We concluded that postoperative analgesia was best in intranasal fentanyl group, sedation was maximum in intranasal ketamine group and adverse effects although minimal, were mostly observed in intranasal ketamine group. Intranasal fentanyl group showed good cardiovascular stability during perioperative period as compared to the other two groups.
Fentanyl and ketamine both produced significant post-operative analgesia in good number of patients without any significant adverse effects. Hence they are recommended for use in post-operative analgesia by intranasal instillation in nasal endoscopic surgeries.
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Prior to intubation for a surgical procedure, the anesthesiologist administered a single dose of the neuromuscular blocking agent, succinylcholine, to a 23-year-old female to provide muscular relaxation during surgery and to facilitate the insertion of the endotracheal tube. Following this, the inhalation anesthetic was administered and the surgical procedure completed.
1Fentanyl is a powerful synthetic opiate analgesic, which has a primary function in managing malignant and non-malignant contractible pain, similar to morphine however it is more potent. This is because fentanyl has an octanol-water partition of 9550 compared to morphine, which has 6. This effectively demonstrates that fentanyl is highly lipid soluble, crossing the blood brain barrier more rapidly. Hence it has a quicker reaction time but at a shorter duration compared to morphine. It is commonly used to treat patients with severe pain or patients experiencing pain after a surgery. Fentanyl can also be used to treat patients with chronic pain that are physically tolerant to opiates. Patients who are not physically tolerant to opiates should avoid the use of fentanyl as this can cause undesirable side effects, which can in some cases be toxic. Fentanyl is registered as a class II prescription drug, meaning that it has a greater potential for being abused, which could have negative implications on a patient’s health as it can result in psychological or physical dependence.1
Dr. Tagge, the lead surgeon, finally updated the family over two and a half hours later stating that Lewis did well even though he had to reposition the metal bar four times for correct placement (Kumar, 2008; Monk, 2002). Helen reported wondering if Dr. Tagge had realized how much Lewis’ chest depression had deepened since he last saw him a year ago in the office, especially considering he did not lay eyes on Lewis until he was under anesthesia the day of surgery (Kumar, 2008). In the recovery room, Lewis was conscious and alert with good vital signs, listing his pain as a three out of ten (Monk, 2002). Nurses and doctors in the recovery area charted that he had not produced any urine in his catheter despite intravenous hydration (Kumar, 2008; Monk, 2002). Epidural opioid analgesia was administered post-operatively for pain control, but was supplemented every six hours by intravenous Toradol (Ketorolac) (Kumar, 2008; Solidline Media,
This essay describes how the anaesthetic machine and airway management equipment are prepared in operating theatres and discusses how they are ensured safe for use. It evaluates the Association of Anaesthetists of Great Britain and Ireland (AAGBI) guidelines related to safe practice and the preparation of the ET tubes, laryngeal masks, guedels, Naso pharyngeal airways and the laryngoscope. The function of the anaesthetic workstation is to deliver a mixture of anaesthetic agents and gases safely to the patient during the induction process and throughout surgery. In addition, it also provides ventilation to support breathing and monitors the patient’s vital signs to minimise the anaesthetic risks to the patient whilst in the care of health professionals. The pre-use check is vital to patient safety as an inadequate check of the anaesthetic machine or airway management equipment can and does lead to significant harm of the patient including mortality (Medicines and Healthcare Products Regulatory Agency (MHRA), 2008 and Magee, 2012).
Nitrous oxide is administered via a face mask and is used to take the edge off of your nerves. This form of sedation is great for uncomplicated procedures and for patients experiencing only mild levels of fear or anxiety. If you fall into this category, nitrous oxide sedation may be for you.
Winfield, H., Katsikitis, M., Hart, L. and Rounsefell, B. (1989). Postoperative pain experiences: Relevant patient and staff attitudes. [online] 34(5): pp.543-552. Available at: http://www.sciencedirect.com/science?_ob=ArticleURL&_udi=B6T8V-45WYV7R-7G&_user=10&_coverDate=12%2F31%2F1990&_rdoc=1&_fmt=high&_orig=gateway&_origin=gateway&_sort=d&_docanchor=&view=c&_acct=C000050221&_version=1&_urlVersion=0&_userid=10&md5=35e6b5e8c8f803b487b35d4ae3b06cef&searchtype=a[ [accessed 8/5/2013]
If the drug is being used primarily to treat severe pain not responsive to other analgesics, in a painful terminal condition, (such as advanced widespread cancer), it may ...
" Chronic Pain (CP) statistics astounding according to The Institute of medicine approximately 100 million adults suffer from chronic pain which is more than heart disease, diabetes, and cancer combined."(IOM Relieving Pain in America 2011, p. 1)
If birth has been occurring since the beginning of time why do so many women act as if it’s something new? Nowadays, you have women asking for morphine, walking epidurals, and spinal epidurals. Why are so many women deciding that they can’t do a natural childbirth and what are the risks of not having one? Researchers have done studies on epidurals to determine if they cause women to get an increase in c-sections. They have also done studies to determine if getting an epidural to early will increase the chances of getting an epidural.
The dosage of the drug should be used according to the carton instructions. A 10 gram over dose in adults, 140 mg for kids, can cause permanent liver damage. Also if you had just taken some other drugs , The acetaminophen may become more toxic since the drugs are catabolized in the liver. To protect yourself from injury, you should take 1 gram of vitamin C and Cysteine -a bodily antioxidant.
Potent pain medication contains the aspects of utilizing medications such as morphine or demerol, how the medications are dispensed, and t...
As a pain killer, morphine is used in hospitals around the United States for pain management and post-surgery. The main types of consumption is through smoking, snorting, rectal, I.V, orally, and through injection. A pump can also be used to administer the drug to the patient. Most times pumps are used in extreme cases of nerve disorders which usually entail a catheter being microscopically implanted into the spinal cord.
Anesthesia is used in almost every single surgery. It is a numbing medicine that numbs the nerves and makes the body go unconscious. You can’t feel anything or move while under the sedative and are often delusional after being taken off of the anesthetic. Believe it or not, about roughly two hundred years ago doctors didn’t use anesthesia during surgery. It was rarely ever practiced. Patients could feel everything and were physically held down while being operated on. 2It wasn’t until 1846 that a dentist first used an anesthetic on a patient going into surgery and the practice spread and became popular (Anesthesia). To this day, advancements are still being made in anesthesiology. 7The more scientists learn about molecules and anesthetic side effects, the better ability to design agents that are more targeted, more effective and safer, with fewer side effects for the patients (Anesthesia). Technological advancements will make it easier to read vital life signs in a person and help better decide the specific dosages a person needs.
Kalant, Harold. “Medicinal Use of Cannabis: History and Current States.” Pain Research and Management 6.2 (2001): 80-94. Web. 18 Mar. 2014.
Pharmacology is a vital component in the perioperative practice. Medication use is monitored closely during the perioperative period. Preoperatively, there are certain drugs that must be discontinued prior to a surgery as they increase surgical risk, including anticoagulants, tranquillisers, corticosteroids and diuretics (Laws, 2010b). In fact, these drugs can increase the risk of respiratory depression, infection, fluid and electrolyte imbalance and increased risk of bleeding (Hamlin, 2010). Open communication is important in obtaining a medication history, and in identifying the drugs taken prior to the surgery. If any of these medications has be...