Perioperative Nursing Care for Bladder Cancer Patients undergoing Radical cystectomy with Ileal conduit under General Anesthesia at Sakonnakhon Hospital : 2 Case Studies

การพยาบาลปริศัลยกรรมในผู้ป่วยโรคมะเร็งกระเพาะปัสสาวะที่ได้รับยาระงับความรู้สึก ทั่วร่างกาย ในการผ่าตัดกระเพาะปัสสาวะออกทั้งหมดและนำลำไส้เล็กส่วนปลาย มาทำทางระบายน้ำปัสสาวะ : กรณีศึกษา 2 ราย

Abstract

Giving General Anesthesia for Radical cystectomy with Ileal conduit is the advance and complex general anesthesia. The general anesthesia which affects on patients to unconscious by anesthesia. The complication breathing function can cause side effect to respiratory systems. The effects caused from severe hypoxia to death could occur both during and after surgery. The nurses anesthesia are required sufficient knowledge in early detected to assessment the problem and be promptly troubleshoot to efficiently nursing for patient safety.

Objective Aim to perform the comparative study of perioperative nursing between bladder cancer patient received general anesthesia during create ileal conduit, 2 case studies

Research design Performing in comparative study, compare between 2 case studies by collecting data from patients’ medical records from the beginning, including information in every phrase until 48 hours postoperative care.

Finding In both case studies, there is similarity and difference which are general anesthesia and complications respectively. One of the patients has diabetes and arrhythmia which is the right bundle branch block. The patient lost blood during surgery for 1,500 ml. and was put in intubation, then returned to SICU. As for the second patient, the PCA was used after operation as a result of losing blood while operation for 460 ml. and Oxygen cannula 3 lpm was given, then returned to SICU. The complications were promptly and safely resolved in both patients both in operation and recovery phase.

Conclusion and discussion From both case studies, the results showed that the operations were performed safely and no severe complication from general anesthesia. Assessment and post surgery care was performed inclusively.