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At least 19 recordsLinked to original sources
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

[Hemodynamic and gasometric modifications during the anesthesia recovery period in patients undergoing ventilation after surgery of the abdominal aorta].

This study was carried out on 12 patients (mean age 61) in order to assess the oxygen consumption (VO2) in the post-operative stage of an elective surgical procedure (replacement of the abdominal aorta). Anesthesia was a combination of thiopentone, pancuronium bromide and high doses of droperidol and fentanyl. Patients were kept intubated and ventilated in the post-operative period. VO2 and other related metabolic parameters as well as hemodynamic parameters were measured every 45 minutes over a period of 5 hours. A VO2 increase (127%) related to the increase in body temperature was noted. Mean VO2 for all patients during the whole period was 170 +/- 13 ml.min-1.m-2 (range: 51-411 ml.min-1.m-2). Mean value of maximal VO2 was 240 +/- 21 ml.min-1.m-2 (range: 1471-411 ml.min-1.m-2). Large dose of droperidol are shown to limit VO2 increase. In patients with shivering, the maximal value of VO2 was found during shivering. The amount of droperidol administered during anesthesia was greater in patients without shivering. VO2 increase was due to a rise in tissular O2 extraction. Cardiac index was insufficiently increased (+ 9.4%) and a certain extent of myocardial inadaptability was suspected in relation with: high blood pressure, hypovolaemia and/or myocardial effect of anesthesia agents.

Anesthesia Recovery Period↗
PubMed1989

[Does flumazenil, a benzodiazepine antagonist used during the anesthesia recovery period, have an anxiogenic effect?].

The goal of this study was to assess the degree of postoperative anxiety flumazenil might provide in patients when used to reverse the sedation induced by midazolam. Twenty-four patients, aged 18 to 60 yrs, and scheduled for elective orthopaedic surgery of the upper limb, were included in the study Regional anaesthesia (brachial plexus block) was carried out 20 min after the patient had been premedicated with 0.15 mg.kg-1 intramuscular midazolam. When the block was clinically complete, 0.12 mg.kg-1 midazolam was given intravenously. Sedation was maintained throughout surgery using 0.03 mg.kg-1 midazolam every quarter of an hour (mean total dose 0.206 mg.kg-1). At the end of the procedure, the patients were randomly allocated to one of two groups: A+, the patients were given 0.1 mg intravenous flumazenil repeated every min until the patient was fully awake (mean 4.5 +/- 2.6 micrograms.kg-1); and A-, the patients were allowed to recover spontaneously. A wakefulness, and a determination just before premedication (E1, P1, H1 respectively). The degree of recovery was assessed in both groups, and, when the value of the wakefulness test had returned to that of E1 (E2) (E2 = E1), P2 and H2 were carried out. There were no statistically significant differences between P1 and P2, and between H1 and H2, and this for either group of patients. So, the doses of flumazenil used, which awoke all the patients within 3 min, did not create any anxiety. In accordance with most of the recently published studies, flumazenil can be safely used to reverse benzodiazepine induced sedation.

Adolescent↗
PubMed1990

[Cardiac arrest during anesthesia and recovery period].

Cardiac arrests (CA) occurring during anaesthesia and recovery can be classified into three groups: CA not related to anaesthesia (NACA), CA related to anaesthesia (ACA), whether partially (PACA) or totally (TACA). In the French survey, NACAs were three times more frequent than ACAs. Nearly 25% of ACAs occurred at induction and consisted mainly in TACAs. Another quarter of ACAs occurred during maintenance and consisted mainly in PACAs. About 50% of ACAs occurred after the end of anaesthesia and had the highest mortality rate. Cardiac arrest corresponds to the status of a heart unable to generate the minimum aortic blood flow required for functioning of vital organs. For the brain, a zero-blood flow of more than 4 seconds results in coma. Consequently CA exists when the time interval between two subsequent efficient systoles is greater than 4 seconds. Anaesthetic agents can result in CA by 1) overdose (absolute, relative), 2) anaphylactoid/anaphylactic reactions, 3) specific effects (acetylcholine-like effect, hyperkalaemia and malignant hyperthermia for succinylcholine; vagal effect of vecuronium and atracurium; cardiotoxicity of bupivacaine) and 4) drug interaction. In hypoxic CA, severe neurologic impairment often still exists at the time of onset of CA. The anaesthesia machine and controlled ventilation can induce CA by hypoxic ventilation, overdose of anaesthetic vapour, excessive CO2 reinhalation, hypoventilation, disconnection, excessive pressure in airways. Cardiac hypothermia can be a cause of CA as well as a cause of unsuccessful CPR. Massive infusion of unwarmed fluids and IPPV with unheated gases generate a temperature gradient within the heart which may result in severe arrhythmias and CA.(ABSTRACT TRUNCATED AT 250 WORDS)

Anaphylaxis↗
PubMed1992

[Hemodynamic complications during the recovery period after anesthesia].

In the postoperative period the alterations of blood pressure are the main hemodynamic complications. Hypotension or hypertension may compromise the coronary circulation and increase the metabolic demand of the myocardium. Pulmonary oedema is the most frequent manifestation of heart failure. The aim of its treatment is to increase myocardial contractility and decrease the metabolic demand. Myocardial ischemia is mostly silent and is an important correlate of adverse cardiac outcomes. The treatment of these hemodynamic events starts during the peroperative period by prevention of their risk factors.

Anesthesia Recovery Period↗
PubMed1990

[The recovery period following total intravenous anesthesia using propofol and alfentanil versus inhalation anesthesia using nitrous oxide and enflurane at 1.3 MAC].

Recovery of motor and mental functions were investigated in two groups with 20 young patients each. One group received total intravenous anaesthesia (TIVA) with propofol and alfentanil for urological surgery and the other group received nitrous oxide-oxygen anaesthesia in combination with 1.3 MAC of enflurane for lumbar nucleotomy. The following parameters were investigated before and up to 100 minutes after extubation: simple and discriminating motor activities, vigilance and short and long term memory. --Simple and in discriminating motor actions show a significantly faster recovery was seen in the TIVA group during the first 20 minutes after extubation compared to the enflurane-treated patients. Speech-related functions were particularly inhibited in the inhalational anaesthesia group. After 30 to 40 minutes the propofol-alfentanil group was able to meet all requirements while patients with inhalational anaesthesia needed 80 minutes to reach the same level. Recovery of short and long-term memory was also significantly shorter in the TIVA group. This clearly indicates a faster return of mental and motor functions following total intravenous anaesthesia with propofol and alfentanil. However the large dosages of alfentanil may be a problem with regard to post-anaesthetic respiratory depression. Further studies with larger numbers of patients will be necessary to evaluate the potential side effects of continuous propofol/alfentanil infusion. Presently, safety demands require, at least a sixty-minute post anaesthesia monitoring for patients receiving this new anaesthesia method.

Adult↗
PubMed1996

[Total intravenous anesthesia (TIVA) with propofol/ketamine as an alternative for patients at risk in abdominal surgery].

Propofol/ketamine combination, used in total intravenous anesthesia (TIVA), is assayed in patients with abdominal diseases presenting surgical and anesthesiological risk of a varying degree. The aim of the study is to outline an optimal regimen of propofol infusion as a hypnotic agent and ketamine as analgetic during TIVA with a special reference to the hemodynamic effects and characteristic features of the recovery period. Anesthesia is applied to 15 patients presenting physical condition III--IV degree according to ASA and indications for various intraabdominal surgical interventions, including operations on an emergency basis. To improve anesthesia control, microprocessor infusion pumps Ohmeda and Becton-Dickinson, allowing for prompt dosage correction, consistent with individual needs, are employed. The strategy of dosing each of the drugs used is described. The basic hemodynamic parameters are followed with parallel assessment of the quality of anesthesia with a view to prevent operative stress, working conditions of the operative team, and characteristic features of the recovery period. From clinical viewpoint the technique proves to be satisfactory, and may be used as an alternative to conventional anesthesia in poor-risk patients indicated for abdominal surgery.

Abdomen↗
PubMedDate not supplied

Recovery following outpatient anesthesia: use of enflurane versus propofol.

STUDY OBJECTIVE: To compare the intraoperative conditions and postoperative recovery of patients following the use of either propofol-nitrous oxide (N2O) or enflurane-N2O for maintenance of outpatient anesthesia. DESIGN: Randomized, single-blind study. SETTING: University hospital outpatient surgery center. PATIENTS: 61 ASA physical status I and II, healthy female outpatients undergoing laparoscopic surgery. INTERVENTIONS: Patients were randomly assigned to one of three anesthetic regimens. Group 1 (control) received thiopental sodium 4 mg/kg intravenously (i.v.), followed by 0.5% to 1.5% enflurane and 67% N2O in oxygen (O2). Group 2 received propofol 2 mg/kg i.v., followed by 0.5% to 1.5% enflurane and 67% N2O in O2. Group 3 received propofol 2 mg/kg i.v., followed by propofol 50 to 160 micrograms/kg/min i.v. and 67% N2O in O2. All patients received succinylcholine 1 mg/kg i.v. to facilitate tracheal intubation and atracurium 10 to 20 mg i.v. to provide adequate relaxation during the maintenance period. MEASUREMENTS AND MAIN RESULTS: Recovery from anesthesia was assessed by a research nurse who was unaware of the anesthetic technique used. The mean +/- SD time to eye opening was significantly longer in the thiopental-enflurane-N2O group (Group 1) than in the propofol-propofol-N2O group (Group 3) (6.1 +/- 2.5 minutes vs. 3.5 +/- 2.8 minutes, respectively). In addition, the mean time to respond to verbal commands was significantly shorter in the propofol induction groups compared with the thiopental induction group. However, the use of enflurane versus propofol for maintenance of anesthesia did not significantly prolong the time from arrival in the recovery room to sitting, tolerating oral fluids, walking, or being judged "fit for discharge." There were no differences among the three groups with respect to postoperative pain or analgesic requirements. Finally, patients who received enflurane for maintenance of anesthesia had a significantly higher frequency of nausea and vomiting than the propofol maintenance group. CONCLUSION: Induction of anesthesia with propofol is associated with a more rapid emergence from anesthesia than induction with thiopental. Maintenance of anesthesia with enflurane did not prolong recovery compared with maintenance with propofol, but enflurane was associated with increased frequency of postoperative nausea and vomiting.

Adult↗
PubMed1997

Prolonged (12 hours) intravenous anesthesia in the rat.

A method is described for prolonging anesthesia in the rat for periods of up to 12 h, with subsequent recovery. Ketamine and xylazine in a ratio of 30 to 1 were infused intravenously by use of an adjustable syringe pump at rates of 40 to 50 microliters/min (1,000 to 1,250 micrograms/kg of body weight/min for ketamine and 32 to 40 micrograms/ kg/min for xylazine), and the rate of infusion was adjusted to maintain a stable depth of anesthesia. Primary assessment of the depth of anesthesia was provided by observation of the respiratory rate, which was maintained between 80 and 100 breaths/min. Rectal temperature was maintained between 35 and 36 degrees C. Blood pressure, pulse, and blood pH and bicarbonate concentration were stable during the 12-h period. The PCO2 increased slightly to 53 mm Hg; PO2 decreased gradually to 59 mm Hg at the last measurement. Plasma glucose concentration decreased progressively; supplemental glucose was given to maintain plasma concentration > 5 mM. After anesthetic administration was discontinued, the animals recovered promptly.

Anesthesia Recovery Period↗
PubMed1999

The impact of saline flush of the epidural catheter on resolution of epidural anesthesia in volunteers: a dose-response study.

UNLABELLED: We evaluated the effect of 1, 20, and 40 mL of epidural saline flush on recovery from lidocaine epidural anesthesia. Eight volunteers were studied for three study periods, each separated by 72 h. The volume of saline was randomized, and a new catheter was inserted for each study period. A standardized dose of 20 mL of 2% plain lidocaine was injected for 10 min, followed by an epidural saline flush 30 min later. Sensory block was assessed by pinprick and transcutaneous electrical stimulation and motor block by a modified Bromage scale and isometric maximal force contraction. Times to void and ambulate independently before discharge were recorded. Peak plasma lidocaine concentrations and time to peak concentration were determined. Results from six volunteers showed that epidural saline, 40 mL, significantly altered anesthetic resolution, accelerating the time of complete sensory and motor block regression (P < 0.05). Median peak levels of sensory and motor block and times to void and ambulate were similar among treatment groups. Peak plasma lidocaine concentrations were similar in all treatment groups. Our data suggest that a 40-mL epidural saline injection 30 min after the induction facilitates regression of epidural lidocaine anesthesia, but a 20-mL bolus does not. Epidural saline injection does not affect vascular absorption of epidural lidocaine. IMPLICATIONS: Epidural catheter flushing with 40 mL of saline, after establishment of epidural lidocaine anesthesia, can facilitate sensory and motor block recovery. However, this does not affect vascular absorption of epidural lidocaine.

Absorption↗
PubMed2006

The OxyArm: a supplemental oxygen delivery device.

Facemasks and nasal cannulae are used to provide supplemental oxygen to patients in the postoperative period after general anesthesia. These devices are associated with several patient complications, including aspiration, hypercarbia, and mechanical trauma. A new device, the OxyArm, is designed to eliminate these problems. It is an "open oxygen" system that does not require physical contact with the patient's face. In this clinical study we evaluated the OxyArm in the immediate postoperative period. Sixty patients received supplemental oxygen via the OxyArm for the first 8 min after tracheal extubation after general anesthesia. Oxygen saturation values were continuously recorded during 3 4-min time periods: 1) while breathing oxygen through an endotracheal tube before tracheal extubation, 2) while breathing oxygen delivered by the OxyArm at 4 L/min 4 min after tracheal extubation, and 3) while breathing oxygen delivered by the OxyArm at 2 L/min 8 min after tracheal extubation. There were no significant differences in oxygen saturation among the three time periods and no patient experienced an oxygen desaturation event less than 88%. Patients and clinicians praised the OxyArm for its comfort and ease of use, allowing nursing facial care without interrupting oxygen therapy. We conclude that the OxyArm delivers adequate levels of oxygen for most patients during the early postoperative period.

Anesthesia Recovery Period↗