Nursing in Primary Surgical Pleuroscopy
Abstract: [Objective] To investigate unexplained pleural effusion in patients without the need for anes- thesiologists care and domiciliary oxygen; to apply traditional methods based on local anesthesia and a small dose of midazolam-fentanyl intravenous injection for primary surgical pleuroscopy. [Methods] 50 patients were examined by nurses for routine aspect of health education, psychological counseling, patient preparation, maintenance drug and pleuroscopy set. 30 minutes prior to the pleuroscopy, local anesthesia was provided with 2% lidocaine (5 - 8 ml) + 0.1% adrenaline solution (0.2 - 0.3 ml); based on the patient’s age, weight and underlying disease a small dose of midazolam 2 - 3 mg, fentanyl 1 ug/kg intravenous injection was given as analgesia. Thoracic drainage care, prevention of re-expansion pulmonary edema, pain, fever, pleural hemorrhage, pleural air leaks, subcutaneous emphysema and other possible complications were taken care of intra-operatively; oxygen supplementation, monitoring of vital signs and oxygen saturation, maintenance of airway patency was continuously done. [Results] 50 patients suc- cessfully underwent primary surgical pleuroscopy, 30 cases were diagnosed with malignancy, 12 cases of chronic inflammation, 5 cases of tuberculosis, and 3 cases with uncertain diagnosis. None of the patients had post pleuroscopy complication. [Conclusion] Patients with unexplained pleural effusion should undergo primary surgical pleuroscopy using the traditional methods of local anesthesia and a small dose of midazolam-fentanyl intravenous injection. The aspect of nursing includes health education, psychological counseling, patient preparation; maintenance drug and pleuroscopy set check. Intra-operative monitoring of heart rate, respiratory rate, oxygen satura- tion, suction of respiratory secretions, maintaining airway patency followed by good postopera- tive care and thoracic drainage reduces the complications of pain, fever, subcutaneous emphy- sema, swelling, re-expansion pulmonary edema. Proper nursing care and the outcome of primary surgical pleuroscopy are closely related.
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