Ebook Orthopaedic surgery essentials hand and wrist: Part 2
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Ebook Orthopaedic surgery essentials hand and wrist: Part 2
https://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of saf Ebook Orthopaedic surgery essentials hand and wrist: Part 2fety is a building block of patient reassurance and a hallmark of modern outpatient surgery, rhe methods to be described are effective and safe in emergency rooms, outpatient settings, as well as in more formalized operating theaters. Emphasis upon outpatient surgery has dramatically increased the d Ebook Orthopaedic surgery essentials hand and wrist: Part 2esirability of effective regional and local anesthesia methods that can be used by operating surgeons and anesthesiologists. In many of the settings wEbook Orthopaedic surgery essentials hand and wrist: Part 2
here surgery is performed today, there is not an anesthesiologist available—or even necessary-. This is an additional stimulus to the operating surgeohttps://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of saf Ebook Orthopaedic surgery essentials hand and wrist: Part 2 the fact that genuine allergies to local anesthetics are exceedingly rare, if the patient describes an allergy to a local anesthetic, the surgeon should not use it. even if I he history is inconclusive or vague.If the patient is right, and a reaction occurs, the physical and legal consequences can Ebook Orthopaedic surgery essentials hand and wrist: Part 2be serious.■If a local anesthetic agent is necessary- for medical or other reasons, the surgeon should consider using an alternative drug or skin testEbook Orthopaedic surgery essentials hand and wrist: Part 2
ing.■Of the two types of local anesthetics, esters, being derived from para-aminobenzoic acid (PABA), are far more likely to produce an allergic reacthttps://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of saf Ebook Orthopaedic surgery essentials hand and wrist: Part 2ort, wheezing, coughing, sneezing, shock, and tachycardia.■Much more commonly, the patient will not have had a true allergic reaction to the local anesthetic, but rather symptoms associated with one of the following:Inadvertent direct intravenous or arterial injection of the agent or a drug overdose Ebook Orthopaedic surgery essentials hand and wrist: Part 2. These symptoms can include convulsions, disordered speech, tachycardia, or bradycardia.Reaction to local agents containing epinephrine (palpitationsEbook Orthopaedic surgery essentials hand and wrist: Part 2
, severe anxiety, tachycardia).A vasovagal reaction.An anxiety-hyperventilation event.■One can choose another type and perform a skin test.■Otherwise,https://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of saf Ebook Orthopaedic surgery essentials hand and wrist: Part 2eases the risk of implanting and spreading bacteria.4Inject more proximally to avoid multiple needle sticks and the resulting multiple punctures and patient discomfort.L Block a peripheral nene well proximal to the site of surgery.■This w ill result in less needle sticks and a larger area of anesthe Ebook Orthopaedic surgery essentials hand and wrist: Part 2sia.5Know the anatomy.■Knowing the location of peripheral nenes is necessary to accomplish a successfid regional nene block.■The sensory distributionEbook Orthopaedic surgery essentials hand and wrist: Part 2
of peripheral nerves is reasonably consistent.■Figure 8-1 represents the distribution of the three major peripheral nenes in the upper extremity.■It ihttps://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of saf Ebook Orthopaedic surgery essentials hand and wrist: Part 2diagnosis.■A patient’s injury may have resulted in damage to a nene, and that fact should be known before surgery so that one can select a proper treatment plan and choose the appropriate peripheral nene, or nenes, to block.6lake care in choosing the needle bore and type.■One has to balance the issu Ebook Orthopaedic surgery essentials hand and wrist: Part 2es of pain versus effectiveness and safety.■We tend to assume that needles of small diameter cause less pain. However, the disposable needles we use aEbook Orthopaedic surgery essentials hand and wrist: Part 2
re so sharp that patients cannot tell the difference between one with a gauge of 25 or 22.■There are several advantages to using a larger-bore needle.https://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of safhttps://khothuvien.cori!ANESTHESIAcHAJILES JkMCDOWELL KEVIN CUNNINGHAMRelief from pain delivered with a minimum of discomfort and a high degree of safGọi ngay
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