Nursing Care for Patient with General Anesthesia Craniectomy: Case Study

Abstract

Introduction: Brain tumors might increase pressure inside the skull leading to cerebral edema, hydrocephalus, brain herniation, and brain infarction. Increased pressure can lead to general symptoms such as headaches and may eventually cause death. Craniectomy is an option to treat brain tumors and alleviate the rising intracranial pressure. Nurse anesthetist plays an important role in keeping patients asleep or pain-free during surgery and constantly monitoring every biological function of patients’ bodies for their safety.

Methods: The study investigated a male patient with glioblastoma multiforme at the Male Surgical Ward, Nakhon Nayok Hospital, as a case study. The case underwent Craniectomy and received perioperative care. Presentation of case: A 53-year-old male with progressive left hemiplegia and a speech problem was referred from a rural hospital. His CT brain revealed a well-defined heterogeneously enhancing lesion of about 6.0 x 6.0-cm. at the front right to the left about 1.0-cm. The patient underwent a craniectomy with tumor removal under general anesthesia. The surgery was performed successfully. The patient stayed for 15 days in hospital. A perioperative nursing care plan was implemented for brain tumor. The patient was provided with nursing intervention, rationales, and nursing recommendations.

Conclusion: In perioperative care of craniectomy for brain tumor removal, nurse anesthetists should understand patients’ physiology and optimum anesthetic protocol, selecting volatile anesthetic protocol, volatile anesthetic agent, and pharmacologic cerebral protection. Patients’ postoperative problems will reduce, and they will return to work fast and have quality of life.