PACU Recovery room

BACKGROUND: Inadvertent perioperative hypothermia is an unintentional drop in core body temperature to less than 36 °C perioperatively and is associated with many negative outcomes such as infection, a prolonged stay in a recovery room, and decreased patient comfort. OBJECTIVE: To determine the incidence of postoperative hypothermia and to identify the associated factors with postoperative hypothermia in patients undergoing head, neck, breast, general, urology, and vascular surgery...

BACKGROUND: Our institution implemented a post-anesthesia care unit (PACU) extended-stay model (Grey Zone model), where the post-operative level of care for high-risk adenotonsillectomy patients (general care vs. intensive care unit) was decided based on the clinical course of 2-4 h of PACU admission. OBJECTIVE: To assess the correlation between post-tonsillectomy respiratory compromise and the need for respiratory support during an extended stay at PACU...

OBJECTIVE: To compare intra-operative UDS results with UDS in the post-operative care unit (PACU) to assess the accuracy and efficacy of intra-operative UDS in children who cannot tolerate ambulatory urodynamic evaluation. METHODS: Pediatric patients undergoing intra-operative UDS at a single institution were enrolled over a 5-year time period (1/2013 - 8/2018). Urodynamics were performed in the operating room under general anesthesia, then in the PACU after recovery from anesthesia...

STUDY OBJECTIVE: To investigate if an erector spinae plane (ESP) block decreases postoperative opioid consumption, pain and postoperative nausea and vomiting in patients undergoing minimally invasive mitral valve surgery (MIMVS). DESIGN: A single-center, double-blind, prospective, randomized, placebo-controlled trial. SETTING: Postoperative period; operating room, post-anesthesia care unit (PACU) and hospital ward in a university hospital...

BACKGROUND: Neostigmine used to reverse the muscle relaxants should be guided by neuromuscular monitoring, as the degree of spontaneous pre-reversal recovery is the key to success to reverse the neuromuscular block. But neuromuscular monitoring is not always available for some patients during anesthesia and, in consequence, we need to use other clinical judgment to guide the use of neostigmine to reverse the neuromuscular block. In this trial, we aimed to evaluate the incidence of residual neuromuscular blockade (rNMB) in pediatric patients with routine use of neostigmine after recovery of spontaneous breathing compared with the patients with the use of neostigmine guided by neuromuscular monitoring...

Background: Studies have proposed that the routine use of the modified gamma-cyclodextrin, sugammadex, could provide perioperative time savings. However, these investigations have been limited to small group analyses. The purpose of this study was to test the effectiveness of sugammadex on perioperative times when compared to neostigmine under general clinical practice conditions following rocuronium-induced neuromuscular blockade for laparoscopic cholecystectomy. Methods: Following institutional review board approval, data from 1,611 consecutive surgical records for laparoscopic cholecystectomy were reviewed...

Affected by the residues of narcotic drugs, patients under general anesthesia are vulnerable to emergence of agitation, delirium, hemodynamic changes, and other adverse events in the recovery period of anesthesia. Therefore, it is necessary to strengthen the observation and care of these patients. Depth of anesthesia monitoring (DAM) has always been a concern for anesthesiologists, but there are few reports related to it. This study compared the early warning value of DAM for patients under general anesthesia with delayed exit from the anesthesia recovery unit (PACU) and delirium and summarized the related nursing experience...

INTRODUCTION: Caudal block is frequently performed to provide analgesia for hypospadias repair. Literature suggests that pudendal block provides prolonged postoperative analgesia as compared with caudal block in children between 2 and 5 years. We compared the efficacy of pudendal and caudal blocks in children less than 2 years. METHODS: 60 children scheduled for hypospadias repair received standard general anesthesia along with either pudendal or caudal block (groups of 30 each)...

OBJECTIVE: To examine the effect of bispectral index (BIS)-guided anesthesia on the incidence of postoperative delirium (POD) in elderly patients undergoing surgery. DESIGN: A systematic review, meta-analysis, and trial sequential analysis (TSA). SETTING: In the operating room, postoperative anesthesia care units (PACU), and ward. PARTICIPANTS: Elderly patients (>60 years old) undergoing surgery. INTERVENTIONS: The EMBASE, MEDLINE, and CENTRAL databases were searched systematically from their inception until December 2020 for randomized controlled trials comparing BIS and usual care or blinded BIS...

STUDY OBJECTIVE: The quality of recovery (QoR) of remimazolam-based and propofol-based total intravenous anesthesia was compared as measured by QoR-15 scores. DESIGN: A prospective, double-blind, randomized controlled, non-inferiority trial. SETTING: An operating room, a post-anesthesia care unit (PACU), and a hospital ward. PATIENTS: Female patients (n = 140; 20-65 years) scheduled for open thyroidectomy were enrolled and randomly assigned to the remimazolam or propofol group...

STUDY OBJECTIVE: To investigate if an interpectoral-pectoserratus plane (PECS II) block decreases postoperative pain, postoperative nausea and vomiting and improves quality of recovery in patients with neurogenic thoracic outlet syndrome (NTOS) undergoing trans-axillary thoracic outlet decompression surgery. DESIGN: A prospective single center double blinded randomized placebo-controlled trial. SETTING: Perioperative period; operating room, post anesthesia care unit (PACU) and hospital ward...

Objectives: Sublingual sufentanil is a novel opioid medication to treat moderate to severe pain postoperatively. This study's aim was to determine if a single dose of a sublingual sufentanil tablet (SST) is as efficacious as a single dose of intravenous (IV) fentanyl in readiness to discharge from ambulatory surgery. Methods: This was a two-arm, parallel group, randomized prospective outcomes study conducted at a single, free-standing ambulatory surgery center. Patients aged 18-80 undergoing general anesthesia who developed a postoperative pain score of ≥ 4 were enrolled and randomized to receive either 30 mcg SST or 50 mcg IV fentanyl...

INTRODUCTION: This study aimed to compare the efficacy between patient-controlled caudal epidural analgesia (PCCA) and patient-controlled intravenous analgesia (PCIA) after perianal surgery, to provide a feasible solution to postoperative pain. METHODS: This was a prospective, randomized controlled trial comprising 100 patients who underwent caudal epidural block on perianal surgery at Chengdu Shang Jin Nan Fu Hospital of West China Hospital at Sichuan University between April and August 2020...

PURPOSE: Each year cell phones have evolved in capability and sophistication enticing society to become more dependent on them. Presently, our hospital policy states there is no cell phone use allowed in the postanesthesia care unit (PACU) for patients or family members. However, given the almost addictive use of the mobile phone today, a patient connecting with family and friends during a very anxious and personally vulnerable time triggered us to re-evaluate this policy. DESIGN: This was a quality improvement project...

Utilization of opioids for acute pain control during surgical procedures is commonplace for anesthesia providers. Opioid use is associated with many undesirable side effects, including opioid use disorder. Opioid-free anesthesia for surgical procedures using a multimodal approach can reduce these side effects. This quality improvement project evaluated the implementation of an opioid-free anesthesia protocol for elective abdominal surgical procedures in a community hospital. The project had specific aims of detecting a reduction in opioid consumption in the operating room and the first 30 minutes in the post anesthesia recovery unit (PACU) while confirming pain relief comparable to that seen with opioid analgesia...

OBJECTIVES: Prolonged recovery time in the postanesthesia care unit (PACU) increases cost and administrative burden of outpatient surgical staff. The primary aim of this study was to determine whether body mass index (BMI) is associated with prolonged recovery in the PACU after outpatient surgery in a freestanding ambulatory surgery center. METHODS: We retrospectively studied 3 years of surgeries performed at a freestanding ambulatory surgery center. Mixed-effects logistic (for binary outcomes) and linear (for continuous outcomes) regressions were performed, in which the random effect was the surgical procedure...

This study aimed to investigate whether there was an association between an unanticipated prolonged post-anaesthesia care unit (PACU) length of stay and early postoperative deterioration, as defined as the need for a rapid response team activation, within the first seven days of surgery. We conducted a single-centre retrospective cohort study of adult surgical patients, who stayed at least one night in hospital, and were not admitted to critical care immediately postoperatively, between 1 July 2017 and 30 June 2019...

STUDY OBJECTIVE: The efficacy of infiltration of liposomal bupivacaine against an active comparator, such as bupivacaine, remains debated on acute postoperative pain control. We evaluated the analgesic efficacy, patient satisfaction, and side effects of liposomal bupivacaine compared to bupivacaine during hemorrhoidectomy procedures. DESIGN: A pre- and post-implementation quality improvement evaluation. SETTING: Operating room and post-anesthesia care unit...

BACKGROUND: Days before surgery, add-ons may be scheduled to fill unused surgical block time at an outpatient surgery center. At times, outpatient surgery centers have time limitations for end of block time and discharge from the postanesthesia care unit (PACU). The objective of our study was to develop machine learning models that predicted the following composite outcome: (1) surgery finished by end of operating room block time and (2) patient was discharged by end of recovery room nursing shift...

INTRODUCTION: The purpose of our study was to evaluate the effects of tablet computer method on children with and without anxiety. The study was designed as a prospective single-blinded randomized controlled trial. MATERIALS AND METHODS: The population of the study were 300 patients between the ages of 4 and 10 years old who were scheduled for their first elective surgery for phimosis-inguinal hernia-hydrocele-undescended testis-hypospadias. The initial anxiety scores of the patients were evaluated using modified-Yale Preoperative Anxiety Scale (mYPAS)...