Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Recovery Room”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 505 records · Page 28Linked to original sources
PubMed1977

Environmental air and airborne infections.

The results of a study on the epidemiology of airborne (aerobic) surgical infections are presented. The first phase of the study was carried out in a surgical suite which contained no environmental or traffic control systems. The second phase of the study took place within a modern "up to date" operating room suite containing multiple air screens as well as an elaborate ventilation system utilizing HEPA type filters which provided the operating room with clinically sterile air. One hundred and fifty-six patients were also studied. All patients underwent major procedures. The ratio of clean, clean-contaminated, and dirty cases was the same in both groups. Preoperatively, a nasal swab, clean voided urine (or vaginal swab) and a rectal swab were obtained on each patient. Daily nasal cultures and cultures of suspected sites of infection were obtained postoperatively. Daily nasal cultures and "glove sweat" cultures were obtained on all personnel attending the patient. Environmental cultures of the operating room, the operating room hallway, recovery room and patients' rooms were also taken. All samples were checked for the presence of staphylococci, streptococci, Escherichia coli, proteus species, enterobacter, klebsiella, and pseudomonas. In all, 15,000 cultures were taken during the study. The rate of infection was essentially the same in both phases of the study. Environmental air only occasionaly served as the source of infecting organisms. The results of the study support the conclusion that the most common source of infecting organisms in surgical infections is thepatient or those around him. The most common time of contamination is during the surgical procedure itself. Surgical infections can best be minimized by meticulous observation of fundamental principles of antisepsis rather than by dependence on elaborate and costly ventilation and air control systems.

Adolescent↗
PubMed1994

Influence of surgery on serum concentrations of hyaluronan.

OBJECTIVE: To investigate the changes in serum hyaluronan concentrations in response to surgery. DESIGN: A prospective case series evaluating serum hyaluronan concentrations before, during, and after surgery. SETTING: Operating room and recovery room of a university hospital. PATIENTS: Twelve consecutive patients undergoing vascular surgery because of arterial insufficiency of the lower extremities. MEASUREMENTS AND MAIN RESULTS: Serum hyaluronan concentrations were measured before and after induction of anesthesia and before, during, and after surgery. Routine chemical analyses of blood samples were made before and after surgery. Blood loss and fluid volumes infused were registered. Mean serum hyaluronan concentrations increased from baseline 25 +/- 10 (SD) to 36 +/- 15 micrograms/L (p < .05) during surgery, and increased further at 1 hr after the end of surgery to 52 +/- 38 micrograms/L (p < .001 compared with baseline), but had decreased nearly to baseline levels at 2 hrs postoperatively. A positive correlation was seen between peak hyaluronan concentrations and baseline serum hyaluronan levels (r2 = .73; p < .001), but no strong relationship was seen between serum hyaluronan concentrations and other parameters studied. CONCLUSIONS: Surgery is accompanied by a small increase in serum hyaluronan concentrations in humans. The major increase is seen in the postoperative period, and is probably due to increased influx of interstitial hyaluronan when the returning muscular tone activates lymph flow.

Aged↗
PubMedDate not supplied

A mobile physiological data acquisition system for clinical research.

The S.R. Powers Trauma Research Center at Albany Medical Center makes a wide variety of standard and specially designed physiological measurements on injured patients. To overcome the disadvantages of admitting patients to a single bed research unit, a mobile data acquisition system was designed to study patients in the Intensive Care Unit, Burn Unit, Emergency Room, and Recovery Room. This mobile system acquires data using microcomputer controlled data acquisition and communicates via modem with a larger computer located in the Trauma Unit Research Center. The laboratory computer performs data analysis and returns results to the instrument cart at the bedside. A dry spirometer, which is reset on inspiration by the mechanical ventilators, was designed, built, and incorporated into the cart for measuring expired gas volumes and flows.

Computers↗
PubMed1998

Safety considerations and fluid resuscitation in liposuction: an analysis of 53 consecutive patients.

There is no agreement as to appropriate fluid resuscitation in patients undergoing liposuction. This has assumed greater significance, as surgeons have undertaken larger volume aspirations (> or = 4 liters) and the potential complications of hypovolemia and fluid overload have materialized. This prospective study of 53 consecutive healthy patients undergoing liposuction using a superwet technique served to develop general guidelines for safe perioperative fluid management, especially in regard to large-volume aspirations. In this context, "aspirate" is defined as the total fat and fluid that is removed during liposuction. All patients were monitored using standard noninvasive hemodynamic monitoring. Thirty-six patients were monitored perioperatively with Foley catheters. The 53 patients underwent liposuction alone. We did not include patients who underwent concurrent aesthetic surgical procedures because our intention was to establish fluid administration guidelines for the liposuction patient. There were no significant complications in our series. The intraoperative fluid ratio, defined as (intravenous fluid + infiltrate)/aspirate, was 2.1 for the small-volume group and 1.4 for the large-volume group. These values were significantly different (p < .001, t test). Average urine output in the operating room and recovery room and on the floor was satisfactory (> 0.5 to 1 cc/kg/hr) and did not relate to volume aspirated (p = 0.21, 0.91, and 0.6, respectively, t test). Four patients who underwent "large-volume" aspirations (> or = 4 liters) had transient hypotension, which was immediately responsive to crystalloid fluid boluses in the first postoperative hours. All other patients required only maintenance intravenous crystalloid postoperatively until oral intake had been resumed. There were no statistically significant differences in postoperative fluid administration between the small- and large-volume groups. Ninety-three percent of patients were discharged within 24 hours of surgery. Our suggested guidelines for fluid resuscitation based on this retrospective study are as follows: (1) small volume (< 4 liters aspirated): maintenance fluid + subcutaneous wetting solution; (2) large volume (> or = 4 liters aspirated): maintenance fluid + subcutaneous wetting solution + 0.25 cc of intravenous crystalloid per cc of aspirate removed after 4 liters. This formula has since been used in the care of 94 patients who have undergone liposuction exclusively. All patients have had unremarkable hospital courses. These guidelines do not replace sound clinical judgment. Good communication between the surgeon and anesthesiologist is critical to optimal patient care and safety.

Adolescent↗
PubMed2006

Fluid resuscitation in liposuction: a retrospective review of 89 consecutive patients.

BACKGROUND: In 1998, the senior author presented the intraoperative fluid ratio, defined as the volume of super-wet solution and intraoperative intravenous fluid divided by the aspiration volume, to guide resuscitation fluid volumes in super-wet liposuction. The senior author demonstrated that intraoperative fluid ratios of 2.1 for small-volume and 1.4 for large-volume liposuction were safe and did not cause volume overload sequelae. A high urine output was common and reflected a mild overresuscitation, which could have adverse consequences in patients with undiagnosed cardiopulmonary disease. The purpose of this study was to compare overresuscitation sequelae in a cohort of consecutive super-wet liposuction patients using a new fluid management formula in which replacement fluid was given after 5000 cc of lipoaspirate instead of 4000 cc, as initially described. METHODS: The charts of 89 consecutive patients undergoing super-wet liposuction were retrospectively reviewed. RESULTS: The intraoperative fluid ratio was 1.8 for the small-volume reductions (< 5000 cc, n = 68) and 1.2 (> 5001 cc, n = 21) for the large-volume reductions. There were no episodes of pulmonary edema, congestive heart failure exacerbation, or other major complications. The average urine output in the operating room, the recovery room, and while on the floor was 1.5, 1.6, and 2.9 cc/kg/hour for the small-volume group and 1.7, 1.8, and 2.5 cc/kg/hour for the large-volume group. CONCLUSIONS: The super-wet subcutaneous infiltration liposuction technique for both small- and large-volume reductions is safe and can be performed without adverse cardiopulmonary sequelae. Given the high urine outputs, the intraoperative fluid ratio can be further improved by possibly eliminating the replacement fluid altogether.

Fluid Therapy↗
PubMed1994

Measurement of surgical costs: a clinical analysis.

Because of reduced health care funding it is becoming necessary for surgeons to take a greater interest in the costs of individual operations. This study reports costs directly measurable to the patient, and also the indirect costs of hospital overheads, an operating suite and teaching, which were 37, 10 and 15%, respectively (62%), of hospital budget. A scheme has been developed which could give surgeons a standard to report direct costs. Pre-admission, ward, operating room, recovery, intensive care and post-admission are defined as cost periods and the modalities of staff, equipment (capital, maintenance and replacement), imaging, laboratory and consumables apply to each. This strategy was applied to assess open cholecystectomy (OC) and laparoscopic cholecystectomy (LC) as an example. The direct costs for OC were $3706 and LC $2868, a difference of $838; the indirect and direct costs were OC $6004 and LC $4646, a difference of $1358. Thus indirect cost magnified the difference between the operations. Bed stay, density of nursing and use of disposable instruments were the major influence on direct costs. The individual cost advantage of a shorter bed stay may be countervailed by an increased hospital activity. The main patient benefit of new operations may be improved quality of life and more rapid return to work with prevention of salary losses. A method has been developed to define costs of a particular surgical operation with the purpose of stimulating surgeons' interest in this topic and developing a common style of reporting.(ABSTRACT TRUNCATED AT 250 WORDS)

Cholecystectomy↗
PubMed1976

Exposure to anesthetic gases and ethanol during work in operating rooms.

The concentration of halothane and ethanol in operating rooms was measured during 37 routine operations performed in nine different departments of surgery at six different hospitals. The time-weighted halothane concentrations in the respiratory zones of anesthetic and surgical nurses were 0.3--34.0 ppm (time-weighted average 7.2 ppm) and 0.1--9.2 ppm (time-weighted average 2.5 ppm), respectively, in the different operating departments. The corresponding ethanol concentrations were 0.3--36.5 ppm (time-weighted average 12.5 ppm) for anesthetic nurses and 1.5--46.6 ppm (time-weighted average 15.3 ppm) for surgical nurses. The anesthetic technique influences the exposure of the operating staff to anesthetic gases, but it does not affect exposure to ethanol. In controlled experiments volunteers were exposed to low concentrations of halothane or ethanol. About 60% of both substances was retained. The content of ethanol in the end-expired air approached zero within a few minutes after the end of exposure, while low residual concentrations of halothane were demonstrable for more than 1 h. Although exposure to ethanol is insignificant in relation to the metabolic capacity of the body, ethanol indicates the presence of volatile disinfectant components, and its spread through the room atmosphere should be kept in mind when the ventilation of operating rooms is designed. The effective elimination of airborne pollutants in operating rooms calls for good general ventilation in conjunction with local exhaust close to the sources of anesthetic gas leakage. General ventilation mainly affects the concentration of substances well-mixed with the room atmosphere, such as volatile disinfectant components and anesthetic vapor that has spread beyond the actual work zones of the medical staff. For a significant reduction in the concentration of anesthetic gases in the respiratory zones of the medical staff, the gases must be vented at the source of leakage. Since airborne anesthetics occur not only in operating rooms, general ventilation has to meet certain minimum requirements also in anesthetic induction rooms and recovery rooms. Operating rooms and anesthetic induction rooms must also be supplied with local exhaust systems.

Air Conditioning↗
PubMedDate not supplied

Comparison between video-assisted thoracoscopic thymectomy and transternal thymectomy for myasthenia gravis (analysis of 82 cases).

Video-assisted thoracoscopic surgery (VATS) provides a new approach to thymectomy for myasthenia gravis (MG). We compared the results of video-assisted thoracoscopic thymectomy (VATT) and transternal thymectomy (TT) in Taiwanese people with MG. From January 1997 to August 2002, we enrolled a total of 82 patients with MG who underwent TT and anterior mediastinal adipose tissue removal in our study. Of those, 51 patients underwent VATT, and 31 patients underwent TT. The men-to-women ratios were 18:33 and 15:16 in the VATT and TT groups, respectively. The mean age was 37.9 +/- 17.56 years in the VATT group and 35.6 +/- 16.8 years in the TT group (P = 0.55). Preoperative Osserman's classification revealed the following: class I: 11 (21.6%), 13 (41.9%); class IIA: 18 (35.3%), 11 (35.5%); class IIB: 18 (35.3%), 5 (16.1%); class III: 2 (3.9%), 0; and class IV: 2 (3.9%), 2 (6.5%), respectively, in the two groups (P = 0.06). During VATT, all but two patients were placed supine in the 45 degrees left lateral decubitus position under double-lumen intubated anesthesia. Usually three 1-cm incision wounds over anterior axillary line at the third, fifth, and sixth intercostal spaces were necessary. A total of 82 patients (51 with VATT and 31 with TT) were studied. There were no statistical differences between the two groups of patients in terms of sex, age, and severity of MG. In VATT and TT groups, postoperative hospital stays were 6.1 +/- 3.3 and 26.9 +/- 14.1 days, respectively (P = 0.001). Intensive care unit stays were 1.5 +/- 1.1 and 3.2 +/- 2.3 days, respectively (P = 0.018). Operative times were 180.0 +/- 53.4 and 248.2 +/- 71.9 minutes, respectively (P = 0.004). Thymus weights were 43.7 +/- 22.5 and 52.2 +/- 29.6 g, respectively (P = 0.141). Fifty-one VATT procedures were performed through a right-side approach without conversion. Most patients were extubated in the operating room or recovery room. The harvested thymus glands had an average weight of 49.4 g (range, 21.4-90 g). There were no surgical mortality cases. There was no statistically significant difference (P = 0.574) in the postoperative improvement classification between the two groups, with a mean of 4 years of follow-up. In the VATT group, 14 (27.5%) patients had complete remission without any medication, 14 (27.5%) patients were in class II, 21 (41.1%) patients were in class III, 2 (3.9%) patients were in class IV, and 0 (0%) patients were in class V, according to postoperative classification of DeFilippi et al. We concluded that VATT is technically feasible and safe and is associated with a favorable postoperative outcome compared with the transsternal approach.

Adult↗
PubMed1980

Intraoperative external pneumatic calf compression to afford long-term prophylaxis against deep vein thrombosis in urological patients.

In a prospective randomized study of patients undergoing open urological operations, we found external pneumatic compression (EPC) of the calves applied in the operating room and recovery room as effective in reducing deep vein thrombosis as EPC continued during convalescence until resumption of ambulation. Provided early postoperative ambulation is practiced, intraoperative EPC appears to be adequate prophylaxis and equivalent to long-term EPC for prevention of deep venous thrombosis in urological patients.

Adult↗
PubMed1999

Comparison of patient-controlled analgesia (PCA) with tramadol or morphine.

PURPOSE: To compared the clinical efficacy of tramadol and morphine using a patient-controlled analgesia (PCA) delivery system. METHODS: In a prospective, randomized, double blind study, we evaluated 80 adult patients scheduled for elective hip or knee arthroplasty with general inhalational anesthesia. When patients complained of pain in the recovery room, patients were randomized to receive either tramadol or morphine by titration in 30 min to achieve analgesia (VAS < or =4). Equivalent volumes containing either 30 mg x ml(-1) tramadol or 1 mg x ml(-1) morphine were used for PCA with a lockout interval of 10 min. The patients were followed six-hourly for 48 hr for VAS, satisfaction rate, analgesic dose, and side effects. RESULTS: Patients obtained adequate analgesia with either drug. More patients had very good satisfaction scores in the morphine group in the recovery room (43% vs. 23%, P<0.05) and at 24 hr (40% vs. 20%, P<0.05) than those in the tramadol group. More nausea was evident in the tramadol group (48% vs. 11% in recovery room and 28% vs. 12% in 24 hr, P<0.05) than in the morphine group. Vomiting was also more (28% vs. 5% in recovery room, 15% vs. 3% in 24 hr, P<0.05). Morphine produced more sleepiness (45% vs. 23% in recovery room, P<0.05 and 35% vs. 15% in 24 hr, P<0.05). CONCLUSION: Tramadol PCA can provide effective analgesia following major orthopedic surgery provided sufficiently high doses are given for loading and by patient demand. However, the incidence of nausea/vomiting is also higher causing decreased satisfaction.

Adult↗
PubMed1990

[Hypoxemia after general anesthesia in healthy adults].

It has been shown that a variable percentage of patients who receive a general anesthetic are significantly hypoxemic when they arrive at the recovery room. Pulse oximetry has proved to be a reliable method to determine arterial oxygen saturation when compared to arterial or mixed venous blood oxygen saturation measurements. The authors determined the incidence and severity of hypoxemia by pulse oximetry in 45 healthy adult patients, (non obese, non smokers) who underwent non thoracic surgery under general anesthesia. Arterial oxygen saturation was measured without premedication before surgery (control), when they arrived at the recovery room, and 5 and 15 minutes later. The axillary temperature was taken at the same times. The results were expressed as the median and standard deviation and were analyzed with Student T Test, and p LO.05 was considered significant. Nine patients (20%) showed unacceptable oxygen saturation when they arrived at the recovery room (88.4 +/- 2.50%, LO.05). All patients showed significant hypothermia (35.3 +/- 0.54 degrees C). The authors conclude that a significant number of healthy adult patients who are given a general anesthetic show severe hypoxemia when they arrive at the recovery room. The severe hypothermia found in these patients can aggravate the hypoxemia. They consider it is mandatory to control the temperature of and to administer oxygen in the recovery room to all patients who receive a general anesthetic.

Adult↗
PubMed1997

Opportunities for control of hospital cost for total knee arthroplasty.

The hospital financial records of 120 consecutive patients who underwent unilateral knee replacement surgery at one hospital during 1995 were reviewed to determine opportunities for control of hospital cost for total knee arthroplasty. The average hospital length of stay for these patients was 4.27 days (range, 3-10 days). The average hospital cost was $10,231. All 120 patients were classified under Diagnosis Related Group 209, principle procedure 81.54 primary total knee arthroplasty. Medicare paid for 70% of the patients. All payers were profitable except Medicaid and one managed care organization. When hospital cost for total knee arthroplasty was allocated to hospital service centers, 78% of the cost was attributed to the operating room, nursing units, recovery room, and pharmacy. When hospital cost for total knee arthroplasty was allocated to hospital days, 80% of the hospital cost occurred during the first 48 hours of hospitalization. Hospital reimbursement for total knee arthroplasty is primarily a prospective case price payment system. After initial cost containment efforts reduce the hospital length of stay for total knee arthroplasty to 4 to 6 days, additional control of hospital cost should focus on these areas of opportunity.

Aged↗
PubMed1995

Complications associated with removal of the laryngeal mask airway: a comparison of removal in deeply anaesthetised versus awake patients.

The purpose of the study was to compare the incidence of complications (coughing, biting, retching, vomiting, excessive salivation and airway obstruction) associated with removal of the laryngeal mask airway. The laryngeal mask airway was used in 100 adults undergoing urological procedures. The patients were randomly assigned to two groups. In 50 patients the laryngeal mask was removed by a nurse when the patient responded to commands in the recovery area. In the other 50 patients it was removed by the anaesthetist with the patient deeply anaesthetized in theatre. The majority of patients were elderly men who had relatively short procedures. The incidence of gastric regurgitation was assessed by measurement of pH of secretions at the tip of the laryngeal mask airway. Complications occurred more frequently in the awake patients (P < 0.01). Most were minor and occurred before removal of the laryngeal mask airway during emergence in the recovery room. Airway obstruction occurred in three patients in whom the laryngeal mask was removed in the recovery room. In two of these patients the oxygen saturation decreased below 80% and the other to 90%. No decrease in arterial oxygenation occurred in the anaesthetised patients in whom the laryngeal mask was removed by the anaesthetist. In 14 patients in the awake group the pH of secretions at the tip of the laryngeal mask was < or = 3 compared with only four patients in the anaesthetised group (P < 0.05). It is concluded that it may be safer to remove the laryngeal mask airway whilst the patients are deeply anaesthetised in the operating room than when they are awake in the recovery room.

Adult↗
PubMed1982

Inaccuracy of liquid crystal thermometry to identify core temperature trends in postoperative adults.

In 71 adult postsurgical patients, simultaneous measurement of core (tympanic membrane) and shell (liquid crystal adhesive temperature strip) cutaneous temperature was assessed on admission and every 15 minutes throughout the recovery room stay. Tympanic membrane sensors were inserted into the ear and adhesive temperature strips were applied to the forehead. Although temperature strip temperatures on admission to the recovery room were correlated significantly with tympanic membrane temperatures on admission to the recovery room (r = 0.61, p less than 0.001), subsequent readings 15, 30, 45, and 60 minutes after admission demonstrated decreasing correlation coefficients. Moreover, changes in temperature strip temperatures over the first 15, 30, and 45 minutes of monitoring in the recovery room did not correlate significantly with changes in tympanic membrane temperatures over the same time period. These data suggest that shell temperature (temperature strip) is not a reliable or valid trend indicator of core temperature (tympanic membrane) in postanesthetic adults.

Adolescent↗
PubMed2003

[Nursing care in the anesthesia recovery period: review of the literature].

The present study was undertaken after it was observed that patients submitted to surgical procedures arrived in recovery room with incomplete records, thus complicating continuing nursing care. The goal of the present study is to analyze bibliographic data from 1990 to 2002 on recovery room nursing care. The data was obtained from LILACS (Latin America Literature about Health Science), PERIENF (Nursing School Library of the University of São Paulo) and BDENF (Library of Federal University of Minas Gerais). The key words were nursing care, recovery room and immediate post-operative period. Only 16 articles were found, indicating a shortage of literature on this topic. The recovery room period is an important period of hospitalization and the data are essential for continuous care.

Anesthesia Recovery Period↗
PubMedDate not supplied

Postoperative pain control with methadone following lower abdominal surgery.

STUDY OBJECTIVES: To describe a technique for the use of methadone during and following lower abdominal surgery that integrates its pharmacokinetic and pharmacodynamic properties with the objective of postoperative analgesia; to compare methadone with morphine for postoperative pain control. DESIGN: Randomized prospective clinical trial. Patients were not told which agent they received (single-blind). SETTING: Department of anesthesia and gynecology surgical service at a university medical center. PATIENTS: Forty women undergoing abdominal hysterectomy (n = 39) or myomectomy (n = 1). INTERVENTIONS: Patients received either methadone (Group 1) or morphine (Group 2) 20 mg intravenously (IV) following induction of anesthesia, additional IV opioid in the recovery room, and subsequent opioid as needed (PRN) intramuscularly (IM) on the postsurgical wards. MEASUREMENTS AND MAIN RESULTS: Pain was assessed using a visual analog scale (VAS). Respiratory rate, sedation, and hemodynamics were assessed frequently (at least every 4 hours). Patients were studied for 72 hours following recovery room discharge. Patients required less methadone than morphine in the recovery room (2.0 +/- 2.9 mg vs 4.4 +/- 2.9 mg). Patients requested less methadone than morphine for pain relief on the wards (4.5 +/- 4.2 mg vs 42.3 +/- 14.3 mg). Patients in the methadone group reported lower pain intensity by VAS (1.9 +/- 0.3 vs 3.4 +/- 0.6). These differences are statistically significant (p less than 0.01). CONCLUSION: Sustained analgesia with methadone is predicted by its pharmacokinetics. Patients who received 22 +/- 2.9 mg of IV methadone (combined intraoperative and recovery room doses) reported less pain and required minimal additional analgesic over the next 72 hours than did patients who received morphine. This is consistent with sustained therapeutic plasma levels due to methadone's long plasma half-life (54 +/- 20 hours). Use of methadone in this manner is an effective therapy for postoperative pain control and is not associated with toxicity or notable side effects.

Adult↗
PubMed1995

A comparison between ketorolac and diclofenac in laparoscopic sterilization.

We compared ketorolac and diclofenac for the prevention and treatment of post-operative pain in patients undergoing laparoscopic sterilization. Fifty ASA I or II women were allocated randomly to receive either diclofenac 75 mg or ketorolac 30 mg intramuscularly 30-90 min before general anaesthesia. Pain scores were assessed half-hourly in the recovery room and then at 2 h and 4 h in the ward. In the recovery room, pain was treated with a second dose of the study drug, followed by parenteral pethidine if necessary. Four patients in the diclofenac group and five patients in the ketorolac group requested no analgesics after surgery. Fifteen patients from each group had satisfactory analgesia after the second dose of study drug. Pain scores were similar between groups at all times. The median (range) initial pain score in the recovery room was 5 (0-9.5) in the diclofenac group and 5 (1-9) in the ketorolac group. Pain at the injection site was more common after diclofenac than ketorolac (12 vs. 3, P < 0.05). In conclusion, both intramuscular diclofenac and ketorolac were relatively ineffective in controlling the pain after laparoscopic sterilization. The drugs were equally well tolerated, but more patients complained of pain at the injection site after diclofenac.

Adult↗
PubMed2003

[Pulse oximetry in perioperative monitoring].

BACKGROUND: Monitoring with pulse oximetry might improve patient outcome by enabling an early diagnosis and consequently, correction of perioperative events that might cause postoperative complications or even death. Only a few randomised clinical trials of pulse oximetry have been performed during anaesthesia and in the recovery room which describe perioperative hypoxaemic events, postoperative cardiopulmonary complications and cognitive dysfunction. OBJECTIVES: To study the effect of perioperative monitoring with pulse oximetry to clearly identify the adverse outcomes that might be prevented or improved by the use of pulse oximetry. SEARCH STRATEGY: Trials were identified by computerised searches of the Cochrane Library, MEDLINE, EMBASE, and by checking the reference lists of trials and review articles. SELECTION CRITERIA: All controlled trials that randomised patients to either pulse oximetry or no pulse oximetry during the perioperative period, including the operating and recovery room. DATA COLLECTION AND ANALYSIS: We collected data in relation to events detectable by pulse oximetry, any serious complications that occurred during anaesthesia or in the postoperative period, intra- or postoperative mortality, and duration of recovery or intensive care stay. Formal statistical synthesis of individual trials was not performed in view of the variety of outcomes studied. MAIN RESULTS: Searching identified six reports; four studies with data from a total of 21,773 patients were considered eligible for analysis. Only two studies specifically addressed the outcomes in question; both found no effect on the rate of postoperative complications using perioperative pulse oximetry. Two studies used hypoxaemia detectable by pulse oximetry to assess the value of perioperative monitoring, although outcomes were not given. It was found that hypoxaemia was reduced in the pulse oximetry group both in the operating theratre and in the recovery room. During observation in the recovery room, the incidence of hypoxaemia in the pulse oximetry group was 1.5-3 times less. The postoperative cognitive function using the Wechsler memory scale and continuous reaction time was independent of perioperative monitoring with pulse oximetry. The other study showed that postoperative complications occurred in 10% of the patients in the oximetry group and in 9.4% in the control group. The two groups did not differ in cardiovascular, respiratory, neurologic, or infectious complications. The duration of hospital stay was a median of 5 days in both groups, and an equal number of in-hospital deaths was registered in the two groups. REVIEWERS' CONCLUSIONS: The studies confirmed that pulse oximetry can detect hypoxaemia and related events. However, we have found no evidence that pulse oximetry affects the outcome of anaesthesia. The conflicting subjective and objective results of the studies, despite an intense, methodical collection of data from a relatively large population, indicate that the value of perioperative monitoring with pulse oximetry is questionable in relation to improved reliable outcomes, effectiveness and efficiency.

Humans↗