Patients' experiences of postoperative respirator treatment--influence of anaesthetic and pain treatment regimens.
The influences of premedication, anaesthetic agents, and postoperative sedation and pain treatment regimens on the experiences of postoperative respirator treatment of surgical patients (n = 107) have been assessed. Of the patients, 55% recalled the respirator treatment. Administration of anticholinergic drugs and halogenated anaesthetic agents was found to impair the memory process and reduce the number of recallers, and sedation in the ICU with benzodiazepines was found to decrease the number of discomforts experienced by the recalling patients. Most of the patients who received treatment postoperatively for pain, mainly by epidural administration of local anaesthetic agents and/or morphine, recalled the respirator treatment period (85%), as compared to only 50% of the patients receiving intravenous opioids. The number and type of complaints experienced by patients receiving epidural pain treatment did not, however, differ from those reported by intravenously treated patients, and no significant adverse psychological reactions seemed to occur. It is concluded that the use of mainly regional techniques, when appropriate, for pain treatment of surgical patients needing postoperative ventilatory support seems advantageous. The primary aim of relieving pain from the wound area is achieved, allowing such light intravenous sedation and pain treatment that the possibility of communication and giving comforting reassurance is maintained. Such nursing care may be more efficient in helping the patient to cope with the stressful respirator treatment situation then heavy intravenous sedation and pain treatment regimens.
Hallenberg
B
B
Department of Anesthesia and Intensive Care, Sahlgren's Hospital, University of Gothenburg, Sweden.
Bergbom-Engberg
I
I
Haljamäe
H
H
D000777:Anesthetics / Q000494:pharmacology*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008568:Memory / Q000187:drug effects*; D010149:Postoperative Pain / Q000188:drug therapy*; D010361:Patients / Q000523:psychology*; D011184:Postoperative Period; D011229:Preanesthetic Medication; D012121:Respiration, Artificial / Q000523:psychology*
D000777:Anesthetics; D006993:Hypnotics and Sedatives