Analgesia in PACU: indications, monitoring, complications
| Autor: | Maria Loreto, Gennaro Savoia, E Gravino, Alfredo Erman |
|---|---|
| Přispěvatelé: | Savoia, G, Gravino, Elvira, Loreto, M, Erman, A. |
| Jazyk: | angličtina |
| Rok vydání: | 2005 |
| Předmět: |
Pharmacology
Analgesics Pain Postoperative biology Nausea business.industry Sedation Clinical Biochemistry Guidelines as Topic Surgical wound biology.organism_classification Triage Pacu Anesthesia Drug Discovery medicine Vomiting Humans Molecular Medicine Anxiety medicine.symptom Adverse effect business Monitoring Physiologic Recovery Room |
| Popis: | The correct treatment of postoperative pain, in the early period immediately following surgery, is founded on the following four principles: 1-correct diagnosis of the source and magnitude of nociception; 2-understanding of the relationship of ongoing nociception and other components of pain including anxiety, ethnocultural components, meaning, prior experience; 3-treatment by establishment and maintenance of drug level at active sites to achieve and maintain analgesia and anxiolysis as appropriate; 4-continued re-evaluation of the therapy and refinement of the approach. The PACU standard of cure requires a strict accordance between intra and postoperative analgesia. It requires "proactive preoperative plan" that includes: preoperative patient evaluation; discussion with a single patient on different treatment options; patient and family education; pre-emptive measures as indicated; intra-operative multimodal analgesia; a correct triage of analgesia, just after initial evaluation of vital parameters in PACU; re-evaluation of analgesia plan, if analgesia is inadequate; a new titration, intravenous or epidural way, in order to achieve a stable VAS < 3; plan a new analgesia scheme or confirm a preoperative plan; control of adverse events, related to analgesia plan (gastric bleeding and/or bleeding of the surgical wound site, NSAIDs-induced renal damage, respiratory depression, delayed canalisation, nausea, vomiting, excessive sedation, difficulty in bladder emptying, itchiness); a transmission of analgesia plan to ward nurses; a control quality for verify at prefixed times patients satisfaction level, analgesia performed, adverse effects percent, analgesia related, plan variations percent. |
| Databáze: | OpenAIRE |
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