Faculty Opinions recommendation of Emergence delirium in adults in the post-anaesthesia care unit.

2006 ◽  
Author(s):  
John Laffey
Keyword(s):  
Post Anaesthesia Care Unit ◽  
Emergence Delirium ◽  
Anaesthesia Care

scholarly journals Emergence delirium in adults in the post-anaesthesia care unit

2006 ◽  
Vol 96 (6) ◽  
pp. 747-753 ◽  
Author(s):  
C. Lepousé ◽  
C.A. Lautner ◽  
L. Liu ◽  
P. Gomis ◽  
A. Leon
Keyword(s):  
Post Anaesthesia Care Unit ◽  
Emergence Delirium ◽  
Anaesthesia Care

Acute complications in the post-anaesthesia care unit after infrainguinal surgery for lower limb ischaemia – a prospective observational cohort study

VASA ◽  
2019 ◽  
Vol 48 (1) ◽  
pp. 89-97
Author(s):  
Karin Yeung ◽  
Jonas Peter Eiberg ◽  
Henrik Kehlet ◽  
Eske Kvanner Aasvang
Keyword(s):  
Lower Limb ◽  
Severe Pain ◽  
Observational Cohort Study ◽  
Limb Ischaemia ◽  
Post Anaesthesia Care Unit ◽  
Lower Limb Ischaemia ◽  
Acute Complications ◽  
Observational Cohort ◽  
Anaesthesia Care ◽  
Pacu Stay

Abstract. Background: Arterial surgery for lower limb ischaemia is a frequently performed procedure in patients with severe cardio-pulmonary comorbidities, making them high-risk patients for acute postoperative complications with a need for prolonged stay in the post-anaesthesia care unit (PACU). However, detailed information on complications during the PACU stay is limited, hindering mechanism-based interventions for early enhanced recovery. Thus, we aimed to systematically describe acute complications and related risk factors in the immediate postoperative phase after infrainguinal arterial surgery. Patients and methods: Patients transferred to the PACU after infrainguinal arterial surgery due to chronic or acute lower limb ischaemia were consecutively included in a six-month observational cohort study. Pre- and intraoperative data included comorbidities as well as surgical and anaesthetic technique. Data on complications and treatments in the PACU were collected every 15 minutes using a standardised assessment tool. The primary endpoint was occurrence of predefined moderate or severe complications occurring during PACU stay. Results: In total, 155 patients were included for analysis. Eighty (52 %) patients experienced episodes with oxygen desaturation (< 85 %) and moderate or severe pain occurred in 72 patients (47 %); however, circulatory complications (hypotension, tachycardia) were rare. Preoperative opioid use was a significant risk factor for moderate or severe pain in PACU (59 vs. 38 % chronic vs. opioid naïve patients (P = 0.01). Conclusions: Complications in the PACU after infrainguinal arterial surgery relates to saturation and pain, suggesting that future efforts should focus on anaesthesia and analgesic techniques including opioid sparing regimes to enhance early postoperative recovery.

scholarly journals Factors associated with low levels of patient satisfaction following peripheral nerve block

2021 ◽  
pp. 0310057X2097240
Author(s):  
Anthony D Hade ◽  
Satomi Okano ◽  
Anita Pelecanos ◽  
Adrian Chin
Keyword(s):  
Patient Satisfaction ◽  
Peripheral Nerve ◽  
Nerve Block ◽  
Peripheral Nerve Block ◽  
Moderate Intensity ◽  
Post Anaesthesia Care Unit ◽  
Negatively Associated ◽  
Factors Associated ◽  
Low Levels ◽  
Anaesthesia Care

Peripheral nerve blocks can provide surgical anaesthesia as well as excellent postoperative analgesia. When questioned postoperatively, however, some patients report low levels of satisfaction with their nerve block experience. At our hospital, patients undergoing regional anaesthesia have their patient characteristics, block characteristics and postoperative feedback routinely recorded in a block registry. We analysed data from 979 consecutive patients undergoing peripheral nerve block for orthopaedic surgery to identify factors associated with low levels of patient satisfaction. The primary outcome was patient satisfaction with their peripheral nerve block (scale 1–5: 4–5 is ‘satisfied’, 1–3 is ‘not satisfied’). Eighty-nine percent (871/979) of patients reported being ‘satisfied’ with their block. Factors negatively associated with patient satisfaction were rebound pain (adjusted odds ratio (aOR) 0.19, 95% confidence interval (CI) 0.04 to 0.85 for moderate rebound pain; aOR 0.11, 95% CI 0.03 to 0.48 for severe rebound pain), discomfort during the block (aOR 0.37, 95% CI 0.16 to 0.82 for moderate discomfort; aOR 0.19, 95% CI 0.05 to 0.76 for severe discomfort) and pain in the post-anaesthesia care unit (aOR 0.30, 95% CI 0.17 to 0.55 for pain ≥8/10). Only 24% (26/108) of patients who reported being ‘not satisfied’ stated that they would be unwilling to undergo a hypothetical future nerve block. Rebound pain of at least moderate intensity, procedural discomfort of at least moderate intensity and severe pain in the post-anaesthesia care unit are all negatively associated with patient satisfaction. Of these factors, rebound pain occurs most frequently, being present in 52% (403/777) of our respondents.

National quality improvement indicators project: an initial descriptive study

2021 ◽  
pp. 0310057X2110278
Author(s):  
Daniel P Ramsay ◽  
Phillip Quinn ◽  
Veronica Gin ◽  
Timothy D Starkie ◽  
Robert A Fry ◽  
...  
Keyword(s):  
Quality Improvement ◽  
New Zealand ◽  
Respiratory Distress ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Public Hospitals ◽  
Nausea And Vomiting ◽  
Post Anaesthesia Care Unit ◽  
National Quality ◽  
Anaesthesia Care

Background Anaesthesia Quality Improvement New Zealand developed a set of five quality improvement indicators pertaining to postoperative nausea and vomiting, pain, respiratory distress, hypothermia and a prolonged post-anaesthesia care unit stay. This study sought to assess the proportion of eligible institutions that were able to measure and provide data on these indicators, produce an initial national estimate of these, and a measure of variability in the quality improvement indicators across hospitals in New Zealand. Methods All public hospitals that provide a representative to Anaesthesia Quality Improvement New Zealand were eligible for inclusion. Participating institutions were required to provide the number and proportion of patients with each of the five quality improvement indicators over a continuous 2-week period between 1 June 2019 and 25 October 2019. The overall percentage of patients and the median percentage with each outcome were calculated. Results A total of 79.2% of eligible hospitals participated. The median incidence of the indicators ranged from 1.67% for respiratory distress to 6.31% for prolonged post-anaesthesia care unit stay. The indicator with the largest interquartile range was hypothermia and the smallest was respiratory distress (13.48 and 2.29, respectively). A large variation was seen for prolonged post-anaesthesia care unit stay, hypothermia, pain and postoperative nausea and vomiting. Conclusion The majority of eligible institutions were able to measure and provide data on the quality improvement indicators. There was a low rate of respiratory distress with low variability. A large amount of variability was observed in the other indicators. Future studies are needed to explore the nature of this variability.

scholarly journals Incidence of hypoxemia in a post-anaesthesia care unit and relevant risk factors: a retrospective study of 14604 patients with general anaesthesia

2019 ◽  
Author(s):  
Shuai Tang ◽  
Liangyan Zhang ◽  
Wei Han ◽  
Yang Xue ◽  
Yi Tian ◽  
...  
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Regression Analysis ◽  
Retrospective Study ◽  
Retrospective Cohort ◽  
Post Anaesthesia Care Unit ◽  
Postoperative Hypoxemia ◽  
Total Incidence ◽  
American Society ◽  
Anaesthesia Care

Abstract Background This article is aim to investigate the incidence and risk factors for postoperative hypoxemia in a post-anaesthesia care unit (PACU). Methods The retrospective cohort assessed 14604 postoperative patients who were admitted to PACU between January 2015 and December 2015. A pulse oximeter was used to monitor and record pulse oxygen saturation (SpO2) every 5 minutes. Clinical data were collected for all these patients, and the incidence of and risk factors for postoperative hypoxemia were analysed. Results The total incidence of hypoxemia was 21.83% (SpO2 ≤ 95%) and 2.79% (SpO2 ≤ 90%). Multiple regression analysis indicated that the risk factors were age ≥50-year old, body mass index (BMI) ≥25kg/m2, American Society of Anaesthesiologists (ASA) II and III, limb surgery, and thoracic surgery. Conclusions Therefore, hypoxemia was common in postoperative patients in the PACU. Age, BMI, ASA classification, and surgical site are associated with postoperative hypoxemia. More attention should be paid to these patients to prevent hypoxemia in the PACU.

scholarly journals Effect of Newer Anaesthetics on Duration of Stay in Postanaesthesia Care Unit in Patients Undergoing Major Abdominal Surgery

2005 ◽  
Vol 33 (3) ◽  
pp. 356-360 ◽  
Author(s):  
C. Gonano ◽  
C. Sitzwohl ◽  
U. Leitgeb ◽  
H. T. Landsteiner ◽  
M. Zimpfer ◽  
...  
Keyword(s):  
Abdominal Surgery ◽  
Major Abdominal Surgery ◽  
Post Anaesthesia Care Unit ◽  
Personnel Costs ◽  
Anaesthetic Agents ◽  
Group Time ◽  
Acquisition Costs ◽  
Anaesthesia Care ◽  
Fentanyl Group ◽  
Postanaesthesia Care Unit

Newer anaesthetic agents, such as remifentanil and sevoflurane, are more expensive than conventional anaesthetics, such as isoflurane and fentanyl. However, newer anaesthetics might outweigh their higher acquisition costs by reducing length of stay in the postanaesthesia care unit and thereby reducing personnel costs. We retrospectively investigated the influence of newer anaesthetics on time to eligibility for discharge from the postanaesthesia care unit in consecutive patients undergoing major abdominal surgery. Using a chart review, patients undergoing major abdominal surgery with three different anaesthetic regimens (isoflurane/fentanyl (n=80), sevoflurane/fentanyl (n=40), and sevoflurane/remifentanil (n=42)) were compared regarding duration of anaesthesia, surgery, time till extubation, and time to eligibility for discharge from the post-anaesthesia care unit. Extubation times were shorter in patients in the sevoflurane/fentanyl and the sevoflurane/remifentanil groups compared to patients in the isoflurane/fentanyl group. Time to eligibility to discharge from the postanaesthesia care unit was similar in isoflurane/fentanyl and sevoflurane/fentanyl group. In the sevoflurane/fentanyl group, time to eligibility for discharge from the unit showed a tendency to be increased (P=0.08), however these patients were significantly older compared to the other groups. Sevoflurane and remifentanil did not appear to reduce time to eligibility to discharge from the postanaesthesia care unit in our patients undergoing major abdominal surgery compared to isoflurane and fentanyl. This study highlighted the necessity for carefully planned transition from remifentanil to other longer-acting analgesia in our patients.

Sign in / Sign up

Export Citation Format

Share Document