Elective joint surgery increases for every year and the operations are associated with postoperative pain. Postoperative pain is a well known phenomenon and pain physiology and analgesics are well known by caregivers, but the significance of the interaction between patient and caregiver is not illuminated. There are still patients experiencing unnecessary postoperative pain. Among patients in elective surgery, 25% runs a risk for underestimated pain. The aim of the study was to describe patient?s experiences of nursing interaction in the context of postoperative pain during hospitalisation after going through knee- or hiparthropasty.

Rabbits carry a high risk of anesthesia related death. This study was part of a project to develop a form of total intravenous anesthesia (TIVA) with minimal effects on cardiac, respiratory and metabolic parameters. In the study, TIVA with sufentanil and midazolam (group TIVA, n=9) was compared with inhalation anesthesia with sevoflurane (group SEVO, n=9) in female rabbits undergoing surgery (ovariehysterectomi). All rabbits were pre-medicated with medetomidin and carprofen before anesthesia induction. Anesthesia was induced with TIVA (2.3 ?g/ ml sufentanil, 0.45 mg/ ml midazolam) at a rate of 4 ml/ kg/ h and the mean induction dose was 0.4 ?g/ kg of sufentanil and 0.1mg/ kg of midazolam.

ABSTRACTBackground: People with colorectal cancer undergoing rectum amputation get a permanent colostomy, which affects the social life. It may be valuable for health care what these people experience living with colostomy in order to provide the greatest possible support. Objective: The aim of this study is to describe how people who received a colostomy experience their daily lives and the support they have received from the health services.Method: Qualitative interview study with six people, with a descriptive phenomenological approach.Results: The analysis of the interviews about how it's like to live with a colostomy resulted in three themes: 1) Living with a colostomy gives an uncertainty that affect the social life, 2) Physical and psychological impact of getting a colostomy and 3) Support for health care and relatives.Conclusion: Subjects had a positive attitude towards life, which contributed to that they could adjust to living with a colostomy and feel a meaningfulness of life. The study shows that all the interviewed people overall were satisfied with the information provided by the healthcare personnel. It was good with both oral and written information and very appreciated with repeated information. One aspect that could be improved was the information given aboute the closure of anus during surgery and the following complications.

Background: Surgical complications has been the main cause of medical injuries and deaths worldwide. In 2008 WHO developed the checklist for safe surgery to reduce the number of surgical complications. The objective of the checklist is to strengthen already established safety routines and contribute to better cooperation and communication. Research shows that compliance to the checklist is deficient, which can affect patient safety.Aim: The aim was to study the extent to which theatre nurses participate in the use of the checklist.Method: Observational study was conducted with a descriptive design and quantitative approach. 24 observations were carried out with aid of an observation protocol of two surgical units at a hospital in central Sweden.Result: The results showed that Timeout initiated widely but compliance to all items was considerably lower.

Introduction Postoperative wound infections leads to increased patient suffering and cost society money because it leads to longer hospital stays. Previous research shows that patient related risk factors such as smoking, diabetes, Chronic Obstructive Pulmonary Disease (COPD), advanced age (>65 years) a low preoperative hemoglobin level (<140g/L) and a high BMI (> 30) increases the risk of suffering a postoperative wound infection. Aim To investigate whether patients that underwent surgery with Coronary artery Bypass Graft (CABG) in a university hospital in central Sweden in 2013 and had any of these risk factors more often suffer from post-operative wound infection.MethodThe study has a descriptive design and is based on an ongoing infection registration area of operations. The study included 148 patients out of 255 (58%) undergoing CABG in 2013. Possible risk factors were collected through medical record review.Results There was no significant correlation between surgical wound infection and patient-related risk factors such as smoking (not quit smoking four weeks before surgery), diabetes, COPD, advanced age (>65 years), low preoperative hemoglobin (<140g/L) or a high BMI (>30) and suffered a postoperative wound infection.Conclusion More research and a larger sample is needed in the field to produce a reliable result could be presented..

ABSTRACTIntroduction: An increasing number of patients undergo surgery under local anesthesia and are thereforeawake during the procedure. Nursing care that is provided to these patients can differ from those thatreceive general anesthesia. Previous research has focused on patients? general experiences of being awakeintraoperative. But there is no research that focuses on patients perceptions of security.

Sahlgrenska Academyat University of GothenburgDepartment of Internal Medicine and Clinical NutritionAbstractTitle: BCAA supplementation in patients undergoing resection for liver cancerAuthor: Mikael Semaan and Viktor SjölingSupervisor: Fredrik BertzExaminer: Frode SlindeProgramme: Dietician study programme, 180/240 ECTSType of paper: Examination paper, 15 hpDate: April 10, 2013BackgroundLiver cancer is the fifth most common cancer worldwide and the third largest to cause death. Protein-energy malnutrition is common in patients with liver disease and they often suffer from changes in the hepatic metabolism of nutrients and other substances. There is a basis for recommending BCAA supplementation in other certain liver diseases. Given the similar clinical picture of liver cancer surgery, it is possible that supplementation of BCAA can be beneficial for these patients as well.ObjectiveThe aim was to study the scientific basis for the effect of branched chain amino acid (BCAA) supplementation in liver cancer patients. Can it improve their recovery in terms of nutritional status and albumin levels, and does it changes the duration of hospital stay, after surgery?Search strategyFive extensive searches were performed on PubMed and Cochrane after appropriate study material.

Background: Surgical complications has been the main cause of medical injuries and deaths worldwide. In 2008 WHO developed the checklist for safe surgery to reduce the number of surgical complications. The objective of the checklist is to strengthen already established safety routines and contribute to better cooperation and communication. Research shows that compliance to the checklist is deficient, which can affect patient safety.Aim: The aim was to study the extent to which theatre nurses participate in the use of the checklist.Method: Observational study was conducted with a descriptive design and quantitative approach. 24 observations were carried out with aid of an observation protocol of two surgical units at a hospital in central Sweden.Result: The results showed that Timeout initiated widely but compliance to all items was considerably lower.

Background: Vacuum assisted closure, VAC, is a method which can benefit wound closure. There are not many reliable studies about the effects of VAC in different types of wounds. Previous studies have shown that patients have experienced pain during dressing changes.Aim: The aim of the study was to survey in what kind of wounds the vascular surgery ward have been using VAC, to study the treatment process of VAC and how it has been documented and also to investigate if patients with VAC experienced pain during dressing changes.Method: The patients were chosen from a ledger, which contained 77 patients that had been treated with VAC on the vascular surgery ward. Data were collected with a journal survey protocol.Results: The result is based on 67 patients with a total of 79 wounds. VAC was shown to have a good effect on wound healing and infected surgical wounds were the most commonly wound category undergoing treatment with VAC.

The main objective of this research was to study how increased arterial oxygenation by the use of Pulsed Inhaled Nitric-Oxide (PiNO) influenced the metabolic and cardiovascular parameters on horses undergoing acute abdominal surgery because of colic. The parameters blood lactate, blood glucose, pH and heart rate were evaluated before and during anesthesia and closely after recovery. The study showed that blood lactate concentrations decreased significantly during anaesthesia in horses treated with PiNO compared to non-treated horses. It was also seen that the lactate concentration decreased most in horses with the highest levels before PiNO treatment. Since enhanced oxygen extraction ratio was evident in the PiNO group, improved oxygen delivery to the tissue may be a possible explanation for the improved situation.

ABSTRACTAim. To describe intensive care nurses´ experiences of caring for patients with postoperative delirium after heart surgery.Background. Delirium is a common condition after heart surgery. Previous research has focused more on pathophysiology, incidence, etiology, prevention, detection and management, and less on how nurses caring for patients with delirium experience it.Design. A qualitative interview study.Method.

Sleep is a vital part of life. Even so a lot of the mechanics regarding sleep is unknown. The dairy cattle of today live a stressful life, as their high milk yields forces them to eat large amounts of feed and spend a great portion of the day ruminating. Do they have time to get enough sleep? Which factors affecting the need of sleep in dairy cattle are largely un-known.

Bakgrund: ERAS (Enhanced Recovery After Surgery) är ett standardiserat multimodalt vårdprogram vid elektiv kolorektalkirurgi, som syftar till snabbare återhämtning och kortare vårdtider genom ett tvärprofessionellt samarbete.  En vecka innan planerad operation träffar sjuksköterskan patienten för ett samtal om vårdförloppet. Syfte: Att identifiera och beskriva patientens upplevelse av sjuksköterskans ERAS- samtal och dess betydelse för patientens delaktighet i sin vård.   Metod: Datainsamlingen skedde genom kvalitativa intervjuer. Tolv patienter, nio män och tre kvinnor har intervjuats. De ljudinspelade samtalen har transkriberats ordagrant och analyserats med hjälp av tolkande fenomenologisk analys (Interpretative Phenomenological Analysis). Resultat: Analysarbetet resulterade i fem olika teman; bli sedd, trygghet, tillit, ansvar samt delaktighet. Alla teman relaterar till varandra och illustrerar en positiv och en negativ sida av den upplevda erfarenheten. Tillsammans bildar en helhet av upplevelsen; ERAS- samtalet och dess betydelse för patientens delaktighet. Konklusion: Resultatet visar att patienterna känner sig sedda under informationssamtalet.

BAKGRUND: CABG blir en allt vanligare åtgärd vid kranskärlssjukdom inom svensk sjukvård. Målet med operationen är att lindra symtom vid kärlkramp och hjärtinfarkt samt att reducera mortaliteten. SYFTE: Syftet var att beskriva patienters emotionella upplevelser under det första året efter en CABG operation. METOD: En allmän litteraturstudie som grundades på kvalitativa vetenskapliga artiklar genomfördes. Resultatet baserades på sju vetenskapliga artiklar som söktes fram via elektroniska databaser och därefter granskades och analyserades.

The aim of the study was to describe how anaesthetic nurses, within both advanced beginner and expert levels, experience their professional role as they perform a general anaesthetic.The study had a descriptive design with a qualitative approach in which ten advanced beginners- and ten expert anaesthetic nurses from an operating theatre and an ambulatory surgical ward at a hospital located in the middle of Sweden, participated. All data was collected in an interview with semi-structured questions which focused on how the anaesthetic nurses experience their work. The data were analysed with qualitative content analysis. The results are presented in categories and themes. The themes were formed from the categories.