| The preoperative intramuscular injection of penehyclidine hydrochloridecan make patients dry mouth, emotional irritability and other adverse reactions,and pull stimulation of tracheal, esophageal tissue during anterior cervicaloperation and stimulation of throat intraoperative endotracheal intubation inpatients would lead to postoperative throat pain, edema.Objective: To explore the optimal nursing method of preoperativeintramuscular injection of penehyclidine hydrochloride in patients withanterior cervical operation after operation through inhalation, sore throatnursing care, dry mouth care, humanistic concern and othercorresponding nursing intervention, and to hope that the optimal nursingmethod studied in this paper can become postoperative routine nursingcare in preoperative intramuscular injection of penehyclidinehydrochloride patients with in anterior cervical operation.Methods:200patients with anterior cervical operation undergeneral anesthesia in Department of Orthopaedic Surgery of a certainstate-level sanchia hospital from May,2011to May,2013were chosenwho were intramuscular injection of0.5mg penehyclidine hydrochloride30min before operation.100patients from May,2011to May,2012wererandomly selected as control group; and100patients from May,2012toMay,2013were randomly selected as experimental group. Theconventional care measures were used in control group, includingpostoperative vital signs monitoring, posture nursing, observation ofincision and drainage, observation of limb sensory and motor, pain nursing, respiratory management, basic nursing and diet nursing. Patientsin experimental group received routine postoperative care, also weregiven aerosol inhalation, mouth nursing, humanistic concern nursingmethods for patients according to the symtoms including postoperativesore throat, mouth parched and tongue scorched, emotional irritability andother symptoms. The atomization inhalation with gentamycin sulfate,dexamethasone, and chymotrypsin could reduce local inflammation, wetsputum, relieve laryngeal edema, and relieve neck pain and feelcomfortable. Mouth care included the wet gauze applying oral spread, wetcotton swab wiping the lips, humidified air humidification using humidifieretc. Psychological nursing after the operation, humanistic concern model inthe whole process were adopted. Comparative analysis of indices in twogroups adopted different nursing methods, respectively, including the changesof blood pressure, heart rate, oxygen saturation, respiratory rate, mean arterialpressure, temperature and other vital signs, and irritability and dry mouthmeasure were compared using the VAS score and the international commonirritability subjective evaluation scale.Results: The general data of two groups of patients were compared,there was no significant difference between two groups, which indicatedthat the two groups of patients were comparable. The respiratoryfrequency analysis showed that postoperative respiratory rate hadsignificant difference between the experimental group and the controlgroup (p<0.05). There was no significant difference between two groupspatients in xerostomia degree by the scores of VAS two hours (2h) afterthe surgery, however there was significant different between two groupsafter nursing intervention6h after operation (p<0.05), showed thatxerostomia degree in the experimental group with care intervention wasbetter than that in the control group. There was no significant differencebetween two groups in the irritable degree2h after the surgery; however there was significantly different between two groups after nursingintervention6h after operation (p<0.05), which showed that nursingmethods in the experimental group was better to relieve the patient’spostoperative irritable mood. There was no significant difference betweentwo groups in the time of operation, anesthesia time, amount of bleeding,transfusion volume, blood pressure, heart rate, SpO2, body temperatureand so on.Conclusion: Preoperative administration of penehyclidinehydrochloride in anterior cervical operation patients with correspondingcare intervention measures including inhalation, sore throat, dry mouthnursing care and humanistic concern had a positive effect on patientsrecovery, could effectively relieve the postoperative sore throat, drymouth, emotional irritability and other symptoms, reduced the pain of thepatients, increased the comfort of the patients, reduced the postoperativepsychological trauma, improved patient satisfaction, contributed to theearly recovery of patients after anterior cervical operation. Nursing staffshould pay full attention to the discomfort in the patients with anteriorcervical operation which were administrated preoperative intramuscularinjection of penehyclidine hydrochloride, take corresponding nursingmeasures actively, improve the postoperative nursing quality. Theoptimized nursing method employed in this study can be used asreference for nursing method for patients with preoperative intramuscularinjection of penehyclidine hydrochloride in anterior cervical operation. |
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