Post-Operative Recovery and Pain Relief / Edition 1

by Roger J. Eltringham, William F. Casey, Michael Durkin

Overview

This updated and revised version of Eltringham's "Post Anaesthetic Recovery" contains sections each devoted to the current best practice in a particular area. It describes the major problems that may be encountered during recovery from anaesthesia and suggests how they may be avoided by careful monitoring, vigilant nursing and sound organization. Post-Operative Recovery and Pain Relief will thus be of interest not only to nursing staff working in operating theatres and post-operative care units, but also to those working in surgical units, house officers and junior anaesthetists.

Product Details

ISBN-13:	9783540760788
Publisher:	Springer London
Publication date:	10/16/1997
Edition description:	Softcover reprint of the original 1st ed. 1998
Pages:	199
Product dimensions:	6.10(w) x 9.25(h) x 0.02(d)

About the Author

Eltringham, Roger J., MB, ChB, FRCA (Gloucestershire Royal Hospital); Durkin, Michael, MBBS, FRCA (Gloucestershire Royal Hospital); Casey, William F., MB, ChB, FRCA, MA (Gloucestershire Royal Hospital)

Table of Contents

1 The Role of the Recovery Room.- Designing a Post-anaesthesia Care Unit.- Equipment.- Equipment Required at Each Recovery Bay.- Cardiorespiratory Equipment.- Paediatric Equipment.- Miscellaneous Equipment.- Drugs and Intravenous Fluids.- Safety.- Pollution.- Blood-borne Infections.- Staffing.- Continuing Education and Training.- Policies and Prools.- References and Bibliography.- 2 Normal Recovery.- Physiology of the Elimination of Drugs Used During Anaesthesia.- Volatile Agents.- Intravenous Induction Agents.- Suxamethonium.- Non-depolarising Muscle Relaxants.- Analgesics.- Progress of Normal Recovery.- Stage IV: Medullary Paralysis.- Stage III: The Stage of Surgical Anaesthesia.- Stage II: The Stage of Excitement.- Stage I: The Stage of Analgesia.- Care-plan Nursing.- Reception of the Patient.- Basic Nursing Position and Safety.- Routine Observations.- Assessment of Colour.- Peripheral and Central Cyanosis.- Assessment of Respiratory Function.- Assessment of Cardiovascular Function.- Tissue Perfusion.- Pulse Measurement.- Doppler Ultrasonic Recorder.- Blood Pressure Measurement.- Sphygmomanometer and Stethoscope.- Oscillotonometer.- Automatic Blood-pressure Recording.- Direct Arterial Pressure Measurement.- Assessment of Level of Consciousness.- Recognition of Blood Loss.- Maintenance of the Airway.- Insertion of Oropharyngeal Airway.- Insertion of Nasopharyngeal Airway.- Suction of the Upper Airway.- Care of the Intubated Patient.- Endotracheal Suction.- Extubation.- Care of the Patient with a Laryngeal Mask Airway (LMA).- The Ventilated Patient.- Oxygen Therapy.- Administration of Oxygen.- Maintenance of Fluid Balance.- Intravenous Fluid Therapy.- Intravenous Infusions.- Intravenous Infusion Drip Rates.- Intravenous Injections.- Blood Transfusion.- Drainage Systems.- Record Keeping and Charting.- Criteria for Discharge.- Discharge to a Ward.- Discharge to Intensive Care or High-dependency Unit.- Transfer of Patient to Ward Staff.- References and Bibliography.- 3 Pain Relief and Local Anaesthesia.- Gate-control Theory of Pain.- Methods of Pain Relief.- Analgesic Drugs.- Patient-controlled Analgesia.- Balanced Analgesia.- Local Anaesthetic Techniques.- Management of Toxic Reactions.- Local Anaesthetic Agents.- Specific Local Anaesthetic Blocks.- Spinal Blockade.- Epidural Blockade.- Caudal Blockade.- Local Infiltration.- Intercostal Nerve Blockade.- Intrapleural Blockade.- Inguinal Field Blockade.- Penile Nerve Block.- Brachial Plexus Blockade.- Intravenous Regional Anaesthesia (Bier’s Block).- Digital Nerve Blockade.- Femoral Nerve Blockade.- Patient Management in the PACU.- References and Bibliography.- 4 Complications.- Respiratory Complications.- Signs of Hypoxaemia.- Signs of Hypercarbia.- Upper Airway Obstruction.- Inadequate Ventilation (Hypoventilation).- Hypoxaemia.- Bronchospasm.- Aspiration of Gastric Contents.- Pneumothorax and Haemothorax.- Tension Pneumothorax.- Cardiovascular Complications.- Hypotension.- Hypertension.- Bradycardia.- Tachycardia.- Dysrhythmias.- Cardiac Arrest.- Initial Management.- Miscellaneous Complications.- Delayed Return of Consciousness.- Restlessness, Excitement and Delirium.- Nausea and Vomiting.- Shivering.- Convulsions.- Hypothermia.- Hyperthermia.- Malignant Hyperthermia.- Blood Transfusion Reactions.- Problems Associated with Massive Blood Transfusion.- Failure of Coagulation.- Oliguria.- References and Bibliography.- 5 Recovery in Different Branches of Surgery.- Emergency Surgery.- Surgery for Trauma.- Surgery in the Accident Department.- Gastroenterology.- Endoscopy.- Upper Gastrointestinal Tract Bleeding.- Surgery for Intestinal Obstruction or Peritonitis.- Bowel Surgery.- Orthopaedic Surgery.- Plaster Casts.- Traction.- Reduction of Fractures.- Hip Operations.- Fractured Vertebrae.- Obstetrics and Gynaecology.- Caesarian Section.- Evacuation of Retained Products of Conception; Suction Termination of Pregnancy.- Laparoscopy.- Hysterectomy.- Ear, Nose and Throat Surgery.- Tonsillectomy.- Laryngoscopy.- Tracheostomy.- Operations on the Nose.- Middle-ear Surgery.- Thyroid Surgery.- Airway Problems.- Thyroid Crisis or Storm.- Dental and Faciomaxillary Surgery.- Post-operative Bleeding.- Wiring of the Jaw.- Fracture of the Zygomatic Arch.- Mentally Handicapped Patients.- Ophthalmic Surgery.- Position.- Intra-ocular Pressure (IOP).- Pupil Size.- Analgesia.- Drug Interactions.- Neurosurgery.- Thoracic Surgery.- Bronchoscopy.- Thoracotomy.- Pain Relief.- Vascular Surgery.- Pain Relief.- Genito-urinary Surgery.- Prostatectomy.- Nephrectomy.- Circumcision.- Paediatric Surgery.- Maintenance of Airway and Adequacy of Ventilation.- Maintenance of Adequate Cardiovascular Function.- Temperature Regulation.- Fluid Balance.- References and Bibliography.- 6 Pre-existing Factors Affecting Recovery.- Premedication.- Anaesthetic Technique.- Intravenous Induction Agents.- Long-acting Inhalational Agents.- Analgesic and Relaxant Technique.- Regional Anaesthesia.- Induced Hypotension.- Ketamine.- Pre-operative Drug Therapy.- Anti-hypertensive Agents.- Monoamine Oxidase Inhibitors (MAOIs).- Corticosteroids.- Insulin and Hypoglycaemic Agents.- Anticoagulants.- Diuretics.- Antibiotics.- Digoxin.- Respiratory Disease.- Chronic Bronchitis.- Asthma.- Cardiovascular Disease.- Coronary Artery Disease.- Hypertension.- Cardiac Failure.- Pacemaker.- Neuromuscular Disease.- Myasthenia Gravis.- Muscular Dystrophy.- Paraplegia.- Liver Disease.- Renal Disease.- Endocrine Disorders.- Diabetes Mellitus.- Thyroid Disease.- Hypothyroidism.- Hyperthyroidism.- Phaeochromocytoma.- Porphyria.- Haematological Disease.- Iron-deficiency Anaemia.- Haemophilia.- Sickle Cell Disease.- Deficiency of Clotting Factors.- Musculoskeletal Disease.- Rheumatoid Arthritis.- Osteoporosis.- Ankylosing Spondylitis.- Geriatric Patients.- Pregnancy.- Malnourishment.- Obesity.- References and Bibliography.- 7 Recovery and Day Surgery.- Patient Selection.- Social Circumstances.- Medical Factors.- Procedure Selection.- Examples of Suitable Procedures.- Pre-admission Clinic.- Documentation.- Anaesthetic Management.- Recovery from Anaesthesia.- Discharge from the Hospital.- Paediatrics.- Management.- Post-anaesthetic Complications.- Pain.- Regional or Local Anaesthesia.- General Anaesthesia.- References and Bibliography.- 8 Monitoring.- ASA Classification.- Routine Monitoring.- Respiratory System.- Cardiovascular System.- Metabolic Systems.- Neurological System.- Specific Monitors.- Electrocardiograph (ECG).- Arterial Pressure.- Invasive Methods.- Non-invasive Methods.- Pulmonary Artery Pressure.- Oxygen Saturation.- Neuromuscular Blockade.- Carbon Dioxide Tension.- References and Bibliography.- Appendix A Drugs Commonly Used in the PACU.- Appendix B Translations of Standard Recovery Phrases.

Editorial Reviews

Reviewer: Diana Sullivan, RN, MSN, CNOR (Indiana University Medical Center)
Description: This is the third edition of a review of the basics of recovery room nursing care, pain management, and potential complications. The second edition was written in 1989.
Purpose: The stated purpose of the book is to describe the problems encountered in recovery room nursing and how they can be avoided. Of the eight chapters, one specifically addresses complications and two touch on the topic. The remainder of the book addresses basic recovery room nursing practice. Although the stated purpose was met, the book is really a composite of all aspects of nursing practice.
Audience: The book is written for operating room and recovery room nursing staff as a source of practical information. The authors also state that the book would be a resource for residents and junior anesthesiologists. This is a great basic text for new recovery room nurses, but it is too superficial for medical staff.
Features: The illustrations are simplistic and straightforward, illustrating the concepts. Although the references are a mix of British, Canadian, and American, they are predominantly British. A fair number of the references are pre-1980, with some as dated as 1961. The overall appearance of the book is good. It progresses from basic introductory comments to more detailed concepts.
Assessment: The book does an outstanding job presenting the basics of recovery room nursing practice, but little in-depth pathophysiological content is included. The material is dated with regard to references and terminology. The content is geared toward beginning practitioners, regardless of specialty area. Topics such as CPR and EKGs are introduced as unfamiliar topics with step-by-step procedural instructions instead of being introduced as familiar nursing treatment modalities. As this edition includes additional information of pain management and day surgery, it is a needed revision.

Doody's Review Service

3 Stars from Doody

This is the third edition of a review of the basics of recovery room nursing care, pain management, and potential complications. The second edition was written in 1989. The stated purpose of the book is to describe the problems encountered in recovery room nursing and how they can be avoided. Of the eight chapters, one specifically addresses complications and two touch on the topic. The remainder of the book addresses basic recovery room nursing practice. Although the stated purpose was met, the book is really a composite of all aspects of nursing practice. The book is written for operating room and recovery room nursing staff as a source of practical information. The authors also state that the book would be a resource for residents and junior anesthesiologists. This is a great basic text for new recovery room nurses, but it is too superficial for medical staff. The illustrations are simplistic and straightforward, illustrating the concepts. Although the references are a mix of British, Canadian, and American, they are predominantly British. A fair number of the references are pre-1980, with some as dated as 1961. The overall appearance of the book is good. It progresses from basic introductory comments to more detailed concepts. The book does an outstanding job presenting the basics of recovery room nursing practice, but little in-depth pathophysiological content is included. The material is dated with regard to references and terminology. The content is geared toward beginning practitioners, regardless of specialty area. Topics such as CPR and EKGs are introduced as unfamiliar topics with step-by-step procedural instructions instead of being introduced as familiar nursingtreatment modalities. As this edition includes additional information of pain management and day surgery, it is a needed revision.

Diana Sullivan