|
| |
|
|
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...
|
|
| |
|
|
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...
|
|
|
Expectations versus hospital reality in women undergoing elective caesarean section
Procházková, Zuzana ; Bláha, Jan (advisor) ; Fanta, Michael (referee)
Each expectant mother comes into the hospital with some idea of how the delivery will proceed, including the c-section. These ideas, created on basis lay and professional opinions, can be dramatically different from the resulting reality. This work deals with the choice of anesthesia for planned c-section from the perspective of expectant mothers. The theoretical part of the work is devoted to current possibilities and trends in obstetric anaesthesia. It describes the types of anesthesia (local vs. total) from the perspective of medicine and from the perspective of mothers in preparation to this operational performance. The aim of the empirical part of the work is the comparison of preoperative expectations of expectant mothers with the resulting hospital reality. It was found out by the quantitative questionnaire method. The questionnaire is divided into two parts- the part before the c-section and the postoperative part. The aim of the work is the detection what information sources influence mothers ideas of the course of the operating, the influences for their decisions of the choice of anesthesia, and how the information is valid and objective. The data are treated in detail in the empirical part. The work also discussion in which the survey results are compared with the stated aims and claims...
|
|
| |
|
| |
|
|
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.
|
|
|
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.
|
|
|
The communication in the stomatology with presschool children.
KŘESALOVÁ, Danuše
Abstract Communication in nursing is the foundation for building up a quality therapeutic relationship between the nurse and the patient. A properly guided conversation, knowledge and use communication skills help the nurse to influence positively the patients, to educate them, to motivate and persuade them to cooperate reasonably. My motivation to write this bachelor thesis focused on communication in dentistry with a preschool age children are children sent to our department of dental surgery in České Budějovice for dental treatment under total anaesthesia. These children could not be treated in a dental armchair. The research is quantitative and qualitative. The quantitative research was conducted using the method of questioning. The technique of data collection involved the use of a questionnaire. A total of 100 questionnaires were distributed to nurses at dental ambulatory care centres and 70 of them were returned completely filled in. The results are presented in graphs. The qualitative research with parents of the children treated under total anaesthesia for dental rehabilitation was conducted in the form of individual depth interviews. The interviews are recorded and the results have been processed into a tabular form. The objective of this thesis was to find out about the nurses? positions to their own communication skills necessary for the successful treatment of preschool age children. The objective has been met. Hypotheses were formulated. H1 - Nurses are interested in communication training in dentistry focused on children of preschool age; this hypothesis has been confirmed. H2 - Nurses use the principles of communication with children of preschool age in dentistry; this hypothesis has not been confirmed. The other objective of this thesis was to identify options which could reduce the number of children that should be treated under total anaesthesia at the department of dental surgery in České Budějovice. Further, a research question was asked whether it is possible to reduce the number of children treated under total anaesthesia at a dental surgery department by establishing communication with their parents. The objective has been met. The results of the thesis show the benefits of encouraging nurses to participate in workshops on communication with child patients. It will also be possible to publish the results in specialised publications.
|
guest ::
