Tecken på smärta under anestesi - hur anestesisjuksköterskan bedömer patienten
ABSTRACT Introduction: One of the great difficulties that the nurse anesthetist encounter in their profession is to assess and estimate sleep depth versus signs of pain in the anesthetized patient. Based on a pre-operative appointment and the perioperative monitoring, an assessment of the patient is made. The experience that the nurse anesthetist has can make it easier to understand what subtile signs of the patient depends on. Purpose: With this in mind, the purpose of the pilot study was to try to find out if there are specific signs of pain during anesthesia and if the professional experience played a role. As a subsidiary aim the authors examined whether there were factors in the patient that the nurse anesthetist takes into account in the identification of pain during anesthesia. Method: The authors used qualitative interviews to enquire nurse anesthetists´ thoughts and opinions. Four nurse anesthetists were interviewed, including two with longer professional experience. The results were analyzed with content analysis, manifest as well as a latent analysis. Results: It was found that nurse anesthetists observed parameters such as blood pressure, heart rate, altered breathing patterns to identify signs of pain. The experience that the nurse anesthetists had was relevant to the assessment of the patient. There were also several factors that were observed already preoperatively as the nurse anesthetist took part in the planning of anesthesia and analgesia. Conclusion: The patient is assessed based on an overall picture where both the preoperative factors and intraoperative observations were included. New knowledge that the study brought forth was that nurse anesthetists observed Entropy® to assess both pain relief needs and inadequate sleep depth. It also emerged that body movements of the anesthetized patient could indicate signs of pain.Keywords: Pain identification, nurse anesthetist, professional experience, preoperative assessment.