscope with thermistor probe at 10 and 70 minutes. Results showed no significant differences between groups at either time point.
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Certified Registered Nurse Anesthetists (CRNAs) provide anesthesia to a wide spectrum of patients, including those undergoing various neurosurgical procedures. While some CRNAs specialize in neuroanesthesia, most are involved on a more episodic basis. Using a case study format, this article reviews the pathophysiology associated with six common neurologic conditions the general practice CRNA may encounter. Important anesthesia considerations for each condition are discussed.
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Historically, pain in ill and injured pediatric patients has not been recognized or attended to. Subsequently, children often suffer in silence. Caretakers are often fearful to intervene aggressively to alleviate pain. ⋯ One of the most important is how to individualize the treatment of pain. We also need to learn more about children's natural coping styles and how parents and health care providers can enhance their effectiveness in contributing to the therapeutic team. It is hoped that readers will notice their patient's behaviors a little more closely, think about the extent of their private suffering, and become willing to offer a more studied, justifiable, and aggressive approach to pediatric pain management.
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Case Reports
Ketorolac as a preoperative nonnarcotic analgesic to enhance anesthesia and postanesthesia recovery.
The benefits of using ketorolac as a preoperative intramuscular (IM) non-narcotic analgesic are described and illustrated by the presentation of two case reports. Case Summary--Patient 1: A 53-year-old female who had experienced refractory nausea and vomiting after six previous exposures to anesthesia presented for outpatient ureteroscopy and dilatation of strictures. ⋯ Case Summary--Patient 2: A 65-year-old male with mild chronic obstructive lung disease presented for extracorporeal shock wave lithotripsy (ESWL). To avoid the respiratory depression associated with opioid narcotics, ketorolac 60 mg IM was given as an analgesic 1 hour before the ESWL procedure.
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Hypnosis has been utilized for at least several hundred years, but the societal view of hypnosis has ranged from raving to ridicule. The advances of hypnosis as a scientific endeavor have occurred within the last two centuries, but many myths and misunderstandings remain about the nature of hypnosis and its effects on the subject. Hypnosis is being recognized as having many medical applications. Important applications for the anesthetist include hypnoanesthesia and hypnoanalgesia, which are found to have some advantages in specific types of patients that present for surgery.