Complications PACU, Dr. Kang

Vimmi Kang, DO

Summary of “Complications Occuring in the Postanesthesia Care Unit: A Survey”

Hines R., Barash P., Watrous, G and Theresa O’Connor. “Complications Occuring in the Postanesthesia Care Unit: A Survey” Anesth Analg 1992;74:503-9.

            The main objectives of the article was to identify the complications that occurred in PACU, the incidence of those complications in PACU and intraoperative, and determine the variables associated with a greater risk of developing PACU complications.  This was a prospective study looking at 18,473 patients in a PACU setting at a university teaching hospital.

            The study showed the incidence of intraoperative events only to be 5.1%, Postoperative events to be 23.7%, and the combined intraoperative and postoperative events to be 26.7%.

            The incidence of events were analyzed and found to have complications mostly associated with nausea and vomiting (9.8%), need for upper airway support (6.9%) and hypotension requiring treatment (2.7%).

            The study also examined the variables associated with greater risk of developing complications. These variable were determined to be ASA II status, duration of anesthesia (2-4hr), anesthetic technique (general anesthesia associated with higher complication rates versus regional or monitored anesthetic), emergency procedures, and certain types of surgical procedures (orthopedic or abdominal).

            Temperature was also found to prolong stay in PACU. A temperature less than 35 degrees Celsius resulted in average stay of 152 minutes versus 116 minutes in patients with a temperature greater than 36 degrees Celsius. 

            ICU patients were excluded from this study and participation was at the discretion of the attending anesthesiologist.

            An important point to be made prior to concluding is that the article found ASA II to be more of a risk factor than ASA III or IV, which could be related to the fact that most of the patients were ASA II to begin with and most of the patients that were ASA III or IV were directly taken to ICU and thus excluded from the study.

Complications Occurring in the Postanesthesia Care Unit

http://www.anesthesia-analgesia.org/content/74/4/503.full.pdf+html