Karlsson Ann-Christin, Ekebergh Margaretha, Mauléon Annika Larsson, Almerud Österberg Sofia
School of Health Science, Blekinge Institute of Technology, Karlskrona, Sweden.
J Perianesth Nurs. 2012 Jun;27(3):155-64. doi: 10.1016/j.jopan.2012.02.005.
Most knee or hip replacement surgery is performed under regional anesthesia, when patients are awake. Previous research has primarily focused on patients' experiences during general anesthesia. The aim of this study was to uncover the meaning of being awake during regional anesthesia and surgery. Nine interviews with patients undergoing knee or hip replacement surgery comprise the data. The phenomenological analysis shows that being awake during surgery can be compared with walking a tightrope because of ambiguous feelings. Four interrelated constituents further elucidated the patients' experiences: balancing between proximity and distance in the operating theater, balancing between having control and being left out, my partly inaccessible body handled by others, and the significant role of the carer. Anesthesia providers and perioperative nurses need to understand the awake patients' intraoperative experiences to support and confirm them when they can no longer experience or have full access to their body.
大多数膝关节或髋关节置换手术是在患者清醒的区域麻醉下进行的。以往的研究主要集中在全身麻醉期间患者的体验。本研究的目的是揭示在区域麻醉和手术过程中保持清醒的意义。对接受膝关节或髋关节置换手术的患者进行的九次访谈构成了研究数据。现象学分析表明,手术过程中保持清醒可因其模糊的感觉而被比作走钢丝。四个相互关联的要素进一步阐明了患者的体验:在手术室中平衡亲近与距离、平衡掌控与被排除在外、他人对我部分无法触及的身体的操作,以及护理人员的重要作用。麻醉医生和围手术期护士需要了解清醒患者的术中体验,以便在他们无法再体验或完全触及自己身体时给予支持和确认。