ANESTHESIA EFFECTS ON CHILDREN
By: Hunter, Erin, Marc, Elise, and Alexis
INTRODUCTION
A nurse anesthetists responsibilities is to assess the patient before administering medication and producing a plan to recommend what medication should be given and the amount. Must give notes after the procedure to the post op team
The medications given have an effect on the child relating to their oxygenation throughout the procedure
Vital signs must be monitored throughout the procedure to ensure the patient is stable
PICO QUESTION
How does anesthesia effect a child in surgery?Population: Children Intervention: anesthesia medication Comparison: type of medication & amount given
Outcome: patient has successful outcome after surgery
NURSING RESEARCH: ARTICLE
“Effects of Anesthetic Agents on Blood Brain Oxygenation Level Revealed with Ultra-high Field MRI”Done because of conflicting results with KetamineWhy use an MRI?Done on rats isoflurane, ketamine-xylazine, and medetomidine How is this related to a nurse anesthetist’s job?
PSYCHOLOGY RESEARCH: PROPOFOL
Background
First used in 1977
Approved by FDA in 2008
Brand name is Diprivan
PSYCHOLOGY RESEARCH: PROPOFOLUSES AND SIDE EFFECTS
Side effects
- Pain at injection site- Seizure - Weak and shallow
breathing
Uses
- Surgery- Medical exams- Patients on ventilators- Sedation during MRI’s
PSYCHOLOGY RESEARCH: HALF LIFE OF PROPOFOL
PSYCHOLOGY RESEARCH: ANESTHESIA USE IN THE PEDIATRIC ICU
Objective: Evaluate Propofol anesthesia delivered to pediatrics in a PICU who undergo oncology procedures
Testing: They studied fifty procedures on 28 pediatric patients ranging from 3 to 12 years old. The study recorded the time the patient entered the PICU, the time anesthesia administration, procedure start and end time, recovery time and discharge time.
PSYCHOLOGY RESEARCH: RESULTS
Time in MinutesPhase (Mean [+ or -] SD) Admit to PICU to the start of 24.6 [+ or -] 9.9 Anesthesia Start of anesthesia till 1.5 [+ or -] .7 anesthetized (Induction Time) Anesthetized to the start of 5.9 [+ or -] 2.6 Procedure Start of procedure to the end of 14.3 [+ or -] 11.3 procedure (procedure time) Anesthesia end time till awake 23.4 [+ or -] 11.5 (recovery time) Awake till discharge from PICU 23.5 [+ or -] 17.5 Length of stay 88.8 [+ or -] 27.7
PSYCHOLOGY RESEARCH: VERSED
Also known as Midazolam
Falls in the category of benzodiazepines
Often combined with Fentanyl
VERSED USES AND SIDE EFFECTS
USES
Procedures that do not require general anesthesia
“Twilight sleep”
In ICU to induce a “coma”
SIDE EFFECTS
• Respiratory depression
• Tachycardia or bradycardia
• Swelling
• Nausea
MIDAZOLAM VS. PROPOFOL
NURSING THEORY
Sr. Callista Roy
COGNITIVE THEORY : JEAN PIAGET
Ranges from infancy to adolescent
- Stages:Sensorimotor (birth- two years)Preoperational (2-7 years)Concrete operational (7-11 years) Formal Operational (11- older)
MAJOR RESEARCH FINDINGS
Medications can affect people in several different ways and it is really important to know what medication is right for your patient.
Propofol is a commonly used anesthetic due to its relatively low risk factor and short half life which allows the patient to be awake with little or no side effects in little as 20 minutes from the end of administration.
Versed, or Midazolam has a slower onset than other drugs, but when it is carefully combined with other anesthetics it can be highly effective in providing ideal comfort for a patient.
There are many ways to use Sr Callista Roy's Adaptation Model. It can be applied to the disease process, new diagnoses and day to day nursing care.
Every person might react differently to drugs no matter what age but younger people are more likely to have a reaction due to the brain not fully developed
CONCEPT MAP
Anesthesia Effects
Health Promotion-Educating the patient on the possible side effects before surgery-Educate the patient on how to have a safe recovery
Ethics - Do not give
patient medication faster than recommended time
- - Always check drug compatibility
Diversity-medication effects everyone differently
Lifespan consideration-different dosages based on weight and age- Monitor infants and elderly more frequently
Resources- Consult another nurse
about drug- Consult with
anesthesiologist - Research
Leadership- Main caregiver
during surgery- Researching the
best drug and does
Information Systems- Access to
latest drug studies
- Document all findings
- Review patient history
CLINICAL IMPLICATION
Asses the patient before administering
medication
Brain damage could be caused
Patient comfort during surgery
Make sure the patient receives the correct dosage
CONCLUSION
REFERENCES
Taylor, C. (2011). Theory, Research, and Evidence-based practice. Fundamentals of nursing: the art and science of nursing care(7th ed., ). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Roy's Adaptation Model. (2013, September 9).Roy's Adaptation Model. Retrieved April 20, 2014, from http://currentnursing.com/nursing_theory/Roy_adaptation_model.html
Anderson, B. D., Dalton, H. J., Gootenberg, J. E., Hauser, G. J., Hertzog, J. H., & Shad, A. T. (2000, October). Prospective Evaluation of Propofol Anesthesia in the Pediatric Intensive Care Unit for Elective Oncology Procedures in Ambulatory and Hospitalized Children. Pediatrics, 106(4), 742. Retrieved from http://go.galegroup.com/ps/i.do?id=GALE%7CA66665100&v=2.1&u=lom_ferrissu&it=r&p=AONE&sw=w&asid=610dc4b08a1e1ed899bcd420eb 220e9a
Propofol Official FDA information, side effects and uses.. (March, 2003). Propofol Official FDA information, side effects and uses.. Retrieved April 24, 2014, from http://www.drugs.com/pro/propofol.html
Diprivan (Propofol) Patient Information: Side Effects and Drug Images at RxList. (n.d.). RxList. Retrieved April 24, 2014, from http://www.rxlist.com/diprivan-drug/patient-images-side-effects.htmCiobanu L, Reynaud O, Uhrig L, Jarraya B, Le Bihan D (2012) Effects of Anesthetic Agents on Brain Blood Oxygenation Level Revealed with Ultra-High Field MRI.
PLoS ONE 7(3): e32645. doi:10.1371/journal.pone.0032645
Lamdin, R., & Shaw, S. (2011, August). Nurses have an ethical imperative to minimize procedural pain. Kai Tiaki: Nursing New Zealand, 17(7), 12+. Retrieved from http://
go.galegroup.com/ps/i.do?id=GALE%7CA266344840&v=2.1&u=lom_ferrissu&it=r&p=AONE&sw=w&asid=2e190fb6b16b1538a38842d1d854e7c
Taylor, C., Lillis, C., LeMone, P., & Lynn, P. (2011). Fundamentals of nursing: The art and Science of nursing care (7th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.364.
The blood supply of the brain and spinal cord (2001). National Center for Biotechnology. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK11042/
MORE REFERENCES
(2013). Medazolam. Drugs.com. Retrieved from http://www.drugs.com/cdi/midazolam.html
Aoki, K., Gokan, D., Hirose, N., Iwasaki, K., Kato, J., Ogawa, S., Ogawa, Y. (2010). The Different Effects of Midazolam and Propofol Sedation on Dynamic Cerebral Autoregulation. Anesthesia & Analgesia, 111(5). Retrieved from http://journals.lww.com/anesthesia- analgesia/Fulltext/2010/11000/The_Different_Effects_of_Midazolam_and_Propofol.30.aspx
Heisler, J. (2014). Versed (Medazolam). About.com Surgery. Retrieved from http://surgery.about.com/od/beforesurgery/qt/VersedMidazolamVersed.htm
Roth, M. (2011). Parasympathetic Nervous System Dominance. Dr. Michael Roth’s Weblog. Retrieved from http://drmichaelroth.wordpress.com/2011/08/03/parasympathetic-nervous-system-dominance/
Roth, M. (2011). Sympathetic Nervous System Dominance. Dr. Michael Roth’s Weblog. Retrieved from http://drmichaelroth.wordpress.com/2011/07/05/sympathetic-nervous-system-dominance/
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