Care of the patient who is under the effects of anaesthesia

Care of the patient who is under the effects of anaesthesia

Patient needs close and diligent observation until the patient fully recover from anaesthesia. This will help to detect the early

signs of complications after surgery and the nurse will be able to respond immediately.

A noisy breathing is indicative of airway obstruction that can occur, due to the tongue falling back and obstructing the pharynx, or fluid collected in the airway passages or fluids aspirated into the lungs. Apply suction immediately, send & call the surgeon and the anaesthetist.

Keep the patient in a suitable position that will be helpful to drain out the vomitus, blood and secretions collected in the mouth and will prevent them aspirating into the lungs. This position is maintained until protective reflexes are returned.

The oro-pharyngeal airway left in the mouth of the patient should be removed as soon as the patient has regained the cough and swallowing reflexes.

Excessive secretions in the mouth or anywhere in the respiratory passage can lead to airway obstruction. It should be sucked out. If intra-tracheal auctioning is necessary, always use sterile technique.

If the patient is cyanosed, administer oxygen inhalation. At the same time, find out the cause and remove the cause. Prolonged oxygen therapy should be guided • by arterial blood gas determinations.

A weak thready pulse with a significant fall in blood pressure may indicate circulatory failure. It may also indicate blood loss from the body. The surgeon and the anaesthetist should be informed.

In order to prevent injury from falls from bed, put on the side rails on the bed. Till the patient recover from the effects of anaesthesia, the nurse should not leave the patient alone. Even, when the patient has recovered from the effects of anaesthesia, entrust the patient to someone responsible for the care.

While awakening from anaesthesia, patients need frequent orientation as to where they are, what has been done to them, and reassurance that they are safe in the hands of the medical team. They also need to know that the operation is over and they are recovering from anaesthesia.

Although these patients, while they are under the effects of anaesthesia, appear to be unconscious, the nurses should be careful, not to make any statement about the patient or his disease conditions that may create anxiety in the patient.

When the patients under the effects of anaesthesia complain pain in the operation site, the narcotics/sedatives may be ordered by the surgeon and it should be given with caution.

The first post operative dose of a narcotic is usually reduced to half the dose the patient will be receiving after fully recovered from anaesthesia. This is because it can cause pronounced depression of the respiratory/circulatory/central nervous systems that may follow.

Patient recovering from anaesthesia may ask for drinking water.

Unless die patient has fully regained the swallowing reflex, drinking water may choke the patient; it should not be given.

As the patient is recovering from the effects of anaesthesia, the patient may become restless due to the discomfort caused by the presence of those devices attached to the patient, such as IV sets, urinary catheters, drainage tubes etc.

The nurse should help the patient by giving adequate explanations.

Keep the family informed of the successful completion of surgery, transfer of the patient from the operating room to recovery room etc. These informations will reduce their anxiety.

If possible, allow the relatives to meet surgeon to clear their doubts.