الفهرس 
PACU Arrangements and ManagementsOnly 14 pages are availabe for public view
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Abstract
Recovery rooms have been in existence for less than 50 years in most medical centers. Prior to that time, many early postoperative deaths occurred immediately after anesthesia and surgery. The realization that many of these deaths were preventable emphasized the need for specialized nursing care immediately following surgery.
Successful completion of a procedure in the operating room does not ensure a smooth and uneventful recovery from anesthesia and surgery. Individualized monitoring and assessment are necessary to ensure adequate recovery. Postoperative complications severe enough to require treatment occur in 7-10% of general postanesthesia care unit (PACU) admissions. The magnitude of this treatment frequently depends on the patient’s underlying medical problems and the rapidity with which the problem is identified.
By far, the most common GI-problems in PACU patients are nausea and vomiting. The incidence ranges roughly from 10%-45%. Less than 1% of patients have to stay in hospital overnight because of uncontrollable nausea and vomiting.
Hemodynamic compromise in the PACU patient manifests in a number of ways (systemic hypertension, hypotension, tachycardia, or bradycardia) alone or in combination. Hemodynamic instability in the PACU has a negative impact on long-term outcome. Interestingly, postoperative systemic hypertension and tachycardia are associated with an increased risk of unplanned critical care admission and a higher mortality than hypotension and bradycardia.
Patients at high risk of partial or complete obstruction should not have their tracheal tube or LMA removed until they are able to maintain an open airway. These patients will also require supplementary oxygen to maintain sufficient arterial oxygen saturation.
External compression of the airway after extubation can lead to obstruction, this may occur after certain surgeries and must be quickly diagnosed and treated before total airway obstruction ensures, immediate surgical reexploration is indicated although the airway concerns in these patients should be approached with extreme caution.
Uncontrolled postoperative pain may produce a range of detrimental acute and chronic effects. The attenuation of perioperative pathophysiology that occurs during surgery through reduction of nociceptive input to the CNS and optimization of perioperative analgesia may decrease complications and facilitate recovery during the immediate postoperative period and after discharge from the hospital.