Bibliografie tematiche / Surgical nursing

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Letteratura scientifica selezionata sul tema "Surgical nursing"

Autore: Grafiati
Pubblicato: 4 giugno 2021
Ultima modifica: 30 luglio 2024

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Articoli di riviste sul tema "Surgical nursing"

1

Orpet, Hilary. "Surgical nursing". Veterinary Record 170, n. 7 (18 febbraio 2012): 182.2–182. http://dx.doi.org/10.1136/vr.e1078.

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Dyer, Janet. "SURGICAL NURSING". AJN, American Journal of Nursing 91, n. 7 (luglio 1991): 14. http://dx.doi.org/10.1097/00000446-199107000-00008.

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Persson, June C. "Surgical Nursing". AORN Journal 51, n. 5 (maggio 1990): 1398. http://dx.doi.org/10.1016/s0001-2092(07)70169-2.

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Fawcett, Josephine N. "Surgical nursing". International Journal of Nursing Studies 23, n. 2 (gennaio 1986): 180. http://dx.doi.org/10.1016/0020-7489(86)90009-x.

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Hawker, Ruth Joyce. "Surgical nursing". Nurse Education Today 6, n. 3 (giugno 1986): 142. http://dx.doi.org/10.1016/0260-6917(86)90111-5.

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Rowe, Rachael. "Cardiothoracic Surgical NursingCardiothoracic Surgical Nursing". Nursing Standard 18, n. 31 (14 aprile 2004): 28. http://dx.doi.org/10.7748/ns2004.04.18.31.28.b252.

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Ziemba, Statira. "Nursing Resources: Medical-Surgical Nursing". American Journal of Nursing 99, n. 2 (febbraio 1999): 24B. http://dx.doi.org/10.2307/3471977.

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Rowe, Rachael. "Cardiothoracic Surgical Nursing". Nursing Standard 18, n. 31 (14 aprile 2004): 28. http://dx.doi.org/10.7748/ns.18.31.28.s40.

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Ameduri, Phyllis. "Medical Surgical Nursing". Journal of Continuing Education in Nursing 22, n. 6 (novembre 1991): 269. http://dx.doi.org/10.3928/0022-0124-19911101-12.

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Matthews, Amanda. "Surgical nursing care". Nursing Standard 20, n. 12 (30 novembre 2005): 67–68. http://dx.doi.org/10.7748/ns.20.12.67.s60.

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Tesi sul tema "Surgical nursing"

1

Gefter, Aleksey. "EMERGENCY SURGICAL CONDITIONS FROM THE NURSING PERSPECTIVE". Thesis, Тернопіль, 2021. https://repository.tdmu.edu.ua//handle/123456789/17173.

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Abstract (sommario):
The aim of the study was to investigate the specific aspects of nursing process as applied to emergency surgery in patients with ballistic injuries and household trauma, to determine the risks faced by medical personnel when working with patients in dangerous neighborhoods, to identify nursing strategies in managing aggressive patients, and to define the need for surgical interventions in ballistic injuries and household trauma as part of a research study.
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Abdou, Jeanne Anne. "Circadian rhythm disruption and post-surgical recovery". FIU Digital Commons, 1998. http://digitalcommons.fiu.edu/etd/1252.

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Circadian rhythms, patterns of each twenty-four hour period, are found in most bodily functions. The biological cycles of between 20 and 28 hours have a profound effect on an individual's mood, level of performance, and physical well being. Loss of synchrony of these biological rhythms occurs with hospitalization, surgery and anesthesia. The purpose of this comparative, correlational study was to determine the effects of circadian rhythm disruption in post-surgical recovery. Data were collected during the pre-operative and post-operative periods in the following indices: body temperature, blood pressure, heart rate, urine cortisol level and locomotor activity. The data were analyzed by cosinor analysis for evidence of circadian rhythmicity and disruptions throughout the six day study period which encompassed two days pre-operatively, two days post-operatively, and two days after hospital discharge. The sample consisted of five men and five women who served as their own pre-surgical control. The surgical procedures were varied. Findings showed evidence of circadian disruptions in all subjects post-operatively, lending support for the hypotheses.
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Oliver, Mary Swarna Philomena. "An ethnogaphic [sic] interpretive approach to describing the clinical practice of registered nurses in the field of medical and surgical nursing practice /". St. Lucia, Qld, 2001. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe16446.pdf.

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Palmer, Josephine Chiara. "Factors associated with professional nursing practice in medical-surgical nurses". Thesis, The University of Arizona, 1990. http://hdl.handle.net/10150/277266.

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The purpose of this study was to identify and describe factors perceived to be important to nursing practice by registered nurses. The sample, 170 medical-surgical nurses, was 37% of the total in the primary study (N = 455). An exploratory/descriptive design was used to content analyze the qualitative data obtained from one open-ended question asked in the Differentiated Group Professional Practice in Nursing project. Results showed two concepts in the conceptual framework, Group Cohesion and Job Satisfaction, with regard to Pay and Physician/Nurse Relationships, were supported. Other categories generated included the importance of Administrative Support, both Nursing and Non-Nursing, Education, Adequate Staffing, Flexibility in Hours, and Role Recognition. Another set of responses were categorized as Conflicts - Dissatisfiers. Categories generated included Entry into Practice, Non-Nursing Functions and Changing Attitudes.
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Kan, Bik-yu Ada. "Nurses' perceptions of communication the oncology and surgical context /". Click to view the E-thesis via HKUTO, 2004. http://sunzi.lib.hku.hk/hkuto/record/B31972925.

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Denzik, Bridget A. "Bedside Nurse Recognition of Delirium in the Medical-Surgical Setting". Thesis, Walden University, 2016. http://pqdtopen.proquest.com/#viewpdf?dispub=10100216.

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Delirium in adults aged 65 and older is a common occurrence in the acute care setting and is often unrecognized by bedside nurses. Delirium can trigger a negative cascade of events resulting in an increase in morbidity and mortality, functional decline, longer length of stay, and high rates of post hospital institutionalization and has a significant socioeconomic impact. The purpose of this quality improvement project was to establish a solid foundation using scholarly literature to support the development of a delirium prevention, recognition, and treatment program in the medical-surgical acute care setting applying the program logic framework. The goal was accomplished by developing a structured program to enhance nurse education (phase 1) using a pretest/posttest design. Phase 2 will be implemented at a later date. The null hypothesis for the project was there is no difference between the pretest group knowledge of delirium scores and the posttest group scores following education. The results of the 36-paired pretests/posttests indicated a significant difference (p < 0.05) following the educational PowerPoint on delirium. Providing education and opportunities for bedside nurses to apply this new knowledge is an effective strategy to increase the identification of delirium, which can lead to improved patient outcomes, reduced socioeconomic burden associated with delirium, and increased positive social change. The economic impact of delirium is considerable with the average cost per day of delirium patients reaching nearly 3 times the cost of patients not having delirium. The elderly population is projected to continue to rise, which will have a profound impact on hospitals and health care as a whole.

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Maneewat, Khomapak. "Nursing Care Practices and Workplace Relations in a Thai Surgical Ward: An Exploration of Clinical Decision-Making". Thesis, Griffith University, 2010. http://hdl.handle.net/10072/367549.

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This thesis offers a study of how a local ward culture underpins nursing actions of Thai surgical nurses in order to account for issues such as lack of sustainability, and failure to use research, including evidence-based nursing practice and the new multimodal model of care which has been officially adopted in the Thai hospital context. The study was conducted at a Thai surgical ward to illuminate and describe the culture of the Thai surgical nurse, including the ways in which the organizational culture influences or guides their thinking, decision-making, and actions in a patterned way. The knowledge about how the Thai surgical nurses allocate care, and make clinical decisions in the surgical ward in the context of social relations and staff culture is constructed through an ethnographic approach based on fieldwork at the non-private general surgical wards of one university hospital in Southern Thailand. A better understanding of the diversity of Thai surgical nursing practice is then enacted from a typical day in the life of the Thai surgical nurses, which consists of the realities, ritualised practices, relations, and integration both with within their group and with others. The study results represent the way that nursing organizational culture informs the practices, decision-making, and the predictions of the nurses’ possible response to change. The pre- and post-operative cares allocated by the nurses of the TSW are routinised, almost ritualised, and reflect fixed assumptions about the way cares ought to be delivered, including those reflecting the lack of commitment to implementing new multimodal models of care as well as research utilization and evidence-based practice. The study raises significant concerns about the status of professional nursing in Thailand in terms of professional autonomy and the status of the nurses within the Thai hospital context. Empowering professional nursing is therefore recommended as a first priority to change Thai nursing culture. The ritualised practices, task-oriented working system, and the dominance of the medical model in the Thai nursing culture further reflect the need to establish an evidence-based nursing culture to create professional identity and improve the quality of care.
Thesis (PhD Doctorate)
Doctor of Philosophy (PhD)
Nursing and Midwivery
Griffith Health
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Lee, Kyung Hae, of Western Sydney Nepean University e Faculty of Nursing and Health Studies. "Do not resuscitate : bioethical and nursing perspectives". THESIS_FNHS_XXX_Lee_K.xml, 1995. http://handle.uws.edu.au:8081/1959.7/672.

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This report focuses on the use of Watson's theory of human caring for Do Not Resuscitate (DNR) patients in acute medical-surgical wards. It discusses the dilemmas facing DNR patients and their nurses and explores the solutions to these dilemmas offered by Watson's theory. Traditional nursing practice places the nurse in a difficult situation by focusing on physical health. The report discusses the philosophical assumptions underlying Watson's theory. These assumptions led Watson to focus on nursing holistically, and to emphasise an integrated approach to nursing, which promotes the comfort of the patient physically, spiritually and emotionally. Her focus is on the broader aspects of caring such as involving the care domain of nursing, instead of the narrower view of nursing which focuses on care for the 'cure' only. This appproach is particularly relevant to DNR situations because these situations involve patients for whom there is no physical cure. Watson's holistic approach to caring offers the nurses of DNR patients guidelines for their practice and meaning for their nursing actions. Because current DNR decisions are often made by medical officers but implemented by nurses, it is the nurse who may be legally liable for the patient's death. This can cause anxiety for the nurses involved. Another cause of anxiety can be the traditional focus in nursing on physical cure. In the care of DNR patients, no such cure is possible. This can leave the nurse feeling distressed and incompetent. DNR the patients, may lack of autonomy and suffer feelings of insecurity. It is in these areas that Watson's ten carative factors can offer support, for both patients and nurses.
Master of Nursing
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McClelland, Beverley. "Critical factors that influence staff retention in an acute perioperative environment a thesis in partial fulfilment of the degree in Master of Health Science at Auckland University of Technology, April 2004". Full thesis. Abstract, 2004. http://puka2.aut.ac.nz/ait/theses/McClellandB.pdf.

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Maron, Margaret M. "The relationship of stress levels among a group of medical-surgical nurses vs. intensive care nurses /". Staten Island, N.Y. : [s.n.], 1990. http://library.wagner.edu/theses/nursing/1990/thesis_nur_1990_maron_relat.pdf.

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Libri sul tema "Surgical nursing"

1

Ann, Black Mary, a cura di. Surgical nursing. 2a ed. Springhouse, Pa: Springhouse Corp., 1995.

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Bickerton, J. Surgical nursing. London: Heinemann Nursing, 1985.

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Bonnie, Allbaugh, a cura di. Surgical nursing. Albany, NY: Delmar Publishers, 1994.

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Ann, Black Mary, a cura di. Surgical nursing. Springhouse, Pa: Springhouse Corp., 1990.

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Martin, Frances L. Medical-surgical nursing. Springhouse, Pa: Springhouse Corp., 1992.

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Rollant, Paulette D. Medical-surgical nursing. St. Louis: Mosby-Year Book, 1996.

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M, Ahlschlager Patricia, e Hale Tammy J, a cura di. Medical-surgical nursing. 2a ed. Clifton Park, NY: Delmar Cengage Learning, 2012.

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8

Jillian, Riley, a cura di. Cardiothoracic surgical nursing. Oxford, UK: Blackwell Science, 2003.

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G, Mayers Marlene, e Pankratz Carol, a cura di. Medical-surgical nursing. New York: McGraw-Hill, 1995.

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M, Gingrich Margaret, e Rhorer Janet H, a cura di. Medical-surgical nursing. Springhouse, Pa: Springhouse Corp., 2000.

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Capitoli di libri sul tema "Surgical nursing"

1

Bird, H. A., Patricia le Gallez e Jacqueline Hill. "Surgical Nursing". In Combined Care of the Rheumatic Patient, 131–50. London: Springer London, 1985. http://dx.doi.org/10.1007/978-1-4471-1365-2_5.

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Willetts, Georgina. "Medical-Surgical Nursing". In Comprehensive Healthcare Simulation: Nursing, 67–78. Cham: Springer International Publishing, 2023. http://dx.doi.org/10.1007/978-3-031-31090-4_8.

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Schmeltzer, Eric. "Surgical Preparation". In Nursing the Feline Patient, 119–20. Ames, Iowa, USA: John Wiley & Sons, Inc, 2016. http://dx.doi.org/10.1002/9781119264910.ch14.

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Di Candido, Francesca Rita, Simona Radice e Antonino Spinelli. "Surgical Management". In Inflammatory Bowel Disease Nursing Manual, 133–41. Cham: Springer International Publishing, 2019. http://dx.doi.org/10.1007/978-3-319-75022-4_16.

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Wang, Gongxian, Yu Zeng e Xia Sheng. "Development History of Surgical Robots". In Robotic Surgery and Nursing, 3–6. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-0510-9_1.

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Wang, Gongxian, Yu Zeng e Xia Sheng. "Management of Robotic Surgical Supplies". In Robotic Surgery and Nursing, 125–29. Singapore: Springer Singapore, 2021. http://dx.doi.org/10.1007/978-981-16-0510-9_6.

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Scott, Karen, e Alasdair Hotston Moore. "Surgical nursing". In BSAVA Manual of Practical Veterinary Nursing, 315–70. British Small Animal Veterinary Association, 2007. http://dx.doi.org/10.22233/9781910443064.13.

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Brown, Donna, e Romain Pizzi. "Surgical nursing". In BSAVA Manual of Exotic Pet and Wildlife Nursing, 222–42. British Small Animal Veterinary Association, 2012. http://dx.doi.org/10.22233/9781910443132.9.

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Meeson, Richard, e Jessica Gilby. "Surgical nursing". In BSAVA Congress Proceedings 2024. British Small Animal Veterinary Association, 2024. http://dx.doi.org/10.22233/9781913859411.14.4.

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"Medical–Surgical Nursing". In Nursing. New York, NY: Springer Publishing Company, 2015. http://dx.doi.org/10.1891/9780826130235.0003.

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Atti di convegni sul tema "Surgical nursing"

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Jang, Sunyoung. "Effects of Nurse Staffing on Surgical Patient-Outcomes with Cerebrovascular Disease in General Hospitals". In Healthcare and Nursing 2015. Science & Engineering Research Support soCiety, 2015. http://dx.doi.org/10.14257/astl.2015.116.36.

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Toqueton, Tainá Rodrigues, Kleyton Matheus Honorato Muniz, João Victor Bezerra Massa, Délio Guerra Sampaio Lima Araujo, Iesser Nick Lauar Barbosa, Márcio Henrique de Carvalho Ribeiro, Alisson Phelipe Dias Braga, Marcus Antonio Studart da Cunha Frota e Igor Costa Santos. "Surgical approach in the treatment of endocrine tumors". In II SEVEN INTERNATIONAL MEDICAL AND NURSING CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/iicongressmedicalnursing-024.

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The surgical approach in the treatment of endocrine tumors is a topic of great relevance in medicine, since these tumors can originate in endocrine glands or tissues that produce hormones, impacting the hormonal balance of the body.
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"Risk Factors in Biliopancreatic Surgical Nursing and Management Countermeasures". In 2020 Conference on Educational Science and Educational Skills. Scholar Publishing Group, 2020. http://dx.doi.org/10.38007/proceedings.0000611.

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Yang, Changyong, e Huijie Zhao. "Open Surgical Nursing Experimental Teaching Reform Based On Network". In 2018 9th International Conference on Information Technology in Medicine and Education (ITME). IEEE, 2018. http://dx.doi.org/10.1109/itme.2018.00124.

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Casida, Jesus M. "21 Surgical care and perioperative nursing management of LVADs". In 2nd Asia Pacific Advanced Heart Failure Forum (APAHFF 2018), 16th November 2018, Hong Kong. BMJ Publishing Group Ltd, British Cardiovascular Society and Asia Pacific Heart Association, 2019. http://dx.doi.org/10.1136/heartasia-2019-apahff.21.

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Toqueton, Tainá Rodrigues, João Victor Bezerra Massa, Délio Guerra Drummond Júnior, Julia Alves de Oliveira, Artur Henrique Sampaio Lima Araujo, Daniel Aparecido dos Santos e Igor Costa Santos. "Possibilities of surgical treatment of carpal tunnel syndrome in elderly women". In II SEVEN INTERNATIONAL MEDICAL AND NURSING CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/iicongressmedicalnursing-023.

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Carpal tunnel syndrome is a common neuromuscular condition that primarily affects elderly women, characterized by compression of the median nerve in the wrist. This compression leads to symptoms such as pain, tingling, and weakness in the hand and fingers, significantly impacting patients' quality of life.
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Fernandez-Aleman, J. L., C. Jayne, A. B. Sanchez, J. M. Carrillo-de-Gea e A. Toval. "Neural network-based data analysis for medical-surgical nursing learning". In 2012 34th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (EMBC). IEEE, 2012. http://dx.doi.org/10.1109/embc.2012.6347370.

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Li, Xuekun, e Lili Zhao. "The Application of Computer Network Technology in Surgical Nursing Teaching". In 2021 International Conference on Education, Information Management and Service Science (EIMSS). IEEE, 2021. http://dx.doi.org/10.1109/eimss53851.2021.00099.

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Zhang, Min, Gao Ling e Li-Hua Xu. "The Study on the Applicability of Modular Teaching in Surgical Nursing". In 2015 International Conference on Medicine and Biopharmaceutical. WORLD SCIENTIFIC, 2016. http://dx.doi.org/10.1142/9789814719810_0062.

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He, Meilin, e Caiqin Mei. "Surgical Nursing Teaching Quality Monitoring Platform Design Based on Big Data". In 2022 International Conference on Education, Network and Information Technology (ICENIT). IEEE, 2022. http://dx.doi.org/10.1109/icenit57306.2022.00013.

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Rapporti di organizzazioni sul tema "Surgical nursing"

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Patel, Deep, Kenneth Graf e David Fuller. Hip Surgical Preparation Educational Video. Rowan Digital Works, gennaio 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1022.

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Abstract (sommario):
This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Catherine Fedorka e David Fuller. Shoulder Surgical Preparation Educational Video. Rowan Digital Works, gennaio 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1023.

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Abstract (sommario):
This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Julio Rodriguez, Vishal Khatri e David Fuller. Spine Surgical Preparation Educational Video. Rowan Digital Works, gennaio 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1021.

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Abstract (sommario):
This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Eric Freeland e David Fuller. Foot and Ankle Surgical Preparation Educational Video. Rowan Digital Works, gennaio 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1020.

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Abstract (sommario):
This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Patel, Deep, Alisina Shahi e David Fuller. Hand and Wrist Surgical Preparation Educational Video. Rowan Digital Works, gennaio 2021. http://dx.doi.org/10.31986/issn.2689-0690_rdw.oer.1019.

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Abstract (sommario):
This series of open educational videos provides an in depth overview of various surgical preparation procedures. These instructional videos could be of interest to various medical and health science trainees in a variety of fields such as nursing or medicine. All patients featured in this video series have signed consent and release forms authorizing the release of these educational videos.
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Zadinsky, Julie K. The Readiness Training Program for Nursing Personnel in the AMEDD. Volume 3A. Training Manual to Accompany the Videotape: Readiness Training in Medical-Surgical Nursing Skills. Fort Belvoir, VA: Defense Technical Information Center, settembre 1995. http://dx.doi.org/10.21236/ada301218.

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Jarron, Matthew, Amy R. Cameron e James Gemmill. Dundee Discoveries Past and Present. University of Dundee, novembre 2020. http://dx.doi.org/10.20933/100001182.

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Abstract (sommario):
A series of self-guided walking tours through pioneering scientific research in medicine, biology, forensics, nursing and dentistry from the past to the present. Dundee is now celebrated internationally for its pioneering work in medical sciences, in particular the University of Dundee’s ground-breaking research into cancer, diabetes, drug development and surgical techniques. But the city has many more amazing stories of innovation and discovery in medicine and biology, past and present, and the three walking tours presented here will introduce you to some of the most extraordinary. Basic information about each topic is presented on this map, but you will ­find more in-depth information, images and videos on the accompanying website at uod.ac.uk/DundeeDiscoveriesMap For younger explorers, we have also included a Scavenger Hunt – look out for the cancer cell symbols on the map and see if you can ­find the various features listed along the way!
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Harris, Gregory, Brooke Hatchell, Davelin Woodard e Dwayne Accardo. Intraoperative Dexmedetomidine for Reduction of Postoperative Delirium in the Elderly: A Scoping Review. University of Tennessee Health Science Center, luglio 2021. http://dx.doi.org/10.21007/con.dnp.2021.0010.

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Background/Purpose: Post-operative delirium leads to significant morbidity in elderly patients, yet there is no regimen to prevent POD. Opioid use in the elderly surgical population is of the most significant risk factors for developing POD. The purpose of this scoping review is to recognize that Dexmedetomidine mitigates cognitive dysfunction secondary to acute pain and the use of narcotic analgesia by decreasing the amount of norepinephrine (an excitatory neurotransmitter) released during times of stress. This mechanism of action also provides analgesia through decreased perception and modulation of pain. Methods: The authors developed eligibility criteria for inclusion of articles and performed a systematic search of several databases. Each of the authors initially selected five articles for inclusion in the scoping review. We created annotated literature tables for easy screening by co-authors. After reviewing the annotated literature table four articles were excluded, leaving 11 articles for inclusion in the scoping review. There were six level I meta-analysis/systematic reviews, four level II randomized clinical trials, and one level IV qualitative research article. Next, we created a data-charting form on Microsoft Word for extraction of data items and synthesis of results. Results: Two of the studies found no significant difference in POD between dexmedetomidine groups and control groups. The nine remaining studies noted decreases in the rate, duration, and risk of POD in the groups receiving dexmedetomidine either intraoperatively or postoperatively. Multiple studies found secondary benefits in addition to decreased POD, such as a reduction of tachycardia, hypertension, stroke, hypoxemia, and narcotic use. One study, however, found that the incidence of hypotension and bradycardia were increased among the elderly population. Implications for Nursing Practice: Surgery is a tremendous stressor in any age group, but especially the elderly population. It has been shown postoperative delirium occurs in 17-61% of major surgery procedures with 30-40% of the cases assumed to be preventable. Opioid administration in the elderly surgical population is one of the most significant risk factors for developing POD. With anesthesia practice already leaning towards opioid-free and opioid-limited anesthetic, the incorporation of dexmedetomidine could prove to be a valuable resource in both reducing opioid use and POD in the elderly surgical population. Although more research is needed, the current evidence is promising.
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Schwieger, Alexandra, Kaelee Shrewsbury e Paul Shaver. Dexmedetomidine vs Fentanyl in Attenuating the Sympathetic Surge During Endotracheal Intubation: A Scoping Review. University of Tennessee Health Science Center, luglio 2021. http://dx.doi.org/10.21007/con.dnp.2021.0007.

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Purpose/Background Direct laryngoscopy and endotracheal intubation after induction of anesthesia can cause a reflex sympathetic surge of catecholamines caused by airway stimulation. This may cause hypertension, tachycardia, and arrhythmias. This reflex can be detrimental in patients with poor cardiac reserve and can be poorly tolerated and lead to adverse events such as myocardial ischemia. Fentanyl, a potent opioid, with a rapid onset and short duration of action is given during induction to block the sympathetic response. With a rise in the opioid crisis and finding ways to change the practice in medicine to use less opioids, dexmedetomidine, an alpha 2 adrenergic agonist, can decrease the release of norepinephrine, has analgesic properties, and can lower the heart rate. Methods In this scoping review, studies published between 2009 and 2021 that compared fentanyl and dexmedetomidine during general anesthesia induction and endotracheal intubation of surgical patients over the age of 18 were included. Full text, peer-reviewed studies in English were included with no limit on country of study. The outcomes included post-operative reviews of decrease in pain medication usage and hemodynamic stability. Studies that were included focused on hemodynamic variables such as systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and use of opioids post-surgery. Result Of 2,114 results from our search, 10 articles were selected based on multiple eligibility criteria of age greater than 18, patients undergoing endotracheal intubation after induction of general anesthesia, and required either a dose of dexmedetomidine or fentanyl to be given prior to intubation. Dexmedetomidine was shown to effectively attenuate the sympathetic surge during intubation over fentanyl. Dexmedetomidine showed a greater reduction in heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure than fentanyl, causing better hemodynamic stability in patients undergoing elective surgery.Implications for Nursing Practice Findings during this scoping review indicate that dexmedetomidine is a safe and effective alternative to fentanyl during induction of general anesthesia and endotracheal intubation in attenuating the hemodynamic response. It is also a safe choice for opioid-free anesthesia.
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Lumpkin, Shamsie, Isaac Parrish, Austin Terrell e Dwayne Accardo. Pain Control: Opioid vs. Nonopioid Analgesia During the Immediate Postoperative Period. University of Tennessee Health Science Center, luglio 2021. http://dx.doi.org/10.21007/con.dnp.2021.0008.

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Background Opioid analgesia has become the mainstay for acute pain management in the postoperative setting. However, the use of opioid medications comes with significant risks and side effects. Due to increasing numbers of prescriptions to those with chronic pain, opioid medications have become more expensive while becoming less effective due to the buildup of patient tolerance. The idea of opioid-free analgesic techniques has rarely been breached in many hospitals. Emerging research has shown that opioid-sparing approaches have resulted in lower reported pain scores across the board, as well as significant cost reductions to hospitals and insurance agencies. In addition to providing adequate pain relief, the predicted cost burden of an opioid-free or opioid-sparing approach is significantly less than traditional methods. Methods The following groups were considered in our inclusion criteria: those who speak the English language, all races and ethnicities, male or female, home medications, those who are at least 18 years of age and able to provide written informed consent, those undergoing inpatient or same-day surgical procedures. In addition, our scoping review includes the following exclusion criteria: those who are non-English speaking, those who are less than 18 years of age, those who are not undergoing surgical procedures while admitted, those who are unable to provide numeric pain score due to clinical status, those who are unable to provide written informed consent, and those who decline participation in the study. Data was extracted by one reviewer and verified by the remaining two group members. Extraction was divided as equally as possible among the 11 listed references. Discrepancies in data extraction were discussed between the article reviewer, project editor, and group leader. Results We identified nine primary sources addressing the use of ketamine as an alternative to opioid analgesia and post-operative pain control. Our findings indicate a positive correlation between perioperative ketamine administration and postoperative pain control. While this information provides insight on opioid-free analgesia, it also revealed the limited amount of research conducted in this area of practice. The strategies for several of the clinical trials limited ketamine administration to a small niche of patients. The included studies provided evidence for lower pain scores, reductions in opioid consumption, and better patient outcomes. Implications for Nursing Practice Based on the results of the studies’ randomized controlled trials and meta-analyses, the effects of ketamine are shown as an adequate analgesic alternative to opioids postoperatively. The cited resources showed that ketamine can be used as a sole agent, or combined effectively with reduced doses of opioids for multimodal therapy. There were noted limitations in some of the research articles. Not all of the cited studies were able to include definitive evidence of proper blinding techniques or randomization methods. Small sample sizes and the inclusion of specific patient populations identified within several of the studies can skew data in one direction or another; therefore, significant clinical results cannot be generalized to patient populations across the board.
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