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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Randomized Controlled Trial Clinical Trial
Do antiarrhythmic doses of magnesium potentiate vecuronium?
The purpose of this study was to investigate whether magnesium sulfate (MgSO4) at a dose commonly used to treat arrhythmias potentiates vecuronium. After Institutional Review Board approval, 20 randomly assigned, consenting patients received a bolus of either MgSO4 (30 mg/kg) or placebo in a blinded fashion. Immediately after receiving the bolus of either MgSO4 or placebo, the study patients were taken to the operating room (OR) and anesthetized. ⋯ A 30 mg/kg bolus of MgSO4 roughly doubled ultrafilterable magnesium levels from baseline. The limited sample size precluded making any firm conclusions from this data. The data trend suggested that antiarrhythmic doses of MgSO4 may not potentiate vecuronium.
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Randomized Controlled Trial Clinical Trial
Effect of transport time and FiO2 on SpO2 during transport from the OR to the PACU.
Early postoperative hypoxemia may be due to a reduced functional residual capacity, hypoventilation, and ventilation-perfusion mismatch. These factors reduce the partial pressure of the arterial oxygen which ultimately reduces the oxygen transported to the tissues by decreasing the hemoglobin saturation. This may lead to cellular ischemia and death. ⋯ The treatment group received 40% oxygen via a venturi mask during transport while the control group breathed room air. After a routine transport to the postanesthesia care unit, the SpO2 was again measured and the transport time was recorded. Oxygen saturation was found to be significantly greater in the group breathing supplemental O2 during transport.
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Randomized Controlled Trial Clinical Trial
Efficacy of continuous epidural analgesia and the implications for patient care in the early postoperative phase.
Management of postoperative pain has been shown to be inadequately controlled, and, in fact, can have significant deleterious effects on a patient's early postoperative recovery. Continuous epidural analgesia has recently been used to control postoperative pain. This mode of analgesia controls postoperative pain without the delays inherent in the PRN administration of systemic narcotics. ⋯ The results of this study showed that the level of pain relief and recovery of postoperative function was superior to that provided by the more widely used (PRN) systemic administration of narcotics. With the exception of the report of back pain by patients receiving the normal saline epidural solution, complications did not occur in a significantly greater proportion when using the epidural route. Although some nursing care problems were identified, patients who received epidural analgesia were able to be cared for on general care units with no adverse effects reported.