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Minerva Anestesiologica 2001 July-August;67(7-8):555-62

Copyright © 2009 EDIZIONI MINERVA MEDICA

language: Italian

Recovery Room. One-year activity experience

Leykin Y., Costa N., Furlan S., Nadalin G., Gullo A.

Azienda Ospedaliera «Santa Maria degli Angeli» - Pordenone II Servizio di Anestesia e Rianimazione *Università degli Studi - Trieste Unità Clinica Operativa di Anestesia, Rianimazione e Terapia Antalgica

Back­ground. The objec­tive of our ­study is to ­present the anal­y­sis of the organ­iza­tion­al and clin­i­cal ­work car­ried out in the ­first ­year of activ­ity of the Recov­ery ­Room (RR) at the Azien­da Osped­a­lie­ra San­ta ­Maria ­degli Ange­li of Porde­none and to com­pare per­so­nal expe­ri­ence ­with ­what is stat­ed in the lit­er­a­ture.
Meth­ods. The RR is locat­ed at the cen­ter of the oper­at­ing ­block (com­posed of 10 oper­at­ing ­rooms), the num­ber of bed is 6, 3 of ­which are ­equipped ­with ven­ti­la­tors. ­There is a cen­tral nurs­ing sta­tion ­where it is pos­sible to con­cen­trate all ­data deriv­ing ­from the sin­gle mon­i­tors on one sin­gle ­screen. The RR oper­ates ­from Mon­day to Fri­day ­from 8.00 to 20.00. An Anes­the­tist is on ­duty for the 12 ­hours and has the clin­i­cal, ther­a­peu­tic and deci­sion-mak­ing respon­sibil­ity regard­ing the dis­charge of ­patients, ­while nurs­ing assis­tance is pro­vid­ed by 2 qual­i­fied pro­fes­sion­al nurs­es for ­shift, assist­ed by an aux­il­iary. In the ­first ­year of activ­ity of the RR, a ­total of 11,626 sur­gi­cal oper­a­tions ­were car­ried out; of ­these 1,047 ­patients, ­equal to 9%, ­were assist­ed in the RR. The age of 51% of the ­patients was ­between 61 and 80 ­years; 53.3% ­belonged to the ASA 2 ­group and ­only 0.48% to the ASA 4 ­group. The oper­a­tions ­were sub-divid­ed as fol­lows: 56.8% gen­er­al, tho­rac­ic and vas­cu­lar sur­gery, 15.3% uro­log­i­cal, 10% ortho­pe­dic, 7.7% obstet­ri­cal and gyne­co­log­ical, 6.1% ENS, 3% sto­mat­o­log­i­cal, 1% oth­ers. 56.8% off the ­patients under­went gen­er­al anes­the­sia, 30.5% com­bined anes­the­sia and 12.6% ­local-region­al anes­the­sia. The ­time ­spent by the ­patients in RR was ­between 1 ­hour 30 min­utes and 10 ­hours 45 min­utes, ­with an aver­age ­time of 3 ­hours 49 min­utes.
­Results. Of the 1,047 ­patients stud­ied no ­case of car­dio-res­pir­a­to­ry ­arrest or ­death was record­ed, ­while the com­pli­ca­tions encoun­tered ­were: 13.15% car­dio-cir­cu­la­to­ry, 3.62% res­pir­a­to­ry, 3.62% ­PONV, 2.1% oli­gu­ria, 1.24% hypo­ther­mia, 0.48% dis­orient­ed ­patients, 0.38% hyper­ther­mia and 0.38% shiv­er­ing. In the ­area of car­dio-cir­cu­la­to­ry com­pli­ca­tions encoun­tered, the ­most impor­tant was arte­ri­al hyper­ten­sion (5.6%), fol­lowed by car­diac arrhyth­mia, ­such as brad­y­car­dia (2.5%) and tach­y­car­dia (2.6%).
Con­clu­sions. The con­clu­sion is ­drawn ­that cor­rect admin­is­tra­tion in the ear­ly post­op­er­a­tive peri­od is deci­sive for the ­final out­come of sur­gery and ­that the pres­ence of RR con­trib­utes sig­nif­i­cant­ly to a reduc­tion in the post­op­er­a­tive mor­bid­ity ­rate. Our ­case-­series ­leads us, how­ev­er, to ­reflect on an excel­lent organ­iza­tion of the open­ing ­hours of RR.