Academic literature on the topic 'Anesthesia Recovery Period'
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Journal articles on the topic "Anesthesia Recovery Period"
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Talley V, Henry C., Mona N. Wicks, Michael Carter, and Brad Roper. "Ascorbic Acid Does Not Influence Consciousness Recovery After Anesthesia." Biological Research For Nursing 10, no. 3 (November 17, 2008): 292–98. http://dx.doi.org/10.1177/1099800408323222.
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Several studies have examined the influence of general anesthesia on changes in consciousness and unconscious cognitive processes. However, much remains to be learned about potential moderators of general anesthetic agents, such as antioxidants including ascorbic acid, and their influence on the recovery of consciousness following general anesthesia. General anesthesia potentially affects plasma ascorbic acid levels and may impair consciousness during the postoperative period; however, published literature regarding these relationships is equivocal. Ascorbic acid is important for brain function and may be related to the return of postoperative consciousness through action on the synaptic receptors in the brain. This study was designed as a pretest—posttest repeated measures investigation. Ascorbic acid levels were measured at four time periods in patients (N = 50) undergoing surgery and general anesthesia. Following surgery, patients were administered a paper-and-pencil measure of concentration that served as an index of post-anesthesia consciousness. The results suggest that changes occur in plasma ascorbic acid levels at different time points during the anesthesia regimen in nonemergent surgical patients. No statistically significant relationships were found between plasma ascorbic acid levels and improved post-anesthesia consciousness, suggesting that ascorbic acid does not influence recovery of consciousness following general anesthesia.
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Hadžimešić, Munevera, Semir Imamović, Vasvija Uljić, Mirsad Hodžić, Fatima Iljazagić-Halilović, and Renata Hodžić. "Cognitive function recovery rate in early postoperative period: comparison of propofol, sevoflurane and isoflurane anesthesia." Journal of Health Sciences 3, no. 1 (April 15, 2013): 48–54. http://dx.doi.org/10.17532/jhsci.2013.29.
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Introduction: There is no simple answer to the question as to when the brain function is back to normal after anaesthesia. Research done so far has identified different factors influencing the rate of cognitive function recovery and type of anaesthetic as one of those factors.Methods: This study encountered 90 patients hospitalized in neurosurgical department of University Clinical Centre Tuzla in period from October 2011 to may 2012 year. Aim of the study was to compare influence of three different anesthetics (propofol, isofl urane and sevofl urane) on recovery rate of cognitive performance 1, 5 and 10 minutes following extubation. Assessment of cognitive functions was preformed using the short Orientation-Memory-Concentration (OMC) Test. All patients included in the study underwent lumbar microdiscectomy surgery and were allocated to one of three groups: propofol, sevoflurane and isoflurane.Results: Trough comparison of OMC test values there is obvious superiority in recovery of cognitive functions between propofol group and inhaled anesthetic group, after 1 minute (p = 0.008) and after 5 minutes (p =0.009). Comparison of propofol and isoflurane anesthesia shows significantly faster recovery of cognitive performance in propofol group (after 1 minute p = 0.002, 5 minutes p = 0.004, 10 minutes p = 0.038). Faster recovery of cognitive function is present in sevoflurane compared to isoflurane group only 1 minute after extubation p = 0.049.Conclusions: Fastest recovery of cognitive performance appears after propofol anesthesia, than follows sevofl urane based anesthesia and after that isoflurane anesthesia.
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Olfah, Yustiana, Reza Andisa, and Sugeng Jitowiyono. "The Relation of Body Mass Index and Duration of Anesthesia with Conscious Recovery Time in Children with General Anesthesia in Regional General Hospital Central Java Kebumen." Journal of Health 6, no. 1 (January 31, 2019): 58–64. http://dx.doi.org/10.30590/vol6-no1-p58-64.
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The calculation of body mass index and duration of anesthesia is the first step of a series of actions performed anesthesia on pediatric patients who planned to undergo anesthesia . The calculation of body mass index and duration of anesthesia determine the smoothness of anesthesia , and the patient's recovery period after general anesthesia. The study is to determine the relationship of body mass index and duration of anesthesia with conscious recovery time after general anesthesia in children using observational analytic cross sectional survey approach. The site of research is in recovery room of The Central Surgery Installation RSUD Kebumen Central Java with as many as 44 research sample consists of body mass index and duration of anesthesia, with postoperative assessment instruments Steward score. The result is patients with conscious recovery time after general anesthesia slowly, over 30 minutes is a patient with a body mass index is not ideal that 13 people ( 68.42 % ) of the total sample whereas patients who recovered quickly in less than or equal to 30 minutes as many as 17 people ( 72 % ) with an ideal tubu mass index of the total sample . From the statistical test Chi-square computer program values obtained value , the probability asymp . Sig . ( 2 - sided ) : 0,008 which means there is a relationship of body mass index of anesthesia with the patient recovery time , and patients recover with time after general anesthesia consciously slowly , over 30 minutes is a patient with a long lebi anesthesia time of 1 hour 12 people ( 75 % ) of the total sample whereas patients who recovered quickly in less than or equal to 30 minutes of 20 people ( 71.43 % ) with a time of anesthesia faster than the total sample . From the statistical test Chi-square computer program values obtained value , the probability asymp. Sig. ( 2 - sided): 0,003 which means there is a long-standing relationship with the anesthesia recovery time of patients, so there is a relationship of body mass index and duration of anesthesia with conscious recovery time
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Satvaldieva, Elmira A., Otabek Ya Fayziev, and Anvar S. Yusupov. "Multimodal anesthesia and analgesia at the stages of the perioperative period in children with abdominal surgical pathology." Russian Pediatric Journal 24, no. 1 (March 12, 2021): 27–31. http://dx.doi.org/10.46563/1560-9561-2021-24-1-27-31.
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Aim of the study was assess both the effectiveness and safety of anesthetic management and optimizing postoperative anesthesia under conditions of multimodal anesthesia and analgesia during abdominal operations in children. Patients and methods. The authors examined 58 children aged 1 to 17 years with abdominal operations (malformations, diseases, and abdominal organ injuries). To ensure anesthetic protection, patients underwent combined general anesthesia with propofol and fentanil (induction) with inhalation of sevoflurane + propofol intra venous (maintenance) in combination with epidural blockade with bupivacaine. Results. According to surgical intervention, the arrangement of perioperative analgesic protection provided a favorable correction of the hemodynamic status of patients, a decrease in inhalation anesthetic, promoted a smooth course of the postoperative period, a long painless period, an excellent psychoemotional background, and rapid postoperative recovery.
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Galante, Rafaela, Elizabeth Regina Carvalho, José A. P. C. Muniz, Paulo H. G. Castro, Vanessa Nadine Gris, Dorli S. Amora Júnior, and Ricardo G. D’Otaviano C. Vilani. "Comparison between total intravenous anesthesia with propofol and intermittent bolus of tiletamine-zolazepam in capuchin monkey (Sapajus apella)." Pesquisa Veterinária Brasileira 39, no. 4 (April 2019): 271–77. http://dx.doi.org/10.1590/1678-5150-pvb-5847.
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ABSTRACT: Dissociative anesthesia results in stressful and long recovery periods in monkeys and use of injectable anesthetics in medical research has to be refined. Propofol has promoted more pleasure wake up from anesthesia. The objectives of this study were to investigate the use of intravenous anesthetic propofol, establishing the required infusion rate to maintain surgical anesthetic level and comparing it to tiletamine-zolazepam anesthesia in Sapajus apella. Eight healthy capuchin monkeys, premedicated with midazolam and meperidine, were anesthetized with propofol (PRO) or tiletamine-zolazepam (TZ) during 60 minutes. Propofol was infused continually and rate was titrated to effect and tiletamine-zolazepam was given at 5mg/kg IV bolus initially and repeated at 2.5mg/kg IV bolus as required. Cardiopulmonary parameters, arterial blood gases, cortisol, lactate and quality and times to recovery were determined. Recovery quality was superior in PRO. Ventral recumbency (PRO = 43.0±21.4 vs TZ = 219.3±139.7 min) and normal ambulation (PRO = 93±27.1 vs TZ = 493.7±47.8 min) were faster in PRO (p<0.05). Cardiopulmonary effects did not have marked differences between groups. Median for induction doses of propofol was 5.9mg/kg, varying from 4.7 to 6.7mg/kg, Mean infusion rate was 0.37±0.11mg/kg/min, varying during the one-hour period. In TZ, two animals required three and five extra doses. Compared to tiletamine-zolazepam, minor post-anesthetic adverse events should be expected with propofol anesthesia due to the faster and superior anesthetic recovery.
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Tung, Avery, Bernard M. Bergmann, Stacy Herrera, Dingcai Cao, and Wallace B. Mendelson. "Recovery from Sleep Deprivation Occurs during Propofol Anesthesia." Anesthesiology 100, no. 6 (June 1, 2004): 1419–26. http://dx.doi.org/10.1097/00000542-200406000-00014.
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Background Some neurophysiologic similarities between sleep and anesthesia suggest that an anesthetized state may reverse effects of sleep deprivation. The effect of anesthesia on sleep homeostasis, however, is unknown. To test the hypothesis that recovery from sleep deprivation occurs during anesthesia, the authors followed 24 h of sleep deprivation in the rat with a 6-h period of either ad libitum sleep or propofol anesthesia, and compared subsequent sleep characteristics. Methods With animal care committee approval, electroencephalographic/electromyographic electrodes and intrajugular cannulae were implanted in 32 rats. After a 7-day recovery and 24-h baseline electroencephalographic/electromyographic recording period, rats were sleep deprived for 24 h by the disk-over-water method. Rats then underwent 6 h of either propofol anesthesia (n = 16) or ad libitum sleep with intralipid administration (n = 16), followed by electroencephalographic/electromyographic monitoring for 72 h. Results In control rats, increases above baseline in non-rapid eye movement sleep, rapid eye movement sleep, and non-rapid eye movement delta power persisted for 12 h after 24 h of sleep deprivation. Recovery from sleep deprivation in anesthetized rats was similar in timing to that of controls. No delayed rebound effects were observed in either group for 72 h after deprivation. Conclusion These data show that a recovery process similar to that occurring during naturally occurring sleep also takes place during anesthesia and suggest that sleep and anesthesia share common regulatory mechanisms. Such interactions between sleep and anesthesia may allow anesthesiologists to better understand a potentially important source of variability in anesthetic action and raise the possibility that anesthetics may facilitate sleep in environments where sleep deprivation is common.
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Hickman, Leonard Brian, ShiNung Ching, Mathias Basner, Wei Wang, Nan Lin, Max Kelz, George Mashour, Michael S. Avidan, and Ben J. A. Palanca. "3147 Electroencephalographic suppression from anesthesia and cognitive recovery." Journal of Clinical and Translational Science 3, s1 (March 2019): 104. http://dx.doi.org/10.1017/cts.2019.237.
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OBJECTIVES/SPECIFIC AIMS: (1) Assess if the total duration of EEG suppression during a protocolized exposure to general anesthesia predicts cognitive performance in multiple cognitive domains immediately following emergence from anesthesia. (2) Assess if the total duration of EEG suppression in the same individuals predicts the rate of cognitive recovery in a three-hour period following emergence from anesthesia. METHODS/STUDY POPULATION: This was a non-specified substudy of NCT01911195, a multicenter investigation taking place at the University of Michigan, University of Pennsylvania, and Washington University in St. Louis. 30 healthy volunteers aged 20-40 years were recruited to receive general anesthesia. Participants in the anesthesia arm were anesthetized for three hours at isoflurane levels compatible with surgery (1.3 MAC). Multichannel sensor nets were used for EEG acquisition during the anesthetic exposure. EEG suppression was detected through automated voltage-thresholded classification of 2-second signal epochs, with concordance assessed across sensors. Following return of responsiveness to verbal commands, participants completed up to three hours of serial cognitive tests assessing executive function, reaction time, cognitive throughput, and working memory. Non-linear mixed effects models will be used to estimate the initial cognitive deficit and the rate of cognitive recovery following anesthetic exposure; these measures of cognitive function will be assessed in relation to total duration of suppression during anesthesia. RESULTS/ANTICIPATED RESULTS: Participants displayed wide variability in the total amount of suppression during anesthesia, with a median of 31.2 minutes and range from 0 minutes to 115.2 minutes. Initial analyses suggest that greater duration of burst suppression had a weak relationship with participants’ initial cognitive deficits upon return of responsiveness from anesthesia. Model generation of rate of recovery following anesthetic exposure is pending, but we anticipate this will also have a weak relationship with burst suppression. DISCUSSION/SIGNIFICANCE OF IMPACT: In healthy adults receiving a standardized exposure to anesthesia without surgery, burst suppression appears to be a poor predictor of post-anesthesia cognitive task performance. This suggests that burst suppression may have limited utility as a predictive marker of post-operative cognitive functioning, particularly in young adults without significant illness.
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Whitehair, Karen J., Eugene P. Steffey, Neil H. Willits, and Michael J. Woliner. "Recovery of horses from inhalation anesthesia." American Journal of Veterinary Research 54, no. 10 (October 1, 1993): 1693–702. http://dx.doi.org/10.2460/ajvr.1993.54.10.1693.
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Summary To study behavioral and cardiopulmonary characteristics of horses recovering from inhalation anesthesia, 6 nonmedicated horses were anesthetized under laboratory conditions on 3 different days, with either halothane or isoflurane in O2. Anesthesia was maintained at constant dose (1.5 times the minimum alveolar concentration [mac]) of halothane in O2 for 1 hour (H1), halothane in O2 for 3 hours (H3), or isoflurane in O2 for 3 hours (I3). The order of exposure was set up as a pair of Latin squares to account for horse and trial effects. Circulatory (arterial blood pressure and heart rate) and respiratory (frequency, PaCO2, PaO2, pHa) variables were monitored during anesthesia and for as long as possible during the recovery period. End-tidal percentage of the inhaled agent was measured every 15 seconds by automated mass spectrometry, then by hand-sampling after horses started moving. Times of recovery events, including movement of the eyelids, ears, head, and limbs, head lift, chewing, swallowing, first sternal posture and stand attempts, and the number of sternal posture and stand attempts, were recorded. The washout curve or the et ratio (end-tidal percentage of the inhaled agent at time t to end-tidal percentage of the inhaled agent at the time the anesthesia circuit was disconnected from the tracheal tube) plotted against time was similar for H1 and H3. The slower, then faster (compared with halothane groups) washout curve of isoflurane was explainable by changes in respiratory frequency as horses awakened and by lower blood/gas solubility of isoflurane. The respiratory depressant effects of isoflurane were marked and were more progressive than those for halothane at the same 1.5 mac dose. During the first 15 minutes of recovery, respiratory frequency for group-I3 horses increased significantly (P < 0.05), compared with that for the halothane groups. For all groups, arterial blood pressure increased throughout the early recovery period and heart rate remained constant. Preanesthesia temperament of horses and the inhalation agent used did not influence the time of the early recovery events (movement of eyelids, ears, head, and limbs), except for head lift. For events that occurred at anesthetic end-tidal percentage < 0.20, or when horses were awake, temperament was the only factor that significantly influenced the nature of the recovery (chewing P = 0.04, extubation P = 0.001, first stand attempt P = 0.008, and standing P = 0.005). The quality of the recoveries did not differ significantly among groups (H1, H3, I3) or horses; however 5 of 6 horses recovering from the H1 exposure had ideal recovery. During recovery, the anesthetic end-tidal percentage did not differ significantly among groups. However, when concentrations were compared on the basis of anesthetic potency (ie, mac multiple) a significantly (P < 0.05) lower MAC multiple of isoflurane was measured for the events ear movement, limb movement, head lift, and first attempt to sternal posture, compared with that for horses given halothane, indicating that isoflurane may be a more-potent sedative than halothane in these horses.
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Alshkarchy, Samer Saleem, Khalidah S. Al-Niaeem, and Raaed Sami Attee. "Assessment of Valerian (Valeriana officinalis) on Common Carp, Cyprinus carpio: Anesthesia." IOP Conference Series: Earth and Environmental Science 1215, no. 1 (July 1, 2023): 012061. http://dx.doi.org/10.1088/1755-1315/1215/1/012061.
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Abstract The anesthetic efficacy of Valerian (Valeriana officinalis) powders was evaluated on common carp (Cyprinus carpio L.) The following concentrations (250, 350, 450) mg/liter were used in three replicates. During the experiment, the period required for partial and total anesthesia and the time required for partial and total recovery was tested, as well as the number of red and white blood cells after and before Anesthesia in addition to blood serum enzymes represented (ALP, GOT, GPT, CK, and LDH in Ul / l). The results showed that the least period of anesthesia occurred in the fourth treatment, the treatment with a concentration of 450 mg / l, as well as the least period required for recovery, while the recovery period was the longest. And anesthesia in the first treatment exposed to a concentration of 250 mg/liter, and it was not noticed that there was a significant difference between each the number of red blood cells, white blood cells in the test fish before the experiment and after treatment with valerian plants, as well as each of (ALP, GOT, GPT, CK, and LDH in Ul / l) There were no significant differences between all treatments before and after exposure to valerian, and it is concluded from the study that valerian is a safe plant for use in anesthetizing fish.
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Neumann, Mireille A., Richard B. Weiskopf, Diane H. Gong, Edmond I. Eger, and Pompiliu Ionescu. "Changing from Isoflurane to Desflurane toward the End of Anesthesia Does Not Accelerate Recovery in Humans." Anesthesiology 88, no. 4 (April 1, 1998): 914–21. http://dx.doi.org/10.1097/00000542-199804000-00010.
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Background In an attempt to combine the advantage of the lower solubilities of new inhaled anesthetics with the lesser cost of older anesthetics, some clinicians substitute the former for the latter toward the end of anesthesia. The authors tried to determine whether substituting desflurane for isoflurane in the last 30 min of a 120-min anesthetic would accelerate recovery. Methods Five volunteers were anesthetized three times for 2 h using a fresh gas inflow of 2 l/min: 1.25 minimum alveolar concentration (MAC) desflurane, 1.25 MAC isoflurane, and 1.25 MAC isoflurane for 90 min followed by 30 min of desflurane concentrations sufficient to achieve a total of 1.25 MAC equivalent ("crossover"). Recovery from anesthesia was assessed by the time to respond to commands, by orientation, and by tests of cognitive function. Results Compared with isoflurane, the crossover technique did not accelerate early or late recovery (P > 0.05). Recovery from isoflurane or the crossover anesthetic was significantly longer than after desflurane (P < 0.05). Times to response to commands for isoflurane, the crossover anesthetic, and desflurane were 23 +/- 5 min (mean +/- SD), 21 +/- 5 min, and 11 +/- 1 min, respectively, and to orientation the times were 27 +/- 7 min, 25 +/- 5 min, and 13 +/- 2 min, respectively. Cognitive test performance returned to reference values 15-30 min sooner after desflurane than after isoflurane or the crossover anesthetic. Isoflurane cognitive test performance did not differ from that with the crossover anesthetic at any time. Conclusions Substituting desflurane for isoflurane during the latter part of anesthesia does not improve recovery, in part because partial rebreathing through a semiclosed circuit limits elimination of isoflurane during the crossover period. Although higher fresh gas flow during the crossover period would speed isoflurane elimination, the amount of desflurane used and, therefore, the cost would increase.
Dissertations / Theses on the topic "Anesthesia Recovery Period"
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Loadsman, John Anthony. "Perioperative Sleep and Breathing." Thesis, The University of Sydney, 2005. http://hdl.handle.net/2123/689.
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Sleep disruption has been implicated in morbidity after major surgery since 1974. Sleep-related upper airway obstruction has been associated with death after upper airway surgery and profound episodic hypoxaemia in the early postoperative period. There is also evidence for a rebound in rapid eye movement (REM) sleep that might be contributing to an increase in episodic sleep-related hypoxaemic events later in the first postoperative week. Speculation regarding the role of REM sleep rebound in the generation of late postoperative morbidity and mortality has evolved into dogma without any direct evidence to support it. The research presented in this thesis involved two main areas: a search for evidence of a clinically important contribution of REM sleep rebound to postoperative morbidity, and a re-examination of the role of sleep in the causation of postoperative episodic hypoxaemic events. To assess the latter, a relationship between airway obstruction under anaesthesia and the severity of sleep-disordered breathing was sought. In 148 consecutive sleep clinic patients, 49% of those with sleep-disordered breathing (SDB) had a number of events in non-rapid eye movement sleep (NREM) that was greater than or equal to that in REM and 51% had saturation nadirs in NREM that were equal to or worse than their nadirs in REM. This suggests SDB is not a REM-predominant phenomenon for most patients. Of 1338 postoperative deaths occurring over 6.5 years in one hospital only 37 were unexpected, most of which were one or two days after surgery with no circadian variation in the time of death, casting further doubt on the potential role of REM rebound. Five of nine subjects studied preoperatively had moderately severe SDB. Unrecognised and significant SDB is common in middle-aged and elderly patients presenting for surgery suggesting overall perioperative risk of important adverse events from SDB is probably small. In 17 postoperative patients, sleep macro-architecture was variably altered with decreases in REM and slow wave sleep while stage 1 sleep and a state of pre-sleep onset drowsiness, both associated with marked ventilatory instability, were increased. Sleep micro-architecture was also changed with an increase in power in the alpha-beta electroencephalogram range. These micro-architectural changes result in ambiguity in the staging of postoperative sleep that may have affected the findings of this and other studies. Twenty-four subjects with airway management difficulty under anaesthesia were all found to have some degree of SDB. Those with the most obstruction-prone airways while anaesthetised had a very high incidence of severe SDB. Such patients warrant referral to a sleep clinic.
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Loadsman, John Anthony. "Perioperative Sleep and Breathing." University of Sydney. College of Health Sciences, 2005. http://hdl.handle.net/2123/689.
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Sleep disruption has been implicated in morbidity after major surgery since 1974. Sleep-related upper airway obstruction has been associated with death after upper airway surgery and profound episodic hypoxaemia in the early postoperative period. There is also evidence for a rebound in rapid eye movement (REM) sleep that might be contributing to an increase in episodic sleep-related hypoxaemic events later in the first postoperative week. Speculation regarding the role of REM sleep rebound in the generation of late postoperative morbidity and mortality has evolved into dogma without any direct evidence to support it. The research presented in this thesis involved two main areas: a search for evidence of a clinically important contribution of REM sleep rebound to postoperative morbidity, and a re-examination of the role of sleep in the causation of postoperative episodic hypoxaemic events. To assess the latter, a relationship between airway obstruction under anaesthesia and the severity of sleep-disordered breathing was sought. In 148 consecutive sleep clinic patients, 49% of those with sleep-disordered breathing (SDB) had a number of events in non-rapid eye movement sleep (NREM) that was greater than or equal to that in REM and 51% had saturation nadirs in NREM that were equal to or worse than their nadirs in REM. This suggests SDB is not a REM-predominant phenomenon for most patients. Of 1338 postoperative deaths occurring over 6.5 years in one hospital only 37 were unexpected, most of which were one or two days after surgery with no circadian variation in the time of death, casting further doubt on the potential role of REM rebound. Five of nine subjects studied preoperatively had moderately severe SDB. Unrecognised and significant SDB is common in middle-aged and elderly patients presenting for surgery suggesting overall perioperative risk of important adverse events from SDB is probably small. In 17 postoperative patients, sleep macro-architecture was variably altered with decreases in REM and slow wave sleep while stage 1 sleep and a state of pre-sleep onset drowsiness, both associated with marked ventilatory instability, were increased. Sleep micro-architecture was also changed with an increase in power in the alpha-beta electroencephalogram range. These micro-architectural changes result in ambiguity in the staging of postoperative sleep that may have affected the findings of this and other studies. Twenty-four subjects with airway management difficulty under anaesthesia were all found to have some degree of SDB. Those with the most obstruction-prone airways while anaesthetised had a very high incidence of severe SDB. Such patients warrant referral to a sleep clinic.
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Barr, Gunilla. "Novel neurophysiological monitors of the transition from wakefulness to loss of consciousness during anaesthesia /." Stockholm, 2003. http://diss.kib.ki.se/2003/91-7349-597-2/.
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Nilsson, Ulrica. "The effect of music and music in combination with therapeutic suggestions on postoperative recovery /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/med809s.pdf.
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Ricardo, Carolina Martins. "Tempo das intervenções e atividades de enfermagem na sala de recuperação pós-anestésica: subsídio para determinação da carga de trabalho." Universidade de São Paulo, 2013. http://www.teses.usp.br/teses/disponiveis/7/7140/tde-10092013-144343/.
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A escassez de pesquisas, instrumentos e parâmetros que subsidie o planejamento e a avaliação quantitativa e qualitativa de profissionais de enfermagem em salas de recuperação pós-anestésicas (SRPA) dificulta a provisão adequada de profissionais nessa área. Objetivo: Identificar o tempo médio das intervenções e atividades realizadas pela equipe de enfermagem em SRPA, como subsídio para a determinação da carga de trabalho. Método: Trata-se de um estudo de caso, observacional, transversal, de natureza quantitativa, realizado na SRPA do Hospital Universitário da Universidade de São Paulo (HU-USP). Participaram do estudo todos os profissionais de enfermagem que trabalharam na SRPA durante o período de coleta de dados. Os dados da pesquisa foram coletados e organizados de acordo com as seguintes etapas: identificação das atividades realizadas pela equipe de enfermagem, por meio da análise dos prontuários dos pacientes e da observação direta dos profissionais; mapeamento das atividades identificadas em intervenções de enfermagem, segundo a Nursing Intervention Classification (NIC); validação do mapeamento das atividades em intervenções de enfermagem, por meio de Oficinas de trabalho; mensuração do tempo despendido na execução das intervenções e atividades, utilizando a técnica Tempos Cronometrados. Resultados: Foram coletadas 6032 amostras de intervenções e atividades realizadas pelos profissionais de enfermagem na SRPA. O tempo total de execução dessas intervenções e atividades, cronometrados por observadores de campo, correspondeu a 192 horas, 56 minutos e 40 segundos. A distribuição da proporção do tempo de execução das intervenções de enfermagem evidenciou que as principais intervenções executadas foram Cuidados Pós-ANESTESIA (16,9%), DOCUMENTAÇÃO (14,3%), Controle de INFEÇÃO (5,9%). Os Domínios de maior representatividade foram: Domínio 6 - Sistema de Saúde (37%), Domínio 2 - Fisiológico Complexo (36%), Domínio 4 - Segurança (16%), Domínio 1 - Fisiológico Básico (10%) e Domínio 5 - Família (1%). O tempo da equipe está dividido em: 67% de intervenções de enfermagem; 9% de atividades associadas; 11% de atividades pessoais; 11% de tempo de espera e 2% de atividades realizadas no CC. A produtividade das enfermeiras foi de 92%, enquanto o tempo produtivo dos técnicos/auxiliares correspondeu à 86%. O tempo médio das intervenções e atividades correspondeu a dois minutos e treze segundos. A literatura não oferece dados que possibilite a comparação dos tempos médios das intervenções e atividades de enfermagem encontrados na presente pesquisa. Conclusão: A realização deste estudo permitiu identificar os tempos médios das intervenções e atividades executadas pela equipe de enfermagem na SRPA, contribuindo para a determinação da carga de trabalho e, consequentemente, para a superação das dificuldades relacionadas ao dimensionamento de profissionais nessa áreaThe scarcity of studies, tools and parameters to subsidize the planning and quantitative and qualitative evaluation of nursing professionals in post-anesthesia recovery room (PARR) hinders the adequate supply of professionals in this area. Objective: To identify the mean time of interventions and activities performed by the nursing staff in PARR, as the basis to determine the workload. Method: This is an observational, cross-sectional, quantitative case study, performed in the PARR of Hospital Universitário da Universidade de São Paulo (HU-USP). All study participants were nurses who worked in the PARR during the data collection. The study data were collected and organized according to the following steps: identification of the activities performed by the nursing staff, analysis of patients\' medical records and direct observation of professionals; mapping of activities identified in nursing interventions according to Nursing Intervention Classification (NIC); validation of activity mapping in nursing interventions through workshops; measuring the time spent on the implementation of interventions and activities, using the Clocked Time. Results: A total of 6032 samples of interventions and activities performed by nurses in the PARR were collected. The total performance time of these interventions and activities, timed by field observers, corresponded to 192 hours, 56 minutes and 40 seconds. The distribution of the performance time proportion of nursing interventions showed that the main interventions performed were: POST-ANESTHESIA care (16.9%), DOCUMENTATION (14.3%), INFECTION control (5.9%). The most representative domains were: Domain 6 - Health System (37%), Domain 2 - Physiological Complex (36%), Domain 4 - Security (16%), Domain 1 - Basic Physiologic (10%) and Domain 5 - Family (1%). The team\'s time is divided into: 67% of nursing interventions; 9% of associated activities 11% of personal activities, 11% waiting time and 2% for activities in the OR. The nurses productivity was 92%, whereas the productive time of technical/auxiliary staff corresponded to 86%. The mean time of interventions and activities corresponded to two minutes and thirteen seconds. The literature does not provide data that allows the comparison of the mean time of nursing interventions and activities found in this study. Conclusion: This study identified the mean times of interventions and activities performed by the nursing staff in the PARR, contributing to determine the workload and, consequently, to overcome the difficulties related to the activities of professionals in this area.
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Manzano, Roberta Munhoz. "Efeito da fisioterapia respiratória no pós-operatório imediato, em pacientes submetidos à cirurgia abdominal alta: estudo prospectivo." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/5/5160/tde-16102014-110912/.
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Introdução: A piora da função muscular respiratória pós-cirurgia aumenta o risco de hipoventilação, hipóxia, atelectasia e infecções. O fisioterapeuta tem um papel essencial na recuperação desses pacientes. O objetivo da pesquisa foi avaliar se a intervenção da fisioterapia respiratória no pós-operatório imediato de pacientes submetidos à cirurgia abdominal alta eletiva, em sala de recuperação pós-anestésica, resulta em melhor função pulmonar, observando valores de espirometria e oximetria de pulso e dados da evolução clínica. Métodos: O estudo é do tipo ensaio clínico prospectivo e aleatorizado observando-se valores de espirometria e oximetria de pulso. Também foi realizada análise retrospectiva dos prontuários. Os grupos foram avaliados no pré-operatório e no segundo pós-operatório (espirometria, oximetria de pulso, exame físico, escala analógica de dor). O grupo experimental recebeu fisioterapia respiratória na recuperação pós-anestésica. Resultados: Não houve diferença entre os valores espirométricos, de pico de fluxo expiratório e de saturação de oxigênio entre os grupos controle e experimental. No presente estudo a saturação de oxigênio melhorou após a fisioterapia (p=0,029). Porém essa melhora não se manteve até o segundo pós-operatório. Também foi avaliado o tempo de internação, tempo cirúrgico, escala analógica de dor e complicações pós-operatórias, não houve diferenças entre os grupos. Conclusões: A espirometria não se mostrou sensível para detectar eventual piora da função pulmonar no segundo pós-operatório. A saturação de oxigênio atingiu números próximos aos do pré-operatório após exercícios de fisioterapia. A fisioterapia respiratória no pós-operatório imediato não causou dor ao pacienteIntroduction: Surgical procedures can affect the respiratory muscles increasing the risks to hypoventilation, hypoxia, atelectasis and infections. Physiotherapists are essentials to care those patients. The purpose of this study was to evaluate the intervention of chest physiotherapy in immediate postoperative, in anesthesia recovery period room, analyzing lung functions, spirometry and oximetry in patients submitted to elective abdominal surgery. Methods: Clinic prospective and arbitrary, observing spirometry and oxygen saturation. A retrospective analysis from the notes was also done. The groups were evaluated in preoperative and 2nd postoperative (spirometry, oxygen saturation, physic examination and graduated pain scale).The physiotherapy group received chest physiotherapy in recuperation post anaesthetic. Results: There is no evidence to support a significant difference between control group and physiotherapy group analyzing spirometric values, expiratory peak flow and oxygen saturation. The oxygen saturation improves after physical therapy (p=0,029). But this improve can\'t kept until second postoperative. The period in hospital, surgery duration, graduated pain scale and postoperative pulmonary complications were analyzed but there was not significant difference between groups. Conclusions: Spirometry was not able to show a possible worst in pulmonary function on the second postoperative. The oxygen saturation reached similar numbers to preoperative post chest physiotherapy. In immediate postoperative chest physiotherapy do not cause pain to the patient
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Mendoza, Isabel Yovana Quispe. "Paciente idoso cirúrgico: complicações no período de recuperação pós-anestésica." Universidade de São Paulo, 2006. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-15012007-122326/.
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Este estudo tem como objetivos, identificar os fatores de risco de maior incidência no paciente idoso cirúrgico nos períodos pré-operatório e intra-operatório, identificar as complicações mais freqüentes no paciente idoso cirúrgico no período de recuperação pós-anestésica e relacionar as complicações mais freqüentes do paciente idoso cirúrgico no período de recuperação pós-anestésica aos fatores de risco de maior incidência do paciente idoso cirúrgico nos períodos pré-operatório e intra-operatório. A amostra foi constituído por 110 prontuários de pacientes idosos submetidos a cirurgia durante o ano 2004, que obedeciam os seguintes critérios de inclusão: idosos de ambos sexos, idosos submetidos a cirurgias eletivas, de emergência e urgência. Procedeu-se à coleta de dados, utilizando-se um formulário, a fim de contemplar os objetivos deste estudo. Os resultados mostraram que, 62 (56,4%) eram do sexo masculino; 63 (57,3%) pacientes estavam na faixa etária de 70 a 79 anos; 36 (32,7%) com hipertensão arterial sistêmica; 66 (60%) classificados como ASA II. Referente a fatores de risco relacionado ao período intraoperatório, em 69 (62,7%) pacientes o tempo de cirurgia foi inferior a três horas; 90 pacientes (81,8%) foram posicionados em decúbito dorsal horizontal na mesa cirúrgica; 59 pacientes (53,6%) foram submetidos à cirurgia abdominal e 56 (50,9%) idosos foram submetidos à anestesia geral. Quanto às complicações na sala de recuperação pós-anestésica: (55,5%) apresentaram hipotermia, 48 (43,6%) dor e 40 (36,4%) desenvolveram hipertensão arterial no período pós-operatório. De acordo com os resultados da análise de regressão logística, o sexo masculino e feminino apresentou associação estatisticamente significante com todas as complicações na sala recuperação pós-anestésica, evidenciou-se, maior associação entre os idosos de 70 a 79 anos com a apresentação de dispnéia (OR= 2,78) e idosos de 80 a 89 anos apresentou maior associação com taquicardia (OR= 1,40). Não se obteve associação entre os idosos com idade acima de 90 anos com as complicações investigadas. Quanto à hipertensão arterial, o estágio II obteve maior associação com bradicardia (OR= 8,01); assim como o escore ASA categorias II e III incrementam a possibilidade de apresentar hipertensão arterial no período de recuperação pós-anestésica (OR= 4,79; 10,71) respectivamente,. Em relação à associação entre as complicações mais freqüentes na recuperação pós-anestésica com os fatores de risco relacionados ao paciente cirúrgico idoso no período intra-operatório, o tempo de cirurgia superior a cinco horas teve maior associação com hipertensão arterial (OR = 6,49) quando comparado às cirurgias com duração entre 3 a 5 horas e inferior a 3 horas. A posição decúbito lateral apresentou maior associação com hipotermia, náusea, vômito e dor (OR = 6,68; 5,79; 3,12), respectivamente, quando comparado às posições decúbito dorsal horizontal e litotômica. Dentre os tipos de cirurgia, a artroplastia teve maior associação com náusea e vômito (OR = 7,64) seguida de redução de fratura com taquicardia e dor (OR = 3,71 e 2,05), respectivamente. Quando realizada a associação entre o tipo de anestesia e complicações na recuperação pós-anestésica ,a anestesia raquidiana apresentou maior associação com taquicardia (OR = 4,24), quando comparada à anestesia geral e peridural. Sendo assim, os pacientes idosos constituem-se em um desafio para a equipe de saúde em sala de recuperação pós-anestésica, os quais devem levar em conta a alta prevalência de doenças associadas e as alterações funcionais decorrentes do processo de envelhecimentoThis study has as its goals to identify the most common risk factors for aging surgical patients in the pre-operatory and intra-operatory periods; to identify the most frequent complications in aging surgical patients in the post-anesthetic period; and make the relation between the most frequent complications in the post-anesthetic period for aging surgical patients with the most common risk factors in the pre-operatory and intra-operatory periods. The sample was comprised of 110 records of aging patients submitted to surgery during 2004, which complied with the following inclusion criteria: aging of both sex; aging submitted to elective, emergency and urgency. Data was gathered through a form that includes socio-demographic data, aspects related to the patient, aspects related to the intra-operatory period, and aspects related to the complications in the post-anesthetic recovery. The results showed that 62 (56.4%) patients were male; 63 (57.3%) were in the age group from 70 to 79 years old; 36 (32.7%) suffered from systemic artery hypertension; 66 (60%) classified as ASA II. Concerning the risk factors related to the intra-operatory period, in 69 (62.7%) patients surgery time was under three hours; 90 patients (81.8%) were positioned lying on the side on the operation table; 59 patients (53.6%) underwent abdominal surgery; and 56 (50.9%) patients had general anesthesia. In regards to complications in the post-anesthetic recovery room: (55.5%) experienced hypothermia, 48 (43.6%), pain, and 40 (36.4%) developed artery hypertension in the post-operatory period. According to the result of the logistics regression analysis, males and females showed statistically significant association with all the complications in the post-anesthetic recovery room; it was evidenced more association among the aged from 70 to 79 years old with dyspnea (OR= 2.78), while patients from 80 to 89 years old had more association with tachycardia (OR= 1.40). There was no association among patients older than 90 with the researched complications. Regarding artery hypertension, stage II got more association with bradycardia (OR= 8.01); as the ASA score categories II and III increase the possibility of presenting artery hypertension in the post-anesthetic recovery period (OR= 4.79; 10.71) respectively. Regarding the association between the most frequent complications in the post-anesthetic recovery with the risk factors related to aging surgery patients in the intra-operatory period, surgery time exceeding five hours had more association with artery hypertension (OR = 6.49) when compared with 3 to 5 hour-surgeries and less than 3-hour surgeries. The lateral decubitus position showed more association with hypothermia, nausea, vomiting and pain (OR = 6.68; 5.79; 3.12), respectively, when compared with the lying horizontally on the side and lithotomic positions. Among the types of surgeries, arthroplasty had more association with nausea and vomit (OR = 7.64), followed by fracture reduction with tachycardia and pain (OR = 3.71 and 2.05), respectively. When the association between the kind of anesthesia and complications in the post-anesthetic recovery is made, rachidian showed more association with tachycardia (OR = 4.24), when compared with general anesthesia and peridural. Thus aging patients in the post-anesthetic recovery period are a challenge for the health team, which must take into account the high prevalence of associated diseases and the functional alterations resulting from the aging process
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Aroke, Edwin N. "A Pilot Study of the Pharmacogenetics of Ketamine-Induced Emergence Phenomena: A Dissertation." eScholarship@UMMS, 2016. https://escholarship.umassmed.edu/gsn_diss/43.
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Background: Up to 55% of patients administered ketamine, experience an emergence phenomena (EP) that closely mimics schizophrenia and increases their risk of injury. While genetics accounts for about 50% of severe adverse drug reactions, no studies have investigated genetic association of ketamine-induced EP in healthy patients. Ketamine is metabolized by CYP 2B6 enzymes and CYP 2B^8^ allele significantly alter ketamine metabolism. In addition, ketamine exerts most of its effects by inhibiting the N-methyl-D-aspartate receptor (NMADR), and NMDAR genes (GRIN2B) are associated with learning and memory impairment and schizophrenia.
Purpose: To investigate the relationship between CYP2B6*6 and GRIN2B single nucleotide polymorphisms (SNPs) and ketamine-induced emergence phenomena (EP).
Methods: This cross-sectional pharmacogenetic study recruited 75 patients having minor orthopedic, hand, foot, anorectal surgeries from two outpatient surgical centers. EP was measured with the Clinician Administered Dissociative State Scale (CADSS). DNA was genotyped using standard Taqman assays and protocols. Genetic association of CYP2B6*6 and GRIN2B (rs1019385 & rs1806191) SNPs and ketamine induced EP occurrence and severity were tested using multivariate logistic and linear regression, adjusting for age, ketamine dose, duration of anesthesia, and time since ketamine administration.
Results: Forty-seven patients (63%) received ketamine and were genotyped. Nineteen EP cases were identified (CADSS > 4), leaving 28 non-EP controls. For our population, CADSS has an internal consistency reliability Cronbach’s alpha of 0.82, and could reliably distinguish ketamine from non-ketamine cases. Occurrence and severity of EP were not associated with CYP2B6*6 or GRIN2B (p > 0.1). Models removing genotype and containing age, ketamine dose, duration of v anesthesia, and time since ketamine administration significantly predicted EP occurrence (p = 0.001) and severity (p = 0.007). Presence and severity of EP did not affect patient satisfaction with care.
Discussion: Younger age, higher dose and longer duration of anesthesia significantly predicted EP occurrence and severity among our sample. This study provides effect size estimates useful for the design of adequately powered future genetic association studies. The feasibility of recruitment from patients undergoing elective, outpatient surgeries and ease of post-operative EP assessment with CADSS supports our approach. However, the small sample size may have limited about ability to determine significant differences.
Conclusion: Fully powered studies are needed to investigate this important phenomena. Determining factors for anesthesia-related EP symptoms may reduce risks and costs associated with this adverse medication effect.
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Freria, Zelia Fernanda da. "Condições clínicas dos pacientes e a carga de trabalho de enfermagem na Unidade de Recuperação Pós-Anestésica." Universidade de São Paulo, 2017. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-05112018-125525/.
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Introdução: A Unidade de Recuperação Pós-Anestésica (URPA) é definida como unidade de cuidados intensivos para pacientes que se recuperam da anestesia e cirurgia. Nesse período, a assistência de enfermagem concentra-se na observação da evolução das condições clínicas dos pacientes, como: o retorno da consciência, na resposta dos reflexos protetores, e na estabilidade dos sinais vitais. Para essa avaliação do paciente no período pós-operatório imediato é comum à utilização do Índice de Aldrete e Kroulik (IAK). Um dos indicativos da alta do paciente ocorre quando se atinge um escore total de 8 a 10, isto é, quando o paciente apresenta retorno da consciência, estabilidade dos sinais vitais, retorno da atividade motora e dos reflexos protetores, além de estabilidade térmica e ausência de dor, até então, a observação deve ser contínua. Os criadores desse índice ressaltam que, quanto menor for o escore total, mais cuidado e observação são necessários, isto é, maior é a instabilidade deste paciente. A evolução tecnológica das unidades hospitalares associada ao aumento da complexidade dos pacientes internados interferem no tempo de permanência e no nível de atenção requerido por eles no período de recuperação pós-anestésica. Sendo assim, há necessidade de um número maior de funcionários qualificados para o cuidado de enfermagem adequado. O Nursing Activities Score (NAS) é um instrumento rotineiramente utilizado em Unidades de Terapia Intensiva, pode representar o tempo de cuidado de enfermagem exigido para o paciente, carga de trabalho, o que pode ser extremamente útil e pertinente para a URPA para a adequação e cálculo de número adequado de profissionais. Objetivo: Verificar a relação das condições clínicas avaliadas pelo Índice de Aldrete e Kroulik (IAK), e a carga de trabalho, determinada pelo Nursing Activities Score(NAS) e exigida pelos pacientes durante o tempo de permanência na Unidade Recuperação Pós- Anestésica. Método: Trata-se de uma pesquisa com abordagem do tipo quantitativadescritivo- observacional, não participativa, de corte transversal. O estudo foi desenvolvido na URPA de um Hospital privado com Centro Cirúrgico, de grande porte, na cidade de São Paulo. Resultados: A amostra foi composta de 85 pacientes com maior incidência de pacientes do gênero masculino, idade 18 a 83 anos, com mediana de 41 anos, e proveniente da unidade de internação, as comorbidades mais frequentes foram a Dislipidemia, seguida de Hipertensão Arterial Sistêmica. As cirúrgicas em sua maioria foi eletivas, as especialidades médicas mais assíduas foram Otorrinolaringologia e Gastrenterologia, ambas com porcentagem de 24,7%, e urologia com 17,6%, o tipo de anestesia mais frequente foi a geral, apenas três pacientes tiveram intercorrências no intraoperatório, sendo um a arritmia e dois pacientes apresentaram reação alérgica medicamentosa. Durante o período de internação na URPA os pacientes apresentaram as seguintes intercorrências: Retenção urinária (1,2%), Bradicardia (1,2%), Hiperglicemia (1,2%), Hipotensão (1,2%). O tempo de permanência na URPA variou entre 15 e 130 minutos, com mediana de 45 minutos. A carga de trabalho de enfermagem foi mensurada pelo NAS, o escore total variou de 37,2% e 82,1%, com mediana de 41,1%. O Índice de Aldrete e Kroulik foi medido a partir do momento de admissão e a cada 15 minutos durante toda a permanência do paciente na URPA. O menor índice encontrado foi 4 (quatro) no zero minuto e o escore prevalente na admissão foi 9 (44,7%). O tempo de permanência na URPA variou entre 15 e 130 minutos, com mediana de 45 minutos. Conclusões: este estudo não apresentou relação estatisticamente significante entre as variáveis NAS, IAK e tempo de permanência na URPA.Introduction: A Post-Anesthetic Care Unit (PACU) is a site structured with materials and equipment suitable to receive patients who are submitted to the anestheticsurgical procedure and are awaiting a transfer, either to the room, house, and / or beings that need to be removed for Intensive Care Unit (ICU). During this period, nursing care presents a profile of high complexity, focusing on the evolution of patients\' clinical conditions. For this patient evaluation in the immediate postoperative period it is common to use the Aldrete and Kroulik Score (IAK). Patient is discharged, when a total score of 8 to 10 is reached, when the patient returns consciousness, stability of the vital signs, return of the motor activity and the protective reflexes, until then an observation must be continued. The creators of this score highlight that the lower the total of score, the more care and observation are needed, because it means, the greater is the patient\'s severity. The technological evolution of the hospital units, associated to the increased complexity of hospitalized patients, interferes in the length of stay and the level of attention required by them during the post-anesthetic recovery period. Therefore, there is a need for a larger number of employees for appropriate nursing care. The Nursing Activities Score (NAS) is a routine instrument used in ICU that points out a ratio between the nursing care time required for the patient and the number of higher education professionals that can be used for the PACU. Objective: To verify the relationship between the clinical conditions evaluated by the Aldrete and Kroulik Score (IAK), and a workload, determined by the Nursing Activities Score (NAS) and required by the patients during their stay in the Post Anesthesia Recovery Unit. Method: This is a clinical and field research, with quantitative-descriptive, observational, non-participatory, cross-sectional, and quantitative data analysis. The study was developed in the PACU of a private Hospital with a large Surgical Center in the city of São Paulo. Results: The sample consisted of 85 patients with a higher incidence of male patients aged from 18 to 83, with a median of 41 years, most classified as ASA 1 and coming from the hospitalization unit, the most frequent comorbidities were dyslipidemia, followed by Systemic Arterial Hypertension. The most frequent surgical procedures were elective, the most frequent medical specialties were Otorhinolaryngology and Gastrenterology, both with a percentage of 24.7%, and urology with 17.6%, the most frequent type of anesthesia was general, only three patients had intercurrences in the intraoperative, one being the arrhythmia and two patients had a drug allergic reaction. During the hospitalization period in PACU, patients presented the following complications: Urinary retention (1.2%), Bradycardia (1.2%), Hyperglycemia (1.2%), Hypotension (1.2%). Length of stay in PACU ranged from 15 to 130 minutes, with a median of 45 minutes. The nursing workload was measured by NAS, the total score ranged from 37.2% to 82.1%, with a median of 41.1% (1st quartile 39.7% and 3rd quartile 46.7%). The Aldrete and Kroulik Score was measured from the time of admission and every 15 minutes throughout the patient\'s stay in the PACU. The lowest index found was 4 (four) at zero minute and the prevalence score at admission was 9 (44.7%). The time spent in the PACU ranged from 15 to 130 minutes, with a median of 45 minutes (1st quartile 35 and 3rd quartile 60 minutes). Conclusions: this study did not present a statistically significant relation between the variables NAS, IAK and lenght of stay in the PACU.
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Popov, Débora Cristina Silva. "Indicadores para avaliação do cuidado de enfermagem com o paciente na sala de recuperação pós-anestésica." Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/7/7139/tde-31082016-160123/.
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Introdução: O cuidado com o paciente na sala de recuperação pós-anestésica com qualidade é uma preocupação dos profissionais envolvidos no pós-operatório imediato. Para garantir um cuidado de qualidade, devem ser desenvolvidas ferramentas que auxiliem na avaliação e possibilitem melhorias na assistência, além de satisfazerem o paciente com o cuidado prestado. Objetivo: Desenvolver instrumentos para avaliar a qualidade de serviços de saúde no período pós-operatório imediato; elaborar indicadores para avaliar as práticas assistenciais em unidade ou sala de recuperação pós-anestésica relacionadas ao monitoramento e à prevenção da dor e hipotermia; e proceder à validação de conteúdo dos indicadores. Métodos: Estudo quantitativo, longitudinal, de validação de indicadores com uso do método Delphi. Inicialmente, selecionaram-se as práticas a serem mensuradas relacionadas à dor e à hipotermia. Foi realizada a fundamentação teórica, sendo construídos os indicadores, e elaborados os Manuais Operacionais para a validação de cada indicador. Um grupo composto por seis juízes foi selecionado para o processo de avalição e validação dos indicadores, que, por sua vez, foram elaborados de acordo com o referencial de Donabedian, constituindo indicadores de estrutura, processo ou resultado. Resultados: Após duas rodadas de avaliação e validação, todos os indicadores foram validados com o mínimo de 83,3% de consenso estabelecido estatisticamente como significativo entre os juízes. Foram propostos e validados dez indicadores, sendo um indicador de avaliação da estrutura relacionado à dor e à hipotermia (Porcentual de Profissionais Enfermeiros Exclusivos e Qualificados na Sala de Recuperação Pós-Anestésica), quatro indicadores de processo (Número de Prescrições de Analgesia ao Paciente ao Chegar na Sala de Recuperação Pós-Anestésica; Número de Administrações de Analgésicos Iniciadas na Sala de Recuperação Pós-Anestésica Após Queixa de Dor; Porcentual de Registro da Avaliação da Dor do Paciente ao Chegar na Sala de Recuperação Pós-Anestésica; Número de Prontuários com Registro das Intervenções de Enfermagem Após o Relato de Dor na Sala de Recuperação Pós-Anestésica) e um indicador de resultado de avaliação da dor (Número de Pacientes sem Dor/ou com Dor Mínima no Momento da Alta da Sala de Recuperação Pós-Anestésica); dois indicadores de avaliação da estrutura relacionados à hipotermia (Número de Equipamentos para Avaliação da Hipotermia na Sala de Recuperação Pós-Anestésica; Número de Equipamentos para Tratamento da Hipotermia na Sala de Recuperação Pós-Anestésica), um indicador de processo (Número de Pacientes com Registro da Intervenção Realizada em Caso de Hipotermia na Sala de Recuperação Pós-Anestésica) e, finalmente, um indicador de resultado relacionado à avaliação da hipotermia (Número de Pacientes Hipotérmicos no Momento da Alta da Sala de Recuperação Pós-Anestésica). Conclusão: Os componentes dos Manuais Operacionais dos indicadores e seus atributos foram julgados, e as sugestões dos juízes, incorporadas, sendo que todos os indicadores atingiram o nível de consenso entre os seis juízes. A elaboração de indicadores específicos na Sala de Recuperação Pós-Anestésica é um desafio, porém, como foi aqui demonstrado, é possível trabalhar com tal ferramenta também nesse setor.Background: The care with quality for the patient in the post-anesthetic recovery room is a concern of professionals involved in the immediate postoperative period. To ensure a care with quality, tools should be developed to assist in the evaluation and enable improvements in the assistance, as well as to satisfy the patient with the care provided. Objective: To develop tools to evaluate the quality of health services in the immediate postoperative period; to develop indicators to evaluate the care practices related to monitoring and prevention of pain and hypothermia in the post-anesthetic care unit/room; and to validate the content of the indicators. Methods: This is a quantitative, longitudinal study for the validation of indicators, using the Delphi method. Initially, we selected the practices related to pain and hypothermia to be measured. With a theoretical background, the indicators were built, and the Operational Manuals were developed the for the validation of each indicator. A group composed of six judges was selected for the evaluation and validation process. These indicators were drawn up according to Donabedian\'s theory, and they were classified as structure, process or outcome indicators. Results: After two rounds of evaluation and validation, all indicators were validated with a minimum of 83.3% consensus, which was statistically established as significant among judges. Ten indicators were proposed and validated; one indicator was for assessing the structure and it was related to pain and hypothermia (Percent of Exclusive and Qualified Nurses on the Post-Anesthetic Care Unit), four indicators were process indicators (Number of Analgesia Prescriptions for the Patient that Gets in the Post-Anesthesia Recovery Room; Number of Analgesics Administrations Started in the Post-Anesthesia Recovery Room After Complaining of Pain; Pain Assessment Registration Percentage of the Patient that Gets in the Post-Anesthesia Recovery Room; Number of Medical Charts with Registration of Nursing Interventions After the Pain Reporting in the Post-Anesthesia Recovery Room), one indicator was classified as an outcome indicator (Number of Patients Without Pain/or Minimum Pain When Discharged of the Post-Anesthesia Recovery Room); two indicators of structure evaluation were related to hypothermia (Number of Equipment for Hypothermia Evaluation of the Post-Anesthesia Recovery Room; Number of Equipment for Treatment of Hypothermia in the Post-Anesthesia Recovery Room), one indicator was labeled as a process indicator (Number of Patients with Intervention Registration Carried Out in Case of Hypothermia in the Post-Anesthetic Recovery Room) and, finally, a result indicator was related to the evaluation of hypothermia (Number of Patients with Hypothermia When Discharged of the Post-Anesthesia Recovery Room). Conclusion: The Operational Manuals components for the indicators and their attributes were judged, and the judges suggestions were incorporated. All the indicators have reached the level of consensus among the six judges. The development of specific indicators in the post-anesthesia recovery room is a challenge, however, as we have demonstrated, it is possible to work with this tool also in this sector.
Books on the topic "Anesthesia Recovery Period"
1
Litwack, Kim. Post anesthesia care nursing. St. Louis: Mosby Year Book, 1991.
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2
S, Vender Jeffery, and Spiess Bruce D, eds. Post anesthesia care. Philadelphia: W.B. Saunders, 1992.
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3
E, Fraulini Kay, ed. After anaesthesia: A guide for PACU, ICU, and medical-surgical nurses. Norwalk, Conn: Appleton & Lange, 1987.
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4
1932-, Allen Anne, and American Society of Post Anesthesia Nurses., eds. Core curriculum for post anesthesia nursing practice. 2nd ed. Philadelphia: Saunders, 1991.
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5
B, Drain Cecil, ed. Drain's perianesthesia nursing: A critical care approach. 6th ed. St. Louis, Mo: Elsevier/Saunders, 2013.
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B, Drain Cecil, ed. Perianesthesia nursing: A critical care approach. 4th ed. St. Louis: W.B. Saunders Co., 2003.
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Hatfield, Anthea. The complete recovery room book. 4th ed. Oxford: Oxford University Press, 2009.
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Hatfield, Anthea. The complete recovery room book. 4th ed. Oxford: Oxford University Press, 2009.
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9
Michael, Tronson, ed. The complete recovery room book. Oxford: Oxford University Press, 1992.
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10
Michael, Tronson, ed. The complete recovery room book. 4th ed. Oxford: Oxford University Press, 2009.
Find full textBook chapters on the topic "Anesthesia Recovery Period"
1
"The Recovery Period." In The Practice of Veterinary Anesthesia, 373–82. Teton NewMedia, 2008. http://dx.doi.org/10.1201/b16183-13.
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Sankova, Susan K., and Jeongae Yoon. "Endovascular Procedures of the Abdomen/Lower Extremities." In Vascular Anesthesia Procedures, 145–54. Oxford University Press, 2021. http://dx.doi.org/10.1093/med/9780197506073.003.0011.
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This chapter continues an overview of endovascular procedures, focusing on interventions below the diaphragm. Endovascular intervention has become the major technique for management of abdominal aortic aneurysms (AAAs), both ruptured and unruptured. Advancements in endovascular techniques have shortened AAA operative and recovery times and permitted intervention on patients previously felt too tenuous for an open surgical approach. Peripheral artery disease (PAD) can also be treated with a variety of endovascular techniques, including angioplasty, atherectomy, and stenting. Endovascular interventions in PAD have similarly reduced the recovery burden for patients and provide similar outcomes to open procedures. The minimally invasive nature of the endovascular approach often allows greater flexibility in anesthetic technique compared to open procedures. In conjunction with the procedural approach, the patient’s health status, preferences, and anesthesiologist preferences permit a choice of anesthesia care that may lie along a spectrum ranging from local anesthesia with minimal sedation to full general endotracheal anesthesia. The endovascular approach does, however, present specific anesthesia management concerns in both the intra- and postoperative period, which are reviewed in this chapter.
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Schroeder, Kristopher M., and Andrew Pfaff. "Role of Regional Anesthesia in Enhanced Recovery Protocols." In Advanced Anesthesia Review, edited by Alaa Abd-Elsayed, 86—C32.S8. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med/9780197584521.003.0032.
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Abstract Enhanced recovery protocols offer the promise of improved patient care while simultaneously reducing costs and hospital resource utilization. Core to the development of any successful enhanced recovery protocol is effective pain management. Opioid administration in the postoperative period may be associated with a number of adverse events (nausea, urinary retention, respiratory depression, etc.) that may hinder efforts to improve the postoperative experience and expedite hospital discharge. In contrast, the thoughtful application of regional anesthesia/analgesia techniques may benefit patients via improved pain control and reduced opioid requirements. Improvements in ultrasound imaging techniques and the proliferation of available fascial plane blocks have increased the number of patients and surgical procedures that may benefit from perioperative regional anesthesia.
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Kassem, Hisham, and Ivan Urits. "Enhanced Recovery after Surgery Protocol for Fluid Therapy." In Basic Anesthesia Review, edited by Alaa Abd-Elsayed, 340. Oxford University PressNew York, 2024. http://dx.doi.org/10.1093/med/9780197584569.003.0134.
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Abstract Enhanced recovery after surgery (ERAS) protocols have emerged to apply to many types of surgeries and provide recommendations to reduce variability and improves patient outcomes. An essential pillar of ERAS protocols is fluid management throughout the entire perioperative period. Preoperatively there is emphasis on limiting prolonged fasting; intraoperatively there is a goal-directed approach to maintain adequate organ perfusion; and postoperatively patients are encouraged to have early oral intake. To provide maximal benefit for the patient there needs to be an understanding among the anesthesiologist, surgeon, and ancillary staff with what directions should be followed. Further investigations are still needed to identify the best goals of fluid management during ERAS surgeries.
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Ibrahim, Rowaa, and Ami Attali. "Anesthesia for Cerclage or Nonobstetric Surgery." In Advanced Anesthesia Review, edited by Alaa Abd-Elsayed, 756—C297.S7. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med/9780197584521.003.0296.
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Abstract Anesthetic management of pregnant women can be challenging, with multiple factors affecting the decision-making process, especially when considering nonobstetric surgery. The well-being of the mother and the fetus are a priority; therefore, clear communication between the multidisciplinary team is crucial. Guidelines have been recommended by both the American College of Obstetricians and Gynecologists and American Society of Anesthesiologists for management in both elective and emergent scenarios. A thorough preoperative assessment is needed and can help mitigate the risks associated with anesthesia for both the mother and baby. Intraoperative management must consider the physiological changes, fetal gestational age, as well as concomitant surgical risks that occur with pregnancy. The recovery period postoperatively focuses on multimodal management as well as avoiding possible complications of surgery. With a comprehensive perioperative plan, the gestation can return to its natural course.
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Aquiles Hidalgo Acosta, Javier, Freddy Octavio Zambrano Hidalgo, María Fernanda Calderón León, and Johnny Jerez Castañeda. "Complications in Spinal Anesthesia." In Advances in Regional Anesthesia - Future directions in the use of Regional Anaesthesia [Working Title]. IntechOpen, 2024. http://dx.doi.org/10.5772/intechopen.1002927.
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The justification of this chapter is based on knowing the neurological complications that can be triggered during or after spinal anesthesia since it is one of the most performed procedures in anesthesiology, the main objective is to make a chapter with the most described complications in spinal anesthesia. What are the complications of spinal anesthesia? What complications have been described during the procedure or during its postoperative recovery? The spinal anesthesia technique is a necessary procedure to perform a surgical intervention whose objective is to temporarily block the brain’s ability to recognize painful stimuli. Knowing possible complications that can occur during spinal anesthesia or in the postoperative period allows for early diagnosis and treatment. Complications in anesthesia can be clinically manifested by headache, gluteal pain that radiates to the lower limbs, neuropathy, severe paresthesia, among others, and can generate reversible and irreversible disabling lesions depending on their mechanism of injury.
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"Emergence Agitation After Sevoflurane vs. Propofol in Pediatrics." In 50 Studies Every Anesthesiologist Should Know, edited by Anita Gupta, Elena N. Gutman, Michael E. Hochman, Anita Gupta, Elena N. Gutman, and Michael E. Hochman, 268–72. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780190237691.003.0050.
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This case focuses on what sort of anesthesia to use in young children undergoing small procedures by asking the question: Does maintenance of anesthesia with propofol after sevoflurane induction reduce the incidence of emergence agitation compared with continuing sevoflurane for maintenance? In a randomized, single-blinded, two-period, crossover study, 16 pediatric patients underwent repeat eye examinations under general anesthesia. Study participants were pediatric patients 1 to 5 years of age diagnosed with retinoblastoma requiring routine eye examination under general anesthesia on a regular basis. In these preschool children undergoing noninvasive, repeat eye examinations under general anesthesia, emergence agitation occurred more frequently after maintenance with sevoflurane compared with propofol. Sevoflurane maintenance resulted in statistically faster recovery times but lower parent satisfaction scores.
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Satomoto, Maiko. "Changes in Postoperative Analgesia." In Topics in Postoperative Pain [Working Title]. IntechOpen, 2023. http://dx.doi.org/10.5772/intechopen.109771.
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Postoperative pain management has changed with the evolution of surgical techniques. Epidural anesthesia was a very useful method of postoperative analgesia when laparotomy or thoracotomy was performed by making a large skin incision in the abdomen or chest. Nowadays, surgeries are often performed through very small skin incisions using laparoscopy or thoracoscopy. Furthermore, surgeries are often performed on elderly patients, and in many patients, anticoagulants are used in preoperative period and continued during intraoperative period or started early in postoperative period, and there are concerns that epidural anesthesia cannot be performed, or that epidural anesthesia may delay the start of early postoperative anticoagulation in such patients; hence, there is a tendency to avoid epidural anesthesia. In such cases, intravenous administration of patient-controlled analgesia (PCA) fentanyl is an effective method of postoperative analgesia. We will discuss the advantages and disadvantages of intravenous (IV)PCA and epidural anesthesia and also the combined use of peripheral nerve blocks, which has been in the spotlight in recent years. Early postoperative mobilization is useful in preventing muscle weakness and delirium. What we require today are postoperative analgesics that provide rapid postoperative recovery and do not cause nausea and vomiting.
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O’Farrell, Justin L., and Maxim S. Eckmann. "Guillain-Barré Syndrome." In Advanced Anesthesia Review, edited by Alaa Abd-Elsayed, 507—C194.P15. Oxford University PressNew York, 2023. http://dx.doi.org/10.1093/med/9780197584521.003.0194.
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Abstract Guillain-Barré syndrome is an acute immune-mediated paralytic neuropathy secondary to prior infection. There are multiple variants of Guillain-Barré syndrome that describe the mechanism by which the neurodegeneration occurs. The most common presenting symptoms include areflexia in addition to caudad-to-cephalad progressive muscle weakness. The diagnosis of Guillain-Barré syndrome is made by clinical evaluation of symptoms and laboratory studies. While disease-modifying treatment involves plasmapheresis or intravenous immunoglobulin (IVIG), the majority of care is supportive due to severe dysfunction of the respiratory, cardiopulmonary, and autonomic nervous systems. Patients require close monitoring due to the rapid progression of muscle weakness, which often occurs in the intensive care unit. Complete recovery of Guillain-Barré syndrome may occur over a period of up to 4 weeks; however severe cases may lead to permanent paralysis.
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Sobey, Christopher, and David Byrne. "Total Shoulder Arthroplasty." In Acute Pain Medicine, edited by Chester C. Buckenmaier, Michael Kent, Jason C. Brookman, Patrick J. Tighe, Edward R. Mariano, and David A. Edwards, 25–38. Oxford University Press, 2019. http://dx.doi.org/10.1093/med/9780190856649.003.0003.
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This chapter describes patients undergoing total shoulder arthroplasty (TSA), who often present an array of challenging considerations regarding anesthetic management and perioperative pain control. Unlike in other types of shoulder surgery, patients undergoing TSA often have more significant comorbidities such as advanced age and morbid obesity that can affect outcomes in the perioperative period. Preoperative screening should be performed to allow adequate planning for the day of surgery and to ensure adequate postoperative monitoring. Because the procedure is an open surgical approach, it can be very stimulating, and extra consideration for perioperative analgesia should be taken. Careful consideration of multimodal (balanced) analgesic modalities to account for potential respiratory compromise, and incorporation of regional anesthetic modalities can contribute to successful delivery of anesthesia and safe recovery thereafter.
Conference papers on the topic "Anesthesia Recovery Period"
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Pinho, Rafaela Seixas, Gabriel Aranha Sousa Maués, Paola Bitar de Mesquita Abinader, and Sérgio Beltrão de Andrade Lima. "Post-spinal anesthesia headache: a literature review." In XIII Congresso Paulista de Neurologia. Zeppelini Editorial e Comunicação, 2021. http://dx.doi.org/10.5327/1516-3180.612.
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Background: Headache is the most common neurological symptom and is an important complication of cerebrospinal fluid access (CSF) techniques, reported by 1/3 of the patients after 48 hours of puncture. Objective: Present the most relevant information about the clinic and influential factors of headache after spinal anesthesia. Method: A literature review was conducted in pubmed, Scielo, Lilacs and Google academic databases, having as inclusion criteria articles of great relevance published in English, Portuguese and Spanish in the period 2016 to 2021 and exclusion criteria articles published outside that period. Results: Post-spinal anesthesia headache or post-dural puncture headache (DPC) belongs to the group of secondary headaches resulting from nonvascular disorders. The condition is composed of headache in the occipital and frontal region, which worsens in orthostatic position and may be accompanied by other symptoms such as neck stiffness, hearing disorders, photophobia, and nausea. The incidence of headache after the procedure varies according to the technique used, which can be medial or para - medial; more frequent in females; with the use of calibrated needles and in young patients. Regarding the recovery time, according to the reviewed literature, 72% of the patients had resolved the case within 7 days. Conclusion: Therefore, the correct performance of the procedure, with attention to modifiable factors, and the careful evaluation of clinical aspects for early diagnosis are essential to reduce the incidence and morbidity of this potentially disabling headache.
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Drummond Júnior, Délio Guerra, Tamires Rodrigues Toqueto, Rainally Sabrina Freire de Morais, Rodrigo Daniel Zanoni, and Igor Costa Santos. "Indications for anesthetics in the postoperative period of surgery in children." In III SEVEN INTERNATIONAL MULTIDISCIPLINARY CONGRESS. Seven Congress, 2023. http://dx.doi.org/10.56238/seveniiimulti2023-096.
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Introduction: Proper management of postoperative pain in children is of utmost importance to ensure patients' comfort and adequate recovery. Anesthetics play a key role in this context, providing effective analgesia and minimizing adverse effects associated with pain. Objectives: To analyze the indications of anesthetics in the postoperative period of surgeries in children, examining the available options, their mechanisms of action, the available scientific evidence and the clinical benefits. Theoretical Framework: The topics covered include the different types of anesthetics used in 4 axes: opioids, local anesthetics, non-steroidal anti-inflammatory drugs (NSAIDs) and adjuvant anesthetics. In addition, it deals with the specific indications for the use of each type of anesthetic, the appropriate doses and the possible side effects. Methodology: The literature search was conducted using the electronic databases PubMed, Scopus and Web of Science. The following English descriptors were used: "postoperative pain management", "children", "analgesics". The inclusion criteria adopted comprised original articles available in full text and written in English. Final Results: Opioids, such as morphine and fentanyl, are frequently used to control severe pain, but should be administered with caution due to possible side effects, such as respiratory depression and excessive sedation. Local anesthetics, such as bupivacaine and lidocaine, are widely used for regional blocks and local analgesia, reducing the need for systemic opioids. NSAIDs, such as ibuprofen and paracetamol, are effective and safe options for mild to moderate pain management with few side effects. Study results indicate that the choice of anesthetic in postoperative surgery in children should be based on individual patient characteristics, type of surgery, pain intensity, and safety profile of the drug.