The nurses role in the positioning of the patient perioperatively under general anaesthetic.

"Careful patient positioning is an art and a science that affects patient safety and outcomes" (Gruendemann and Fernsebner 1995, p.388). This statement could not be truer but in the age of advancing medicine and technology basic nursing skills such as perioperative patient positioning are gaining more emphasis from nurses as the medical profession disregards their importance. In this dissertation, the author will re-emphasise the significance of safe and conscientious positioning of the patient under general anaesthetic. What are the physiological effects of general anaesthesia? Is the nursing assessment really that central in the safety of the patient intraoperatively? Also some positions utilized intraoperatively will be examined.

Anaesthesia has its origins from the early 19th century but these days it is a far cry from when they used alcohol and opium to intoxicate the patient during surgical procedures where analgesia and muscle relaxation were needed (Meeker and Rothrock, 1999) These days new anaesthetic drugs have improved the safety profile of anaesthesia, however, problems with General anaesthesia (GA) which is defined as loss of consciousness and sensation, skeletal muscle relaxation, analgesia, and elimination of the somatic, autonomic, and endocrine responses, including coughing, gagging, vomiting, and sympathetic responsiveness (Lewis, Heitkemper and Dirsken, 2000) have changed focus.

Group of nurses, Base Hospital #45

Nurse log, Quinault Rain Forest Nature Trail

Nurse Practitioner

Physiological changes, which result from GA, are vasodilation causing reduced perfusion possibly resulting in hypercarbia or hypoxia of the tissues, bronchodilation, depressed pain and pressure receptors. Loss of tone causes muscle relaxation, which is the body's defence mechanism to protect against joint damage, muscle stretch and strain and nerve impulse blockage can result in postoperative discomfort sometimes due to over flexion of limbs. The body's normal defence is 'shut down' when GA is employed, it is therefore essential that the perioperative nurse is familiar and educated with the body's normal limitations in order to act as the...