INTRODUCTION
Pain: According to the International Association for the study of pain, “It is an unpleasant and sensory and emotional experience associated with actual or potential tissue damage or described in terms of such damage.” Pain is frequently the result of nocioception, an activity in the nervous system that result from the stimulation of nocioceptors.
Sedation: The American College of Emergency Physicians (ACEP) defines the procedural sedation as "a technique of administering sedatives or dissociative agents with or without analgesics to induce a state that allows the patient to tolerate unpleasant procedures while maintaining cardiorespiratory function. Procedural sedation and analgesia (PSA) is intended to
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It is used in combination with anesthesia to prevent pain during or postoperative period. It has a prompt onset and shorter duration of action. It has minimal cardiovascular depressive effects and hypotension rarely occurs. Fentanyl binds with stereospecific opioid receptors at many sites within the CNS and increases the pain threshold, alters pain reception, and inhibits ascending pain pathways. In addition to analgesia, it suppress the cough reflex and cause respiratory depression, drowsiness, and sedation. The half-life is 2-4 hours.
DEXMEDETOMIDINE: It is an alpha2-adrenergic agonist. It provides, analgesia, sedation, anxiolysis, hypnosis and sympatholysis. It provides very little or no respiratory depression. The patients are able to respond and follow verbal commands but fall quickly asleep when not stimulated. It also provide some pain relief, like ketamine, but not to the same degree. This makes the use of other analgesics necessary for the more painful procedures while using it. The cardiovascular effects are minimal and include mild bradycardia and a decrease in systemic vascular resistance. The onset of action is relatively rapid and the context-sensitive half-time is approximately 4 minutes after a 10-minute infusion. It is upto 1600 times more selective for the alpha2 than alpha1 receptors and therefore has a very few side
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
Naloxone [Narcan] is a structural analog of morphine that acts as a competitive antagonist at opioid receptors, thereby blocking opioid actions. Naloxone can reverse most effects of the opioid agonists, including respiratory depression, coma, and analgesia (Lehne, 2013). Naloxone may be administered IV, IM, Intranasal, or subQ. Following IV injection, effects begin almost immediately and persist about 1 hour. Following IM or subQ injection, effects begin within 2 to 5 minutes and persist several hours (Lehne, 2013).
It is not uncommon for a patient to experience pain and anxiety before or after a major procedure or breathing treatment. Imagining the myriad of complications that might occur during an operation can send one into multiple panic attacks. Coping with the loss of mobility and independence joined by the pain that accompanies recovery are only a few examples of the complex and traumatic experiences awaiting pre/post-operation patients. Fortunately, a medication was synthesized by Armin Walser and Rodney I. Fryer in 1975 to aid patients by easing anxiety and promoting sleepiness before an operation. An added benefit was that the events experienced during the operation were also forgotten while the medication was still in effect.
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.
What exactly is pain? According to Webster's dictionary, pain is "physical suffering typically from injury or illness; a distressing sensation in a part of the body; severe mental or emotional distress". Most everyone reading this paper has experienced some form of physical pain at some point during their lives; most everyone has even experienced the common daily pains such as stubbing our toe as we walk through the living room, accidentally biting our tongue as we chew, and having the afternoon headache after a long day of work. No matter the fact that it is unpleasant, pain has a very important role in telling the body that something is not right and leading to behavior that will remove the body from a source of potential injury. Imagine if we could not experience pain. We would not be able to change our behavior in any way when touching the burning hot dish in the oven, resulting in potentially serious burns. We could not recognize that perhaps we twisted an ankle when walking down the stairs, thus continued walking on that foot would exacerbate the injury to the point of not being able to walk at all. Indeed, pain is not pleasant, but in many cases it is an important way for our nervous system to learn from and react to the environment.
Now let’s break down what General Anesthesia actually is. General Anesthesia makes you both unconscious and unable to feel pain during medical procedures. A study done by a team from Harvard Medical School, Weill Cornell Medical college, and the Massachusetts Ins...
Volles, D. F. (2011, April 11). University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures. Retrieved May 12, 2011, from University of Virgina Health System: University of Virginia Health System Adult and Geriatric Sedation/Analgesia for Diagnostic and Therapeutic Procedures
Have you ever wondered why you have no feeling during surgery? The reasoning behind this is a doctor called an anesthesiologist. For those who are wondering who they are and what they do, anesthesiologists are doctors who, after completing many years of school and training, work many hours to make sure patients feel no pain during surgery, and earn a good salary along with good benefits.
Sedation dentistry involves the use of medications to allow a patient to relax when they
Conclusions. An adequate and clear understanding of the concept of pain and implementing interventions of pain treatment and management is essential in the clinical settings. Understanding the concept of pain is necessary for its relationships with other concepts that are related and similar to the pain experience for theory building. The in the end, understanding the concept of pain will ultimately benefit the patient and lead to better and approp...
The practice of patient-controlled analgesia (PCA) has been around for approximately four decades now. During this time there have been improvements to the technology and the understanding of how to use this form of patient pain control; however, there continues to be concern related to the safety and efficacy of PCA. As this analysis proceeds it will briefly explain what PCA is and how it is used, then delve into the benefits and the safety issues surrounding PCA use as it pertains to the patient and the nurse. Some of the benefits of PCA include improved pain management, improved use of nursing resources, increased patient satisfaction, and reduced pulmonary issues (Hicks, Sikirica, Nelson, Schein & Cousins, 2008). Some of the safety issues surrounding PCA use include infusion pump programing errors, basal infusion dosing, and proxy errors when using PCA by proxy (Ladak, Chan, Easty, & Chagpar, 2007). Therefore, the purpose of this report is to examine the benefits and risks of patient-controlled analgesia and how it relates to nursing practice.
...., & Jr, L. H. (1992). Release of vasoactive substances during cardiopulmonary bypass. Annals of Thoracic Surgery. doi:10.1016/0003-4975(92)90113-I-6
it, only slow it down. In the first stages the drugs are very successful. and the patient is kept in relatively good health. In the final stages However, drugs are almost completely unsuccessful and the only thing that can be done for a patient is to make him comfortable with easing drugs. They are a good choice.
The discovery I have decided to investigate and enlighten about was anesthesia. Anesthesia, formed by Thomas Green Morton, made history in 1846. Anesthesia is frequently used in medicine to dose the hospitalized person into a dazing, and possible sleep inducing situation. As stated beforehand in the paragraph, many people will recognize anesthesia as a painkiller that takes away the agony of surgery.
Most commonly the general anesthesia is given by using endotracheal intubation. General anaesthesia with endotracheal intubation is a time-tested procedure and most routinely practiced all over the world. The procedure has evolved over many years. The procedure of laryngoscopy and endotracheal intubation is associated with pressor response and rise in intraocular pressure. It is also characterised by increase in heart rate, transient rise in blood pressure and rise in Intraocular pressure.