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Biomedical subjects

Joseph F Burkard

Publications and source records attributed to Joseph F Burkard.

4 recordsLinked to original sources

Prevention and management of postoperative nausea and vomiting: a look at complementary techniques.

Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.

Acupuncture Therapy↗

The effect of transdermal scopolamine on the incidence and severity of postoperative nausea and vomiting in a group of high-risk patients given prophylactic intravenous ondansetron.

Specific risk factors place patients at greater risk for postoperative nausea and vomiting (PONV). Routinely, these patients are treated prophylactically with intravenous (IV) ondansetron or transdermal (TD) scopolamine. No study has examined what effect using a combination of these prophylactic treatments would have on the incidence of PONV in a group of high-risk patients. A total of 56 patients at high risk for PONV were treated prophylactically with IV ondansetron and randomized to receive a TD scopolamine patch or placebo. Demographics, incidence, and severity of PONV and side effects and antiemetic requirements were measured. Nausea was measured using a 0 to 10 verbal numeric rating scale. Descriptive and inferential statistics were used for analysis. No difference in demographics or the incidence of side effects was noted between groups. Patients in the scopolamine group had a lower incidence of PONV (P = .043), longer time to first reported nausea (P = .044), longer time to first episode of emesis (P = .031), and decreased supplemental antiemetic requirements (P = .016) compared with the placebo group. Based on this study, we recommend using a combination of TD scopolamine and IV ondansetron to prevent PONV in patients identified as high risk for PONV.

Administration, Cutaneous↗

Vocal cord dysfunction: a case report.

Vocal cord dysfunction (VCD) is a respiratory condition characterized by the paradoxical closure of the vocal cords. This condition results in a myriad of symptoms that would be expected from an upper airway obstruction including anxiety, hyperventilation, wheezing, stridor, shortness of breath, dyspnea, and suprasternal and neck muscle retraction. with known VCD who underwent local anesthesia with intravenous sedation for perianal skin tag removal. Postoperatively, the patient experienced respiratory distress, prompting interventions and investigation. A review of the literature revealed limited information on VCD, and no anesthesia literature was found regarding this entity.

Acute Disease↗

Effect of needle size on success of transarterial axillary block.

The transarterial approach to brachial plexus block is a well-established method of producing anesthesia of the upper extremity. However, it is associated with a failure rate of 20% to 30%. Failure may be secondary to the common use of a relatively long needle, which can penetrate the posterior wall of the sheath and result in inadvertent injection of the local anesthetic into the surrounding tissue. The purpose of this investigation was to compare success rates following transarterial brachial plexus block with a standard 22-gauge, 1 1/2-in, B bevel needle or a 26-gauge, 1/2-in needle. We enrolled 98 subjects scheduled for elective surgery at or below the elbow and randomized them into 2 groups. The control group received a transarterial axillary block with a standard 22-gauge, 1 1/2-in, B bevel needle, and the experimental group received a transarterial axillary block with a 26-gauge, 1/2-in needle. Success was defined as no discomfort at the time of incision. Success rates were compared using a chi 2 test, and a P value of less than .05 was considered significant. The overall success rate was significantly higher with the 26-gauge, 1/2-in needle (42/48 [88%]) than with the 22-gauge, 1 1/2-in needle (39/49 [69%]; P = .035).

Adult↗