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Careful patient positioning is an art and a science that affects patient safety and outcomes Gruendemann and Fernsebner 1995 p388 This statement could not be truer but in the age of advancing medicine and technology basic nursing skills such as perioperative patient positioning are gaining more emphasis from nurses as the medical profession disregards their importance In this dissertation the author will re-emphasise the significance of safe and conscientious positioning of the patient under general anaesthetic What are the physiological effects of general anaesthesia Is the nursing assessment really that central in the safety of the patient intraoperatively Also some positions utilized intraoperatively will be examined Anaesthesia has its origins from the early 19th century but these days it is a far cry from when they used alcohol and opium to intoxicate the patient during surgical procedures where analgesia and muscle relaxation were needed Meeker and Rothrock 1999 These days new anaesthetic drugs have improved the safety profile of anaesthesia however problems with General anaesthesia GA which is defined as loss of consciousness and sensation skeletal muscle relaxation analgesia and elimination of the somatic autonomic and endocrine responses including coughing gagging vomiting and sympathetic responsiveness Lewis Heitkemper and Dirsken 2000 have changed focus Physiological changes which result from GA are vasodilation causing reduced perfusion possibly resulting in hypercarbia or hypoxia of the tissues bronchodilation depressed pain and pressure receptors Loss of tone causes muscle relaxation which is the bodys defence mechanism to protect against joint damage muscle stretch and strain and nerve impulse blockage can result in postoperative discomfort sometimes due to over flexion of limbs The bodys normal defence is shut down when GA is employed it is therefore essential that the perioperative nurse is familiar and educated with the bodys normal limitations in order to act as the patients advocate intraoperatively So how can we evaluate the risk with each patient Find out predisposing disorders they may have which may necessitate alternative
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