ABSTRACT
Background : Inaccurate intracuff pressure of endotracheal tube (with measurements being too high or too low) is the main cause of respiratory complications in intubated patients, such as aspiration, tidal volume leakage, tracheal is chemia, necrosis or stenosis. Subjective assessments by physicians or nurses have very low reliability and are inaccurate. Objective measurements are more reliable, can reduce respiratory complication and should be the standard method used.Objective : To increase awareness among nureses of the complications of inaccurate intracuff pressure assessments; to encourage the use by nurese of a simple apparatus that provides more accrate measurements ; and to encourage the use of this method as a standard procedure for intubated patient.Design : Descriptive study..Setting : Srinagarind Hospital, Faculty of Medicine, Khon Kaen University.Subjects : 157 of 289 nurese (54.3%) who cared for intubated patients between 1 September 1997 and 30 April 1998.Meawurements: Date were collected by questionnaires before and after group meetings in which intracuff pressure measurements using a simple apparatus were demonstrated. The data were presented as percentages and means.Results : 84.1% of nurses accepted and agreed to use a new method. 93.6% of them accepted the method for routine nursing care.Conclusions : A large mafority of nurses accepted the objective measurements instead of their previous subjective assessments and thought that they should be the standard method for routine nursing care. The objective method can prevent or reduce respiratory complications in intubated patients.Key words : High volume low pressure endotracheal tube cuff, Intracuff pressure, Measurement, Apparatus.
ABSTRACT
Background: Urinary retention is a common postoperative complication associated with multifactorial risk factors such as types of anesthesia, surgery, analgesics, anticholinergics, and underlying medical conditions.Objective: The goal of this study was to surveillance of the incidence of urinary retention following the single use of spinal and epidural anesthesia in Srinagarind Hospital.Methods: A retrospective study was performed by reviewing the medical records of 1,538 surgical patients undergoing spinal or epidural anesthesia from January 1, 2005 to December 31, 2006. We defined urinary retention as occurring when intermittent urinary catheterization was performed after surgery within 24 hours. We collected variables including age, gender, type of surgery and anesthesia. Descriptive analysis was used to determine the incidence and associated risk factors.Results: The overall incidence of urinary retention after the single use of spinal and epidural anesthesia were 11.2% (95%CI, 9.7-12.9). The study showed a positive correlation between male patients with ascending age. The incidence of urinary retention after spinal anesthesia was 9.9% (95%CI 8.4-11.6). Increasing age (odds-ratio [OR] is 1.7; p-value is 0.002) was found to be the only factors significantly associated with postoperative urinary retention. Gender, type of surgery and choice of anesthesia were not found to be significantly associated with urinary retention.Conclusion: In our patient population, male patients and increasing age are at increased risk of developing urinary retention following single dose spinal or epidural anesthesia. Key words: urinary retention, incidence, spinal and epidural anesthesia,
ABSTRACT
Background: Nowadays surgery is one choice of therapeutic and diagnosis. The impact of surgery may affect behavior of the patients and their family in manyways. They must adjust the perception to acquire an appropriate attitude and/or mind preparation. They consequently can re-plan to lead a normal life after surgery. The anesthesiologists and teams can be aware of the patients perception and behavior in preoperation, intraoperation, and postoperation that they can managed effectively.Objective: The aim of this research was to explore perception of Northeast Thailand patients who undergo surgery Study Design: Qualitative researchTarget population: The patients waited for surgery and the family, and the ones who already had surgery and amounted to 26, 10 men and 16 women.Methods: The participants in the Northeast Thailand, inpatient department of Srinagarind hospital were in-depth interviewed by using semi-structured interview form (SSI) prior to focus group discussion. The data were collected between September 2003 and April 2004. Content analysis and analytical description were presented.Results: This study revealed that their perception about surgical meaning and adjusting the attitude towards the operation are as follows. As to the meaning they though that 1) surgery will help the patients live longer, 2) surgery will cure their illnesses, 3) surgery is a matter of faith in the surgeons to cure the disease, 4) Both general and regional anesthesia are included in surgery, 5) surgery causes fear, 6) surgery is a means to perceive information and experience the pain sensation, and 7) surgery is a last resort of the illness that the patients must accept.Conclusion: The over-all results could be advantageous for the health professional team to realize perception and need of the patients. There are points that could be incorporated in the planning of holistic care to satisfy the patients.Key words: perception of patients, surgery, anesthetic service