Hwa In Lee | 2 Articles |
PURPOSE
This research was conducted to evaluate, analyze, and determine the limitation of the anesthesia that is used in the recovery room in order to provide the foundation for developing the effectiveness of it. METHOD The recovery records of this study were collected from 41 hospitals in Seoul, Kyung Ki, and Inchon province. The post anesthetic recovery records consisted of the evaluation of type, evaluative items, frequency, time, score and S(a)O2. These records were collected from September to December of 2005. RESULTS The most commonly used post anesthetic evaluation tool was Alderete Score, which was used in 73% of hospitals. The second was Aldrete Score with S(a)O2(17%). Also, 5% of the hospitals used the modified AS form. There were 2.5% of the hospitals applying the adult and child in the evaluation separately. Also, the last 2.5% of the hospitals did not use AS but measured BP, pulse, respiration, temperature, and S(a)O2 with observing nausea, vomiting, urinary retention, backache, laryngitis, shock, and neurologic assessment. CONCLUSION It is necessary to develop a post-anesthetic recovery evaluation tool including the application of S(a)O2, so that the early-diagnosis of hypoxia can be possible. In addition, it is necessary to develop a post-anesthetic recovery evaluating method that can distinguish a difference between adults and children.
This study was performed to examine the safety of the Aldrete Scoring system and the reliability of 8 objective non-invasive methods in the evaluation of post-anesthesia recovery. Aldrete Score(AS) and Maximum Inspiratory Force(MIF), Hand Muscle Grip Power(HMGP), Respiratory Frequency(RF), Tidal Volume(V(T)), Arterial Oxygen Saturation(SaO2), systolic blood pressure(sBP), heart rate(HR), and orientation were measured in the pre-anesthesia period, at the arrival in recovery room and using the AS 10, in 137 patients during a 3 month in 1998 at K hospital. Data obtained by the objective non-invasive methods of the AS 10 were compared with their relevant recovery criteria to the 8 objective non-invasive methods by the use of the t-test. The results were as follows: 1. The MIF of 63 patients using the AS 10 was below the discharge criteria from recovery room(DCrm), but the mean MIF(-34.6 +/- 23.4 cmH2O) was above the DCrm. Women, over 30 years of age or weighing below 60kg, showed significant differences from those whose MIF was below the DCrm(P<0.05). 2. V(T) of 118 patients at AS 10 was below their DCrm and the mean V(T)(3.5 +/- 1.4ml/kg) was significant 19 lower than difference below the DCrm(P<0.01). Women were more commonly present among those who V(T) was below the DCrm. 3. SaO2 of 2 patients using the AS 10 was below their DCrm, but the mean SaO2(98.0 +/- 0.8%) was above the DCrm. 4. HMGP and orientation using the AS 10 were above their DCrm. 5. RF, systolic blood pressure and pulse rate using the AS 10 were within the range of their DCrm. 6. V(T), MIF and SaO2 of some patients, who complained of general malaise or respiratory difficulty during the postanesthesia 24 hours, were less than DCrm. The Above results showed that AS 10 alone was not enough to fulfil the recovery discharge criteria of MIF, V(T) and SaO2, Hence some objective non-invasive monitorings such as SaO2, MIF and V(T) need to be adopted to secure the safe recovery in the recovery room.
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