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Postanaesthesia Care Unit (postanaesthesia + care_unit)

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Medical Sciences	100%

Selected Abstracts

Incidence of postoperative nausea and vomitingin paediatric ambulatory surgery

PEDIATRIC ANESTHESIA, Issue 8 2002
I. Villeret
SummaryBackground: We performed a prospective descriptive study over a 5-month period to determine the incidence of postoperative nausea and vomiting (PONV) during the first 24 h following elective ambulatory paediatric surgery, excluding head and neck procedures. Methods: Four hundred and seven patients, aged 15 days to 16 years, were analysed prospectively. Results: The incidence of PONV was 9.4%, occurring most frequently during the first 3 h after anaesthesia and in hospital but rarely during the journey home. It was associated with age, previous history of PONV, tracheal intubation or use of the laryngeal mask airway (LMAÔ), controlled or manual ventilation, opioids and absence of oral intake of liquids or solids. Conversely, type of surgery, premedication, induction mode, association of regional anaesthesia, inhaled nitrous oxide, duration of anaesthesia, stay in the postanaesthesia care unit and duration of journey after discharge were not significantly associated with PONV. Conclusions: PONV never induced complications or delayed patient discharge and curative treatment was rapidly effective. [source]

Analgesia for paediatric tonsillectomy and adenoidectomy with intramuscular clonidine

PEDIATRIC ANESTHESIA, Issue 7 2002
Katherine O. Freeman MD
SummaryBackground: After undergoing tonsillectomy and adenoidectomy (T&A), children may experience significant pain. Clonidine, an ,2 agonist, exhibits significant analgesic properties. The current investigation sought to determine whether intramuscular (I.M.) clonidine would decrease pain in paediatric patients undergoing T&A. Methods: Thirty-nine children undergoing elective T&A were studied. Following inhalational anaesthetic induction, fentanyl (2 ,g·kg,1) was given intravenously, acetaminophen (paracetamol) (30 mg·kg,1) was given rectally and the children then randomly received an i.m. injection of either normal saline or clonidine (2,g·kg,1). Perioperative analgesic requirements in the postanaesthesia care unit and at home following hospital discharge were evaluated. Results: There were no significant demographic, analgesic consumption, haemodynamic or pain score differences between the groups. Conclusions: We do not recommend adding i.m. clonidine (2 ,g·kg,1) to the analgesic regimen of children undergoing tonsillectomy and adenoidectomy. [source]

A new instrument for pain assessment in the immediate postoperative period,

ANAESTHESIA, Issue 4 2009
A. M. Machata
Summary Perceptual-cognitive impairment after general anaesthesia may affect the ability to reliably report pain severity with the standard visual analog scale (VAS). To minimise these limitations, we developed ,PAULA the PAIN-METER®' (PAULA): it has five coloured emoticon faces on the forefront, it is twice as long as a standard VAS scale, and patients use a slider to mark their pain experience. Forty-eight postoperative patients rated descriptive pain terms on PAULA and on a standard VAS immediately after admission and before discharge from the postanaesthesia care unit. Visual acuity was determined before both assessments. The values obtained with PAULA showed less variance than those obtained with the standard VAS, even at the first assessment, where only 23% of the patients had regained their visual acuity. Furthermore, the deviations of the absolute VAS values in individual patients for each descriptive pain term were significantly smaller with PAULA than with the standard VAS. [source]

Monitoring pollution by proton-transfer-reaction mass spectrometry during paediatric anaesthesia with positive pressure ventilation via the laryngeal mask airway or uncuffed tracheal tube

ANAESTHESIA, Issue 7 2002
J. Rieder
Summary Twenty children aged 2,66 months were randomly allocated for airway management with either the laryngeal mask airway or uncuffed tracheal tube using intermittent positive pressure ventilation with a tidal volume of 8 ml.kg,1 and a respiratory rate adjusted to maintain end-expiratory carbon dioxide concentration at 5.3 kPa. Induction was with fentanyl/propofol and maintenance was with sevoflurane 2.5% in oxygen/air. The airway device was removed when the patients were awake and the patients were transferred to the postanaesthesia care unit 10 min later. Air was sampled from a point 1.5 m above the floor at a location remote from the ventilation outlet and analysed using a proton-transfer-reaction mass spectrometer capable of continuous trace gas analysis at the parts per billion volume (ppbv) level. The concentration of sevoflurane was recorded every minute during three consecutive phases: for 5 min before the introduction of sevoflurane (background); after introduction of sevoflurane until removal of the airway device (intra-operative); and every minute after removal until the concentration returned to background levels. Median (interquartile range [range]) intra-operative sevoflurane concentrations were 200,400 times higher than background values for the laryngeal mask airway 1 (1,2 [0,3]) ppbv vs. 404 (278,523 [83,983]) ppbv, respectively, and the tracheal tube 2 (1,3 [0,5]) ppbv vs. 396 (204,589 [107,1735]) ppbv (both p <,0.0001), and returned to background values within 5 min of removal. There were no differences in sevoflurane concentration between devices intra-operatively or after removal. The performance of the proton-transfer-reaction mass spectrometer was identical at the start and end of the 30-day study. We conclude that peri-operative sevoflurane concentration in a modern operating theatre is similar for the laryngeal mask airway and the uncuffed tracheal tube in paediatric patients receiving intermittent positive pressure ventilation. Intra-operative sevoflurane concentrations are five times lower than occupational safety limit requirements, and 1000 times lower 5 min after removal of the airway device with the patient awake. The proton-transfer-reaction mass spectrometer has potential for monitoring air quality in the operating theatre. [source]