Year

2004

Paper Type

Master's Thesis

College

Brooks College of Health

Degree Name

Master of Science in Nursing (MSN)

Department

Nursing

First Advisor

Dr. Kathaleen C. Bloom

Second Advisor

Dr. Lillia M. Loriz

Third Advisor

Dr. M. Catherine Hough

Abstract

Providing comfort is a fundamental nursing responsibility. Unrelieved postoperative pain has adverse physiologic and psychologic effects that contribute to prolonged hospital admissions and significant discomfort to patients. Opioids are standard methods of postoperative analgesia for many surgical procedures. Unfortunately, the use of opioids is associated with side effects such as nausea and vomiting, urinary retention, ileus and respiratory depression. These side effects, with the added problem of inadequate pain control, result in patient dissatisfaction with surgical procedures.

Paravertebral nerve block (PVB) is a regional anesthetic technique that has been shown to result in opioid sparing in many procedures including breast and hernia surgery. This study investigated the possibility of improved postoperative pain and nausea management when combining paravertebral nerve blocks with general anesthesia (GA) , compared to general anesthesia alone, for laparoscopic Nissen fundoplication surgery. The convenience sample consisted of 29 patients receiving surgery at the Mayo Clinic, Jacksonville, Florida. There was significant correlation between the type of anesthesia and pain at 12 hours postoperatively, indicating that those who received PVB had less pain than those receiving GA alone, at that time. Although there was no significant correlation between type of anesthesia and nausea, only one patient vomited and others had minimum to moderate nausea, postoperatively. The information attained from this research will be beneficial to nurses providing pain management for patient comfort in the outpatient surgery center.

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