atelectasis, pneumonia, ileus

1


visual analog scale (VAS)
verbal rating scale (VRS) numeric rating scale (NRS)

1.1 VAS (visual analog scale) 10

VRS (verbal rating
scale)
0-10 0
10
1.2 NRS (numeric rating scale)

0 10


NRS

10

2
3
4
5
6
7

0-10
1.3 Wong Baker faces pain rating scale

0
1 ( )

2 ( )

3 ()


4 ()

5 ( )
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/

2 1
2
(surrogate) 2

2.1 (grimace),
(frown), (wincing), (immobility),
(tearing).
2.2



2.2.1
2.2.1.1 (upper airway obstruction)
laryngeal edema,
laryngospasm, hematoma compression
stridor
2.2.1.2 (bronchospasm)
2.2.1.3 (hypoxemia)
including sedation,
intrapulmonary shunting, inadvertent administration of oxygenpoor inspired gases, pneumothorax, pulmonary edema,
pulmonary embolism, pain causing decreased thoracic and/or
diaphragmatic excursion, failure of reversal of neuromuscular
blocking agents. pulse oximetry (oxygen
saturation)
2.2.2

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2.2.2.1 (hypotension)
, hypovolemia, pneumothorax,
cardiogenic shock, septic shock
2.2.2.2
hypercapnea, hypoxemia, excessive intravascular fluid volume
2.2.2.3 (dysrhythmias)
, electrolyte imbalance
hypokalemia, hypoxia, dysphoria, hypercapnea,
metabolic alkalosis and acidosis
2.2.3
2.2.3.1

hypothermia,
hypoglycemia, hyperglycemia, hypoxia, cerebrovascular disease
2.2.3.2 (agitation)

hypoxia, metabolic causes, intracerebral events.
2.2.4

90
5




3

3.1
3.1.1 minor
surgery paracetamol (500 mg) Sig. 2 tabs syrup
paracetamol (120mg/5ml) 10 mg/kg/dose oral q. 6 hrs. for 3
days then 2 tabs prn for pain q. 6 hrs.
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3.1.2
3.1.2.1 paracetamol (500 mg) Sig. 2 tabs syrup
paracetamol (120mg/5ml) 10 mg/kg/dose oral q. 6 hrs.
for 3 days then 2 tabs prn for pain q. 6 hrs.
3.1.2.2 NSAID non-selective COX
inhibitors
, , tramadol
6-24 half life 3-5
NSAID omeprazole
(20mg) 1 cap oral ac OD

5-7
3.1.2.2.1 Ibuprofen (400 mg) Sig. 1 tab. oral q 6-8 hrs. for
3 days 4-10 mg/kg/dose (syrup 100
mg/5ml)
3.1.2.2.2 Diclofenac (25 mg) Sig. 1 tab. oral q 8 hrs. for 3
days
3.1.2.2.3 Tramadol (50 mg) Sig. 1 cap. oral q 6-8 hrs. for
3 days
3.1.2.3 Tramadol (dose 150-400 mg/day) IV push 50-100
mg 14
3.1.2.4 Morphine (10 mg/ampule) (maximum 0.1 mg/kg/dose)
Sig. 3-5 mg IV drip ()
3.1.2.5 Meperidine, Pethidine (50 mg/ampule) (maximum 0.5
mg/kg/dose) Sig. 25 mg IV drip ()
3.2
3.1.2.3 3.1.2.5
3.3 epidural


opioids
4

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4.1
pain score NRS
3 Wong Baker faces pain rating scale
3
opioids tramadol
3

4.2 24
4 , 24-72 6
4.3
1

4.4 3
72

3
5 morphine meperidine (pethidine)
5.1 morphine
5.1.1 Soluset syringe pump: 0.2 mg/ml
morphine 1 ampule normal saline 5%D/W sterile water for
injection 50 ml ( 1:5)
5.1.2 Soluset syringe pump: 1 mg/ml
morphine 1 ampule normal saline 5%D/W sterile water for
injection 10 ml ( 1:1)
5.1.3 Plastic bag with infusion pump: 0.2 mg/ml
morphine 2 ampule normal saline 5%D/W sterile
water for injection 100 ml (bag)
5.2 meperidine
5.2.1 Soluset: 1 mg/ml meperidine 1
ampule normal saline 5%D/W sterile water for injection 50 ml
5.2.2 Plastic bag with infusion pump: 1 mg/ml
meperidine 2 ampule normal saline 5%D/W sterile
water for injection 100 ml (bag)
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6 opioids
soluset syringe
pump plastic bag
10

opioids

Ramsay sedation score 3 4

opioids epidural space
morphine
7 Ramsay sedation score
Sedation score

1

2

3

4

17 .2552 (version 1.1)

:
1 Numerical rating scale (NRS) 0 10
2 Wong Baker faces pain rating scale NRS

- 24 4
- 24 72 6
- 72 TPR V/S

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0
1
2
3
4
5
6
7
8
9
10
0
1
2
3
4
5
6
7
8
9

Numeric Rating Scale

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10

10

|----------|----------|----------|----------|---------- |----------|----------|----------|----------|----------|
0
1
2
3
4
5
6
7
8
9
10
0
1
2
3
4
5
6
7
8
9

Numeric Rating Scale

17 .2552 (version 1.1)

10