Abstract
Study objectives: To evaluate the patients’ baseline condition upon arrival in the PACU as a method of assessment of the quality of anaesthesia, and to establish a model for future comparisons.
Design: Prospective observational study.
Setting: Surgical PACU in an academic tertiary hospital.
Patients: All patients (n = 11,241) arriving in our hospital’s recovery units after elective surgery.
Interventions: In this observational study, clinical data, vital signs and comfort parameters were collected from surgical patients who arrived in the PACU. For each parameter, its frequency distribution or percentage of occurrence was determined.
Main results: The incidence of anaesthesia associated side effects such as hypoxemia, cold extremities, shivering and/or vomiting was 5%. The incidence of nausea, sore throat, headache and/or pruritus was 9%. Sore throat occurred in 4.8% of intubated patients, in 4% after laryngeal mask insertions and in 3.6% with no usage of any airway device. From all patients 48% had no pain at all (VAS = 0), 31% had low pain scores (VAS 1-3) and 16% had moderate (VAS 4-6) pain levels, while 5% indicated severe pain (VAS 7-10). 97.5% of patients were normothermic (35.0-37.3°C), 77% had normal heart rate (60-100 beats per minute) and 74% had normal systolic blood pressure (90-140 mmHg). After use of neuromuscular relaxants, moderate clinical signs of residual curarisation (2 of 3 clinical criteria positive) were observed in 1% and slight clinical signs of residual curarisation (1 of 3 clinical criteria positive) were observed in 22.4% of patients. These findings were collected in all patients, independently whether they had reversal of neuromuscular relaxation.
Conclusions: Compared with the figures published in the literature, we report a lower incidence and severity of anaesthesia related side effects, measured as baseline data, upon patients’ arrival in the post anaesthesia care unit. The baseline data may serve as a model to trigger specific interventions aimed at improving the quality of anaesthetic care, which could be assessed in future investigations
Alkandari, Z