Preoperative preparation of a neurosurgical patient

U radu su opisane neke od neurokirurških bolesti i stanja koja zahtijevaju neurokirurški zahvat, analizira se stres koji je prisutan kod neurokirurškog bolesnika i utjecaj tog stresa na autonomni živčani sustav i psihološku i tjelesnu spremnost bolesnika za operaciju te se raščlanjuju elemente preoperativne pripreme neurokirurškog bolesnika. Neke od neurokirurških bolesti i stanja koja zahtijevaju neurokirurški zahvat su traumatska ozljeda mozga, tumori mozga, aneurizme, hernije diska i tumori kralježnice. Neurokirurški bolesnik je u pravilu izložen intenzivnom stresu i prije dijagnoze bolesti ili stanja i nakon dijagnoze te u toku pripreme za neurokirurški zahvat. Izloženost stresu smanjuje njegovu psihološku i tjelesnu spremnost za operaciju i time smanjuje vjerojatnost uspješnog ishoda operacije. Stoga je jedna od ključnih komponenti preoperativne pripreme ublažavanje doživljaja stresa kod bolesnika i medicinska sestra u tom procesu ima ključnu ulogu. Savjetodavna uloga medicinskih sestara/tehničara u radu s bolesnicima i njihovim obiteljima jedna je od najčešćih sestrinskih intervencija. Medicinske sestre, kao najbrojniji članovi zdravstvenog tima, s bolesnikom provode najviše vremena. U smanjenju stresa veliku važnost mogu imati i intervencije koje trenutno nisu uobičajeni dio preoperativne pripreme kao što su meditacija i terapija glazbom. Preoperativna priprema neurokirurškog bolesnika uključuje i davanje proceduralnih informacija o neurokirurškom zahvatu bolesniku te različite pripremne medicinske postupke za zahvat. Naposljetku, kvaliteta preoperativne pripreme mogla bi se poboljšati i uvođenjem preoperativnih neurokirurških kontrolnih lista, odnosno popisa svih postupaka uključenih u preoperativnu pripremu neurokirurškog bolesnika.Author describes several neurological diseases and conditions that require neurosurgical intervention, analyses stress typical for neurosurgical patient and influence of that stress on autonomic nervous system and psychological and physical readiness of the patient for the operation and also analyses elements of preoperational preparation of neurosurgical patient. Some of neurosurgical diseases and conditions that require neurosurgical intervention are traumatic brain injuries, brain tumors, aneurysms, disc hernias and spinal tumors. Nerosurgical patient is typically exposed to intensive stress even before the diagnosis of the neurosurgical condition or disease, and after the diagnosis and during preparation for the neurosurgical intervention. Exposure to stress diminishes his psychological and physical readiness and therefore decreases probability of successful outcome of operation. Therefore one of crucial factors of preoperational intervention is ameliorating patient's stress and nurse has a critical role in that process. Advising role of nurses is one of their most important interventions. Nurses, as the most numerous members of medical team spend the most time with patient.Interventions which are currently not a typical part of preoperational intervention set such as meditation and music therapy can have great importance in stress amelioration. Preoperational preparation of neurosurgical patient includes giving procedural information about neurosurgical intervention and different preparational medical procedures for the operation. Finally, the quality of preoperational preparation could be further increased by introduction of preoperational neurosurgical check lists, i.e. list of all procedures included in preoperational preparation of neurosurgical patient