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Opioids in caesarean section
Nosková, Pavlína ; Bláha, Jan (advisor) ; Málek, Jiří (referee) ; Vymazal, Tomáš (referee)
The thesis is focused on perioperative use of opioids during caesarean section. The general part is concerned with pharmacology of opioids due to their practical use during general and regional anaesthesia and postoperative analgesia with particular focus on remifentanil. Emphasis is put on the placental transfer of opioids into breast milk which has the possible influence on postnatal adaptation of the newborns and breastfeeding/lactation. The first part of the research describes current anaesthetic practice and opioid use in obstetrics in the Czech Republic according to the OBAAMA-CZ study in 2011. The second study on a unique group of 151 parturients showed that bolus application of remifentanil at a dose of 1 μg/kg at the time of 30 seconds before induction of general anaesthesia for caesarean section significantly stabilizes maternal hemodynamic parameters (blood pressure, heart rate) and reduces the stress response to tracheal intubation and skin incision. On the contrary, no influence on depth of anaesthesia (monitored by BIS) was found. But we demonstrated a slight effect of remifentanil on the assessment of postnatal adaptation of newborns at first minute after delivery. However, this attenuation was very short and in the fifth minute the results were already fully comparable to the control...
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Opioids in caesarean section
Nosková, Pavlína ; Bláha, Jan (advisor) ; Málek, Jiří (referee) ; Vymazal, Tomáš (referee)
The thesis is focused on perioperative use of opioids during caesarean section. The general part is concerned with pharmacology of opioids due to their practical use during general and regional anaesthesia and postoperative analgesia with particular focus on remifentanil. Emphasis is put on the placental transfer of opioids into breast milk which has the possible influence on postnatal adaptation of the newborns and breastfeeding/lactation. The first part of the research describes current anaesthetic practice and opioid use in obstetrics in the Czech Republic according to the OBAAMA-CZ study in 2011. The second study on a unique group of 151 parturients showed that bolus application of remifentanil at a dose of 1 μg/kg at the time of 30 seconds before induction of general anaesthesia for caesarean section significantly stabilizes maternal hemodynamic parameters (blood pressure, heart rate) and reduces the stress response to tracheal intubation and skin incision. On the contrary, no influence on depth of anaesthesia (monitored by BIS) was found. But we demonstrated a slight effect of remifentanil on the assessment of postnatal adaptation of newborns at first minute after delivery. However, this attenuation was very short and in the fifth minute the results were already fully comparable to the control...
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Nursing care of a patient after general anesthesia.
SOJKOVÁ, Kateřina
The Bachelor Thesis provides a lot of information on the general anaesthesia, presents different aspects of the nursing care including the most frequent diagnoses, mentions the most common complications which patients after the general anaesthesia suffer from, and the extent of knowledge the nurses have on complications which occur during the recovery after the general anaesthesia. It is mainly the basic knowledge of nurses concerning the complications after GA which helps to make proper nursing diagnosis, set the aims and decide on interventions in the process of nursing care for the patient after GA. Results of the research work are useful for making the nursing care standard concerning the patient after GA. This standard can serve as a brief and well-arranged manual in the process of nursing and can provide the patient with comfort and security which are necessary aspects of the quality nursing care after the general anaesthesia.
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Problems in nursing care for klient with general and epidural, spinal anesthesia
PŘEDOTOVÁ, Jana
Abstract:Problems of nursing care for a client with general and epidural spinal anaesthesia.The topic of the Bachelor Thesis is ?Problems of nursing care for a client with general and epidural spinal anaesthesia?. The Thesis has three goals. The first goal is to map the knowledge of the general anaesthesia issues among nurses. The next goal is to map the knowledge of epidural spinal anaesthesia among nurses and the last goal is to check adherence to the nursing care principles in general and epidural spinal anaesthesia.The work consists of a theoretical part and a practical part. The theoretical part deals with definition of general and epidural spinal anaesthesia, their indications and counter indications, the spinal canal anatomy, applied pharmaceuticals and nursing care before, during and after general and epidural and spinal anaesthesia.The research part is based on quantitative data collection method by means of a questionnaire. Standard surgical, gynaecology and orthopaedic wards and an intensive care unit including casualty ward were involved. The questionnaire was designed for nurses and consisted of 35 questions, which may be divided into identification and knowledge ones.The goals of the Thesis have been met. Hypothesis No. 1 ?Nurses are better informed in the field of general anaesthesia then spinal, epidural anaesthesia? was refuted. Hypotheses No. 2 ?ICU and casualty ward nurses adhere to the principles of nursing care for clients with general and epidural spinal anaesthesia better than those at standard wards? and No. 3 ?Nurses adhere to the principles of nursing care for clients with general and epidural spinal anaesthesia? were refuted. Hypotheses No. 4 ?Nurses of standard wards care about more patients after general anaesthesia?, No. 5 ?ICU and casualty ward nurses valuate epidural spinal anaesthesia higher than general anaesthesia? and No. 6 ?Nurses observe that patients prefer general anaesthesia to epidural spinal anaesthesia if they can choose? were confirmed.The research results show that nurses do not have sufficient information in the field of general and epidural spinal anaesthesia. This is why this Thesis may be used for further education of nurses to improve their knowledge and to make them adhere to the nursing care principles in the field of general and epidural spinal anaesthesia. This is why educational material dealing with the general and epidural spinal anaesthesia will be prepared, designed for nurses to improve their information. Better information for nurses might lead to improvement of the health care provided.
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