Nursing care of patients general anesthesia in hypertension who came for surgery for Distal CBD stone, Endoscopic retrograde cholangiopancreatography (ERCP)

Abstract

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is very popular today as it involves the insertion of an endoscope through the mouth, esophagus, stomach, and duodenum to the opening of the bile duct in the small intestine to inject a contrast agent along with X-ray images to assist in the diagnosis of abnormalities of the bile duct and pancreas. By this method, patients need to receive anesthesia while ERCP is being performed. Therefore, there is a potential for major complications in systems including the cardiovascular system that is greatly affected after receiving anesthesia. In hypertensive patients undergoing ERCP surgery, care must be taken and the risk of complications is monitored.

Methods:  Patients with hypertension who came for Distal CBD stone surgery by Endoscopic retrograde cholangiopancreatography (ERCP) received general anesthesia. 1 patient was admitted to Singburi Hospital. Data collected through interviews, observations, and medical records. Then, the nursing process including Gordon's health assessment, nursing diagnoses along with guidelines of the American Association of nursing diagnostic, nursing implementation, and evaluation was performed.

Results: The results revealed the problem before giving general anesthesia. The patient had a throbbing pain under the epithelium due to inflammation of the bile duct. The patient had no previous experience in surgery and, therefore, had anxiety and fear of surgery. At the time of surgery along with giving anesthesia, the patient had hypotension. After 24 hours of receiving anesthesia, the patient had abdominal distension due to inflating during surgery and inflammation of the pancreas. Doctors allowed him to go home 3 days after the surgery. He stayed in the hospital for a total of 12 days.

Conclusions: To provide nursing care for patients with hypertension receiving general anesthesia for Distal CBD stone surgery by Endoscopic retrograde cholangiopancreatography (ERCP, an anesthetist must have knowledge, expertise, and alertness at all times. Before administering anesthesia, the patient's health risks must be assessed to ensure they are physically and mentally ready. Preparations include the preparation of drugs, fluids, blood, and blood components.  Provision of nursing care and observation for complications while giving anesthesia, including pain management, and nursing care after surgery will make patients feel safe and comfortable and reduce complications from receiving anesthesia.