2.50
Hdl Handle:
http://hdl.handle.net/10755/151783
Type:
Presentation
Title:
Pharmacologic treatment of postanesthesia shaking
Abstract:
Pharmacologic treatment of postanesthesia shaking
Conference Sponsor:Sigma Theta Tau International
Conference Year:1992
Conference Date:May 19 - 22, 1992
Author:Vogelsang, Joan, EdD
P.I. Institution Name:University Hospital Pacu
Title:Clinical Nurse
A comparative research design is employed to investigate the

treatemtn of postanesthesia shaking (PS). The cause of this

visible, rhythmic, intermittent muscular activity is unknown. PS

is currently thought to reslut from spinal reflex hyperactivity

secondary to the loss of cortical inhibition when the end-tidal

concentration of anesthetic agents cause inhibition of supraspinal

modulation pathways. PS occurs unpredictabley in 5 percent to 50

percent of emerging general anesthesia patents. When not treated,

PS continues for minutes to hours at great physical and

psychological cost to patients. This study examines whether

butorphanol (Stadol), meperidine (Demerol), and morphine are

differentially effective in suppressing PS. The study is based on

Seyle's Stress-Adaptation Theory and on Roy's Adaptation Model.



The two group study consists of a nonprobability convience sample

of patients between the ages of 18 and 89 years (x=44) undergoing

general anesthesia. Those breathing spontaneously and extubated on

admission to the PACU are observed for shaking at 5 minute

intervals for 60 minutes. PS develops in 120 of 533 patients (22.5

percent) reaching grade 2 or 3 on a 0 to 3 assessment scale of

none, weak, strong, or forceful muscle contractions. Patients

developing PS are divided into four treatment groups (n=66) plus

one nontreatment gourp (n=54). The latter is allowed to continue

shaking until cessation occurs in 5 to 85 minutes (x=28).

Treatment is initiated at the discretion of nurses following

standard procedures and policies. It consists of an IV bolus of

butorphanol 1 mg (n=12), meperidine 15 to 30 mg (n=18, n=23), or

morphine 2 to 4 mg (n=13). PS suppression is measured every minute

for 5 minutes on a 0 to 2 treatment scale of continues, diminishes,

or disappears. The t-test indicates butorphanol is more effective

within 2 minutes than meperidine given for shaking alone, P<.02, or

meperiding given for shaking and pain, P<.03. Morphine does not

suppress PS within 5 minutes. Side effects such as nausea,

vomiting or recurrence do not occur following butorphanol. These

findings provide patient care information valuable within the

clinical pracitce setting for nurses who inititate interventions

amined at altering patient responses associated with the surgical

experience. When PS is promptly suppressed, there is a decreses of

physical and psychological cost inherent in experiencing and in

remembering the shaking condition, and adaptive energy is freed for

utilization in healing processes and recovery. Suggestions for

further research focus on investigating PS suppression with other

opiate based analgesics andon comparing postoperative variables in

patients allowed to continue shaking until cessation in minutes to

hours versus those promptly treated.



Repository Posting Date:
26-Oct-2011
Date of Publication:
19-May-1992
Sponsors:
Sigma Theta Tau International

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titlePharmacologic treatment of postanesthesia shakingen_GB
dc.identifier.urihttp://hdl.handle.net/10755/151783-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Pharmacologic treatment of postanesthesia shaking</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Sigma Theta Tau International</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">1992</td></tr><tr class="item-conference-date"><td class="label">Conference Date:</td><td class="value">May 19 - 22, 1992</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Vogelsang, Joan, EdD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University Hospital Pacu</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Clinical Nurse</td></tr><tr><td colspan="2" class="item-abstract">A comparative research design is employed to investigate the<br/><br/>treatemtn of postanesthesia shaking (PS). The cause of this<br/><br/>visible, rhythmic, intermittent muscular activity is unknown. PS<br/><br/>is currently thought to reslut from spinal reflex hyperactivity<br/><br/>secondary to the loss of cortical inhibition when the end-tidal<br/><br/>concentration of anesthetic agents cause inhibition of supraspinal<br/><br/>modulation pathways. PS occurs unpredictabley in 5 percent to 50<br/><br/>percent of emerging general anesthesia patents. When not treated,<br/><br/>PS continues for minutes to hours at great physical and<br/><br/>psychological cost to patients. This study examines whether<br/><br/>butorphanol (Stadol), meperidine (Demerol), and morphine are<br/><br/>differentially effective in suppressing PS. The study is based on<br/><br/>Seyle's Stress-Adaptation Theory and on Roy's Adaptation Model.<br/><br/><br/><br/>The two group study consists of a nonprobability convience sample<br/><br/>of patients between the ages of 18 and 89 years (x=44) undergoing<br/><br/>general anesthesia. Those breathing spontaneously and extubated on<br/><br/>admission to the PACU are observed for shaking at 5 minute<br/><br/>intervals for 60 minutes. PS develops in 120 of 533 patients (22.5<br/><br/>percent) reaching grade 2 or 3 on a 0 to 3 assessment scale of<br/><br/>none, weak, strong, or forceful muscle contractions. Patients<br/><br/>developing PS are divided into four treatment groups (n=66) plus<br/><br/>one nontreatment gourp (n=54). The latter is allowed to continue<br/><br/>shaking until cessation occurs in 5 to 85 minutes (x=28).<br/><br/>Treatment is initiated at the discretion of nurses following<br/><br/>standard procedures and policies. It consists of an IV bolus of<br/><br/>butorphanol 1 mg (n=12), meperidine 15 to 30 mg (n=18, n=23), or<br/><br/>morphine 2 to 4 mg (n=13). PS suppression is measured every minute<br/><br/>for 5 minutes on a 0 to 2 treatment scale of continues, diminishes,<br/><br/>or disappears. The t-test indicates butorphanol is more effective<br/><br/>within 2 minutes than meperidine given for shaking alone, P&lt;.02, or<br/><br/>meperiding given for shaking and pain, P&lt;.03. Morphine does not<br/><br/>suppress PS within 5 minutes. Side effects such as nausea,<br/><br/>vomiting or recurrence do not occur following butorphanol. These<br/><br/>findings provide patient care information valuable within the<br/><br/>clinical pracitce setting for nurses who inititate interventions<br/><br/>amined at altering patient responses associated with the surgical<br/><br/>experience. When PS is promptly suppressed, there is a decreses of<br/><br/>physical and psychological cost inherent in experiencing and in<br/><br/>remembering the shaking condition, and adaptive energy is freed for<br/><br/>utilization in healing processes and recovery. Suggestions for<br/><br/>further research focus on investigating PS suppression with other<br/><br/>opiate based analgesics andon comparing postoperative variables in<br/><br/>patients allowed to continue shaking until cessation in minutes to<br/><br/>hours versus those promptly treated.<br/><br/><br/><br/></td></tr></table>en_GB
dc.date.available2011-10-26T11:13:34Z-
dc.date.issued1992-05-19en_GB
dc.date.accessioned2011-10-26T11:13:34Z-
dc.description.sponsorshipSigma Theta Tau Internationalen_GB
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