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At least 19 recordsLinked to original sources
PubMed1987

[Pulse oximeter. Clinical assessment in the recovery room].

Fifty unselected recovery room patients were monitored using a Nellcor N101 pulse oximeter. Non invasive SaO2 values were compared with simultaneous spectrophotometric measurements made on arterial blood samples (Co-oximeter). Mean pulse oximeter SaO2 was 86.9 +/- 6.08%, with extreme values of 68 and 95.5%. Arterial blood SaO2 was 91.25 +/- 6.28%, with extreme values of 66 and 100%. Linear regression analysis showed a good correlation between the two sets of measures (r = 0.97; p less than 0.005). Twenty one patients had a SaO2 below 90% (mean: 84.83 +/- 5.93%); their measured arterial SaO2 was of 86.14 +/- 6.32%. The correlation between the two sets of low values was good (r = 0.96; p less than 0.05). Pulse oximetry was a non invasive reliable method, but there were some limits to its clinical use. Hypothermia or shock vasoconstriction precluded the measurement of SaO2. Restlessness or shivering were responsible of probe dysfunction and false alarms. False SaO2 readings may result from high levels of carboxyhaemoglobin or dye infusion. Also, each disposable finger probe was reused for a mean of five patients, its cost being relatively high (170 FF, i.e. 28.3 US dollars).

Adult↗
PubMedDate not supplied

[Determination of subanesthetic concentrations of halothane in the environment of operating and recovery rooms].

Concentrations of halothane in parts per million (ppm) in the air were determined during 4 days in the operating rooms and the recovery room of pediatric surgery during the course of surgical anesthesia by inhalation. The operating rooms did not have an anesthetic gas scavenging system. Eighteen samples of air were taken by passive diffusion in sampling tubes of activated charcoal (mode Dräger Orsa 5). The samples were analysed by gas chromatography). We found concentrations between 4.7 ppm and 34.2 ppm that exceed those considered as admissible that range from 2 to 5 ppm. Our present recommendations to reduce the atmospheric contaminating anesthetic gases are the use of scavenging equipment, air-conditioned rooms and routine inspection and leak detection of apparatus and anesthetic circuits.

Air Pollutants, Occupational↗
PubMed1991

A review of 6978 consecutive admissions to the recovery room at a university hospital.

Recovery from anaesthesia is a time of potential danger to the surgical patients. A retrospective audit of all recovery room admissions over a period of 18 months was carried out at the Aga Khan University Hospital. During this period 6978 patients were admitted to the recovery area and 695 had one or more complications. The complications were recorded by the recovery room nursing staff in a recovery log book. The breakdown of complications according to different physiological systems is discussed. Several surveys have reviewed complications in the western population, but in contrast, no study is available in Pakistani patients. It is recommended that since one in ten patients is likely to have a problem in the early post-operative period, the local hospitals should provide adequate facilities meeting the criteria laid down for the recovery rooms in modern anaesthetic practice.

Adult↗
PubMed1988

The effect of transportation between the recovery room and intensive care unit on postoperative acoustic tumor patients.

Cardiovascular changes have been noted to occur during movement from the operating room or recovery room (RR) to the intensive care unit (ICU). This study examined blood pressure changes and related variables during transport from the RR to the ICU in 135 postoperative acoustic tumor patients. Although there was no significant change in blood pressure values from the RR to the ICU, patients with pre-existing hypertension and elevated RR blood pressures were noted to have an increased frequency of postoperative complications. In addition, a relationship was noted between administration of halothane and frequency of postoperative complications. Results highlight the need for nurses not only to monitor, but also closely control postoperative blood pressure in this population.

Blood Pressure↗
PubMed1990

Simulation of nitrous oxide concentrations in operating and recovery rooms.

A model was developed to predict nitrous oxide (N2O) concentrations in operating (OR) and recovery rooms. The model incorporates general ventilation characteristics, percentage recirculation and the rate at which N2O is emitted into the OR (emission) for the calculation of environmental exposure. A workplace study was carried out during which N2O concentrations were measured continuously and coupled to anaesthetic activities (type and duration), air-change rate and percentage of recirculated air. The data from this study were used to calculate N2O emission. Subsequently, the model was used to predict the effect of technical measures to reduce emissions on mean environmental exposure. After implementation of the control measures an intervention study was made to check whether the reduction in exposure was predicted by our simulation model. Subsequently the 'validated' simulation model was used: (i) to calculate the exposure for different percentages of recirculation and different air-change rates, and (ii) to estimate N2O levels in another situation, i.e. an operating room in an outpatients clinic. In short, our study shows how modelling can help both occupational hygiene and hospital management to control exposure to anaesthetic gases and to design or adapt ventilation systems of operating rooms and recovery rooms.

Computer Simulation↗
PubMed1987

Arterial desaturation in healthy children during transfer to the recovery room.

The oxygen saturation in 71 healthy paediatric patients (3.5 months to 16.7 years) was measured by pulse oximetry during transfer from the operating room to the recovery room. These measurements were recorded continuously while the patients breathed room air. Of the patients studied, 28.1 per cent exhibited significant arterial desaturation of less than or equal to 90 per cent. The corresponding PO2 for this saturation level is less than or equal to 58 mmHg. In only 45 per cent of these desaturated patients was the desaturation recognized clinically by the presence of cyanosis. Age, type of anaesthetic, the use or avoidance of narcotics, and the use of controlled or spontaneous respiration had no significant relationship to the incidence of desaturation. Since more than a one quarter of all patients studied desaturated significantly, and since cyanosis can be difficult to detect clinically during the transfer period, the use of supplemental oxygen during transfer should be considered by the anaesthetist at the end of every paediatric general anaesthetic.

Adolescent↗
PubMed1978

Concentration and elimination of anaesthetic gases in recovery rooms.

The investigation includes measurement of the N2O-concentration in the recovery rooms of three hospitals with different room ventilation systems. The amount of ventilation determines the elimination of the gas exhaled by the patients and, therefore, is related to the number of patients in the recovery rooms. The investigation has shown that non-recirculating room ventilation of 500 m3/pt./hour in recovery rooms gives personnel the same protection against inhalation of anaesthetic gases as is afforded to personnel in operating theatres with scavening equipment.

Air Pollutants↗
PubMed1988

Postoperative recovery rooms. Staffing and facilities in three regions in the United Kingdom.

Postoperative recovery rooms have been used in the United Kingdom for just over 30 years. Anaesthetic and surgical practices have improved during this time but the clinical problems encountered are unchanged essentially. Several surveys have reviewed complications that occur; the most common causes of postoperative morbidity and mortality are still cardiovascular and respiratory problems, the latter particularly of the upper airway. In contrast there are no data available on the standard of staff and equipment in recovery rooms. The results of a survey of this aspect of postoperative recovery rooms in hospitals in Wessex, North West Thames and Yorkshire Regional Health Authorities are reported. Particular effort was made to define the facilities available. The results indicate that 70% of hospitals do not provide staffing levels and facilities which meet recommendations of the Association of Anaesthetists of Great Britain and Ireland. The implications of these findings with regard to anaesthetic morbidity and mortality are discussed.

England↗
PubMed1987

Anaesthetic-related recovery room complications.

A prospective survey was conducted over a one-month period in all surgical patients admitted to the recovery room of a university-affiliated teaching hospital. Complications arising in the recovery room were documented by the nursing staff according to predefined criteria and were critically evaluated. A total of 443 patients were admitted to the recovery room and in 133 (30%) of these, some form of complication was noted. There were 86 patients with complications referable to the central nervous system, 68 with abnormal cardiovascular parameters, 24 with nausea and/or vomiting and 10 with abnormalities referable to the respiratory system. Many patients had more than one complication. The results are discussed, with emphasis on their relevance to current anaesthetic practice. It is concluded that many patients exhibit recovery room complications when they are specifically sought. The recovery period remains a time of great potential danger to patients.

Adult↗
PubMed1989

Residual curarization in the recovery room: atracurium versus gallamine.

Residual curarization in the recovery room was evaluated in 19 patients randomly allocated to two groups with nine and ten patients in each group, respectively. In one group atracurium was used for relaxation, and gallamine was used in the other. Anaesthesia was achieved with thiopental, diazepam, fentanyl and nitrous oxide in oxygen. Mean train-of-four (TOF) ratio in the gallamine and atracurium group was 0.63 and 0.91, respectively. Fifty per cent of the patients in the gallamine group had TOF ratios below 0.70, and none of these patients were able to sustain a head lift for 5 s. All patients in the atracurium group had TOF ratios above 0.70, and all of them were able to lift their head for 5 s. All patients were fully awake when they were evaluated, and no patient had any sign of respiratory difficulty. We conclude that residual curarization in the recovery room remains a problem and that this problem seems to be reduced when muscle relaxants of intermediate duration of action are used for relaxation during operation.

Adult↗
PubMed1989

[Treatment of postoperative pain in children in the recovery room. Use of morphine and propacetamol by the intravenous route].

The analgesic efficiency of morphine and propacetamol for postoperative pain, in the recovery room, was studied in two groups of children, who had undergone either orthopedic or visceral surgery. An injection of 50 mcg/kg of morphine chlorhydrate was given to the first group of 239 children ASA I, who were admitted to the recovery room and who presented signs of severe pain (agitation, crying, complaining). The analgesic efficiency of morphine was judged on physiological criteria (blood pressure, heart rate) and on behavioral criteria (calming of the child). No incidents were noticed. A second study was then performed on a second group of 100 children ASA I, who received 15 mg.kg-1 of propacetamol as an intravenous perfusion for 15 minutes. The analgesic efficiency of propacetamol was judged on behavioral criteria alone. In the morphine group, 67% of the children was calmed following one injection (94% after a second injection given 15 minutes after the first). In the propacetamol group, 77% of the children were calmed. Propacetamol was insufficient for the pain in 23% of the cases but one subsequent injection of morphine was always sufficient to calm the child. These two successive studies show the need for an analgesic protocol for children in the recovery room. Propacetamol should be administered first and then, if insufficient, followed by only one injection of morphine. This protocol of propacetamol and morphine seems to be satisfactory and thus avoids all pernicious side effects.

Acetaminophen↗
PubMed1978

The role of the recovery room for the safety of anesthesia.

Three groups of activities taking place in the recovery room are separately analyzed and compared with the same done on the wards. It is concluded that all three of them are preferably done in the recovery room. When these principles are followed, mortality in the direct postoperative period can be reduced to an absolute minimum. Data from 50,000 cases confirmed this statement.

Critical Care↗
PubMed1989

Decreases in arterial oxygen saturation in paediatric outpatients during transfer to the postanaesthetic recovery room.

Arterial oxygen saturation was measured by pulse oximetry in two groups of paediatric outpatients breathing room air during transport from the operating room to the postanaesthetic recovery room. In Group I (n = 60) readiness for transfer from OR to PARR was decided clinically. In Group II (n = 50) additional criteria of oxygen saturation (SaOe) greater than or equal to 98 per cent with end-tidal gas N2O less than or equal to 10 per cent and CO2 less than or equal to 45 mmHg were met. A higher incidence of desaturation (SaO2 less than or equal to 90 per cent) occurred in Group I (27 per cent) than in Group II (eight per cent) (P less than 0.05). More children under 2 yr desaturated in Group I (50 per cent) than Group II (17 per cent) (P greater than 0.05 less than 0.10). Twenty-two patients in each group had a recent history of upper respiratory tract infections. In these patients, desaturation was more marked in those in Group I (32 per cent) than in Group II (five per cent) (P less than 0.05). Within each group, the incidence of desaturation during transport was similar in patients with or without a recent URI.

Adolescent↗
PubMed1991

Level of consciousness on arrival in the recovery room and the development of early respiratory morbidity.

An audit review of 16,065 patients undergoing operative procedures under general anaesthesia was carried out to examine the relationship between early postoperative respiratory complications and the level of consciousness of patients on arrival in the recovery room. In patients aged over ten years, the incidence of respiratory complications was significantly (P less than 0.005) related to the level of consciousness independent of ASA grade or age. Since the level of consciousness of patients arriving in the recovery room could be modified by changes to anaesthetic practice it is concluded that a significant reduction in respiratory complications might be possible if anaesthetists used general anaesthetic techniques which returned patients awake to the recovery room.

Age Factors↗
PubMed1991

[A survey on recovery rooms of French university hospitals and Ile de France hospitals].

This study reports the results of a survey of post-anaesthesia recovery rooms (PARR) in French public University Hospitals (UH), and in those of the "Ile de France" (IdFH) area. The study, carried out between the 2nd and 8th of April 1990, aimed to identify the place where patients recovered from anaesthesia, and the personnel and monitoring equipment available in these places. 90% of 55 departments of anaesthesia and intensive care in University Hospitals and 94% of 34 departments in "Ile de France" Hospitals responded. A total number of 20,567 patients was collected, with 10,027 from University Hospitals. Of the latter, 31.4% recovered in the operating room or in the anaesthetic room itself; 7.5% were directly transferred to an intensive care unit (ICU), and 61.1% (10,397) were admitted to a PARR. However, 2,460 of those admitted to such a PARR were in fact admitted to a PARR without any permanent nursing staff. Overall, 45.8% of the patients were not admitted to a PARR where adequate care by nurses was available. Of the 3,540 patients anaesthetized in "Ile de France" Hospitals, 3.1% were transferred to an ICU, 25% were not admitted to a PARR, and the remaining 71.7% were. However, 35% of those admitted to a PARR were admitted to a PARR without any permanent nursing staff. Therefore 50.1% of patients anaesthetized in the "Ile de France" Hospitals did not benefit from adequate post-anaesthetic supervision. In 82% of the patients anaesthetized in University Hospitals, the lowest rates of admission to a PARR were found in patients undergoing gastrointestinal endoscopy (GIE), and ENT, ophthalmological or stomatological surgical procedures. After anaesthesia for GIE, 69% of patients recovered at the anaesthetic post and 12% were admitted to a PARR without any permanent nursing staff. In ENT-Ophthalmology-Stomatology, Gynaecology and Obstetrics, and Radiology departments, 56%, 69% and 69% of patients, respectively, recovered in the anaesthetic room or in a PARR without any permanent staff, or, for the Radiology and Obstetrics departments, sent straight back to their room. Similar results were obtained with the patients in the "Ile de France" Hospitals. Nurses were not always present in 37% and 24% of PARR in University and "Ile de France" Hospitals respectively. In the PARR, there were three ECG monitors for 4 beds, and one pulse oximeter for seven beds. It seems therefore that, despite several ministerial recommendations, not all anaesthetized patients are admitted to a recovery room after their anaesthetic.

Academic Medical Centers↗
PubMed1975

A simplified scoring system for the post-operative recovery room.

A new and very simple scoring system for recording post-anaesthetic recovery is described. When numerical values are assigned to factors indicating recovery progress or lack of it is obvious. The records may have medico-legal value. It can be incorporated into the Recovery Room Record.

Anesthesia, General↗