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Related Concept Videos

Hemodialysis I: Introduction01:25

Hemodialysis I: Introduction

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Hemodialysis (HD) is a medical treatment that artificially removes waste products, excess fluids, and toxins from the blood when the kidneys are no longer able to perform these functions effectively. In this process, blood is filtered through a semipermeable membrane, allowing for the selective removal of waste while preserving necessary components like blood cells and proteins. Hemodialysis is typically performed in patients with end-stage renal disease (ESRD) or severe kidney...
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Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

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During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
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Hemodialysis II: Procedure and Complications01:24

Hemodialysis II: Procedure and Complications

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DialyzersA hemodialysis (HD) dialyzer is a plastic cartridge containing thousands of parallel hollow fibers, which serve as semipermeable membranes. These fibers are typically made from cellulose-based or other synthetic materials. During HD, blood is pumped into the top of the cartridge and distributed among these fibers. Simultaneously, dialysis fluid, known as dialysate, is introduced into the bottom of the cartridge, bathing the outside of the fibers. Across the semipermeable membrane,...
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Aneurysm IV: Nursing Management01:22

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Vigilant monitoring for aneurysm rupture is essential for patients undergoing aortic surgery.Preoperative Nursing ManagementContinuously monitor the patient for manifestations of aneurysm rupture, such as pallor, weakness, tachycardia, hypotension, abdominal, back, groin, or periumbilical pain, changes in consciousness, and a pulsating abdominal mass. Regularly assess the patient's peripheral pulses.Instruct the patient to consume a clear liquid diet the day before surgery and administer...
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Cardiac Catheterization IV: Nursing Management01:26

Cardiac Catheterization IV: Nursing Management

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Nursing responsibilities before cardiac catheterization include:Assess for allergies and establish baseline health status.Before cardiac catheterization, assess the patient for allergies to contrast dye. Perform a comprehensive baseline assessment, including vital signs, heart and breath sounds, and a neurovascular assessment of the extremities, noting distal pulses, skin color, and temperature. Instruct the patient to fast for 8-12 hours before the procedure. Evaluate baseline laboratory...
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Cardiac Catheterization I: Pre-Procedure Overview01:28

Cardiac Catheterization I: Pre-Procedure Overview

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Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...
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Related Experiment Video

Updated: Sep 28, 2025

A Murine Model of Hemodialysis Access-Related Hand Dysfunction
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Pain after Arteriovenous Access Creation.

Amy Howk1, Callie McAdams1, Eric Heidel1

  • 1From the Department of Surgery, University of Tennessee, Knoxville.

Southern Medical Journal
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Regional anesthesia significantly reduced narcotic use after dialysis access creation. Patients receiving regional anesthesia required fewer opioid pills and lower morphine milligram equivalents compared to those under general anesthesia.

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Area of Science:

  • Vascular Surgery
  • Anesthesiology
  • Pain Management

Background:

  • Dialysis access creation is a common outpatient procedure.
  • Limited guidelines exist for postoperative opioid pain control after fistula creation.
  • Opioid-related morbidity and mortality remain a public health concern.

Purpose of the Study:

  • To investigate if regional anesthesia (RA) use decreases postoperative narcotic consumption following arteriovenous fistula creation.
  • To compare opioid use in patients undergoing fistula creation with regional versus general anesthesia.

Main Methods:

  • Prospective cohort study of 52 patients undergoing arteriovenous fistula creation.
  • Anesthesia type (regional vs. general) determined by anesthesiologist.
  • Regional anesthesia involved supraclavicular brachial plexus block with ropivacaine.
  • Postoperative opioid use assessed via clinic follow-up questionnaires.

Main Results:

  • Forty patients received regional anesthesia; 12 received general anesthesia.
  • Patients receiving regional anesthesia used an average of 3.3 pills (16.5 MME) versus 6.64 pills (33.2 MME) for general anesthesia.
  • A statistically significant difference (P=0.04) in postoperative opioid consumption was observed.

Conclusions:

  • Regional anesthesia techniques are associated with a significant reduction in postoperative opioid use.
  • This approach may help mitigate public health issues related to opiate use.
  • Regional anesthesia offers a viable alternative for pain management in dialysis access procedures.