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Cerebral syrebrist hos sövda patienter som genomgår axelkirurgi i Beach-chair position
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
2015 (Swedish)Independent thesis Basic level (degree of Bachelor), 10 credits / 15 HE creditsStudent thesis
Abstract [sv]

Bakgrund: Cerebral syrebrist är ett problem som kan ge katastrofala konsekvenser även hos friska individer. Patienter som skall genomgå axeloperation i beach-chair position är en patientgrupp som har högre risk att drabbas av cerebral syrebrist (CDE). CDE är dock svårt att detektera med konventionell intraoperativ övervakning.Syfte: Att undersöka förekomst av CDE hos sövda patienter som genomgår axelkirurgi i beach-chair position samt att identifiera de specifika riskfaktorer för CDE och åtgärder som anestesisjuksköterskan kan utföra för att reducera dessa.Metod: Deskriptiv litteraturstudie med systematisk ansats.Resultat: Incidensen av uppmätta CDE varierade i de olika studierna mellan 3 % och 80 %. Anestesisjuksköterskan kan minska risk för CDE genom att preoperativt bedöma riskfaktorer i patientens anamnes samt intraoperativt genom blodtrycksreglering, ventilationsförändring, kontroll av beach-chair position samt kontroll av huvudets position.Slutsats: Genom att anestesisjuksköterskan uppmärksammar specifika riskfaktorer i patientens anamnes samt utför intraoperativa åtgärder som syftar till att säkerställa adekvat blodtryck och optimal syresättning kan risken för CDE minska. Mätning av cerebral syresättning med NIRS rekommenderas som ett komplement för att detektera förekomst av CDE.

Abstract [en]

Background: Cerebral desaturation is a problem, which may result in catastrophic consequences even with healthy individuals. Patients who will undergo shoulder surgery in beach-chair position are at higher risk to be affected by cerebral desaturation events (CDE). However, CDE is hard to detect with conventional intraoperative surveillance.Purpose: To investigate incidence of CDE with anesthetized patients undergoing shoulder surgery in beach-chair position, and to identify the specific risk factors and measures the nurse anesthetist may perform to reduce those.Method: Descriptive literature review with systematic approach.Result: The incidence of measured CDE varied between 3% and 80% in the different studies. The nurse anesthetist may reduce the risk for CDE by preoperatively assess the risk factors in the medical history of the patient and intraoperatively by regulation of the blood pressure, changes in ventilation, control of beach-chair position and control of the patients head position.Conclusion: By paying attention to specific risk factors in the patients medical history and performing intraoperative measures to ensure adequate blood pressure and optimal saturation the risk for CDE may be lowered. Measuring cerebral saturation with NIRS technology is recommended as a complement to be able to detect incidence of CDE.

Place, publisher, year, edition, pages
2015. , 36 p.
Keyword [en]
Cerebral, anesthesia, shoulder, oxygen, blood, beach chair position
Keyword [sv]
Cerebral, anestesi, axel, syre, blod, beach-chair position
National Category
Nursing
Identifiers
URN: urn:nbn:se:uu:diva-257514OAI: oai:DiVA.org:uu-257514DiVA: diva2:839580
Subject / course
Caring Sciences
Educational program
Freestanding course
Supervisors
Examiners
Available from: 2015-08-03 Created: 2015-07-03 Last updated: 2015-08-03Bibliographically approved

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