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Postanesthetic shivering is one of the leading causes of discomfort in patients recovering from general anesthesia. It usually results due to the anesthetic inhibiting the body's thermoregulatory capability, although cutaneous vasodilation (triggered by post-operative pain) may also be a causative factor.
Aldrete's scoring system is a commonly used scale for determining when postsurgical patients can be safely discharged from the post-anesthesia care unit (PACU), generally to a second stage (phase II) recovery area, hospital ward, or home.
A post-anesthesia care unit (PACU) and sometimes referred to as post-anesthesia recovery or PAR, or simply recovery, is a part of hospitals, ambulatory care centers, and other medical facilities. Patients who received general anesthesia , regional anesthesia , or local anesthesia are transferred from the operating room suites to the recovery area.
In Canada, the Canadian Nurses Association has recently added peri- or post-anesthesia nursing as a certified specialty with the first Certification qualification examination currently being offered (registration fall, 2013 with exam date April 5, 2014). The Canadian certification is PeriAnesthesia Nurse Certified (Canada), or PANC(C).
Multiple studies have demonstrated that incomplete reversal of NMBDs is an important risk factor for postoperative morbidity and mortality. Multiple studies have shown that postoperative residual curarization in the post-anesthesia care unit (PACU) is a common complication, with 40% of patients exhibiting signs of residual paralysis.
If these medications cannot effectively manage the pain, local anesthetic may be directly injected to the nerve in a procedure called a nerve block. [52] [53] In the recovery unit, many vital signs are monitored, including oxygen saturation, [54] [55] heart rhythm and respiration, [54] [56] blood pressure, [54] and core body temperature.
Anesthetic risk factors include the use of volatile anesthetics, nitrous oxide (N 2 O), opioids, and longer duration of anesthesia. Patient factors that confer increased risk for PONV include female gender, obesity , age less than 16 years, past history of motion sickness or chemotherapy-induced nausea, high levels of preoperative anxiety , and ...
TIVA is used to induce general anesthesia while avoiding the disadvantages of volatile anesthesia (and traditional inhalation agents). [9] Intravenous anesthetic agents are titrated at safe doses to maintain stage III surgical anesthesia (unconsciousness, amnesia, immobility, and absence of response to noxious stimulation). [10]