Postanesthesia Recovery Room Research Articles

Incidence of postoperative nausea and vomiting following gynecological laparoscopy: A comparison of standard anesthetic technique and propofol infusion

ObjectiveTo determine the safety, efficacy, and feasibility of propofol-based anesthesia in gynecological laparoscopies in reducing incidences of postoperative nausea and vomiting compared to a standard anesthesia using thiopentone/isoflurane. DesignRandomized single-blind (for anesthesia techniques used) and double-blind (for postoperative assessment) controlled trial. SettingOperation theater, postanesthesia recovery room, teaching hospital. PatientsSixty ASA (American Society of Anesthesiologists) I and II female patients (aged 20–60 years) scheduled for gynecological laparoscopy were included in the study. InterventionsPatients in Group A received standard anesthesia with thiopentone for induction and maintenance with isoflurane–fentanyl, and those in Group B received propofol for induction and maintenance along with fentanyl. All patients received nitrous oxide, vecuronium, and neostigmine/glycopyrrolate. No patient received elective preemptive antiemetic, but patients did receive it after more than one episode of vomiting. MeasurementsAssessment for incidence of postoperative nausea and vomiting as well as other recovery parameters were carried out over a period of 24 hours. Main ResultsSix patients (20%) in Group A and seven patients (23.3%) in Group B experienced nausea. Two patients (6.66%) in Group B had vomiting versus 12 (40%) in Group A (p<0.05). Overall, the incidence of emesis was 60% and 30% in Groups A and B, respectively (p<0.05). All patients in Group B had significantly faster recovery compared with those in Group A. No patient had any overt cardiorespiratory complications. ConclusionPropofol-based anesthesia was associated with significantly less postoperative vomiting and faster recovery compared to standard anesthesia in patients undergoing gynecological laparoscopy.

Papel do enfermeiro no período perioperatório para prevenção da trombose venosa profunda

Objetivos: Conhecer como os enfermeiros realizam a prevenção da Trombose Venosa Profunda (TVP) em pacientes submetidos a cirurgias de grande porte no período perioperatório; e levantar os fatores de risco para o desenvolvimento de TVP identificados pelos enfermeiros. Método: Estudo de caso com abordagem qualitativa. Amostra composta por 12 enfermeiros da unidade de internação, centro cirúrgico e sala de recuperação pós-anestésica de um hospital especializado em trauma de Porto Alegre (RS). Utilizou-se entrevista semiestruturada com 10 questões norteadoras. Para interpretação dos dados utilizou-se Análise de Conteúdo de Bardin. Resultados: Emergiram três categorias: Fatores de Risco para TVP; Medidas Preventivas de TVP e Dificuldades na Execução da Sistematização da Assistência de Enfermagem Perioperatória. Conclusão: Os enfermeiros realizam prevenção de TVP com massagem, observação, exame físico/avaliação, medidas protetivas e mudança de posição, entretanto falta autonomia para aplicar algumas medidas preventivas. Apontaram vários fatores de risco para a ocorrência de TVP conforme literatura, evidenciando conhecimento sobre a patologia. Palavras-chave: Trombose venosa. Enfermagem perioperatória. Prevenção de Doenças.

A Germany-wide survey on anaesthesia in thoracic surgery

This study's objective was to evaluate current thoracic anaesthesia practice in Germany and to quantify potential differences depending on the hospital's level of care. A four-part online survey containing 28questions was mailed to all anaesthesiology department chairs (n= 777) registered with the German Society of Anaesthesiology and Intensive Care Medicine. The general response rate was 31.5 % (n= 245). High monthly volumes (>50operations/month) of intrathoracic procedures, performed by specialized thoracic surgeons are mostly limited to hospitals of maximum care, university hospitals, and specialized thoracic clinics. In hospitals with a lower level of care, intrathoracic operations occur less frequently (1-5/month) and are commonly performed by general (69.3 %) rather than thoracic surgeons (15.4 %). Video-assisted thoracic surgeries are the most invasive intrathoracic procedures for most hospitals with a low level of care (61.5 %). Extended resections and pneumonectomies occur mainly in hospitals of maximum care and university hospitals. Thoracic anaesthesia is primarily performed by consultants or senior physicians (59.9 %). The double lumen tube (91.4 %) is the preferred method to enable one-lung ventilation (bronchial blockers: 2.7 %; missing answer: 5.9 %). A bronchoscopic confirmation of the correct placement of a double lumen tube is considered mandatory by 87.7 % of the respondents. Bronchial blockers are available in 64.7 % of all thoracic anaesthesia departments. While CPAP-valves for the deflated lung are commonly used (74.9 %), jet-ventilators are rarely accessible, especially in hospitals with a lower level of care (15.4 %). Although general algorithms for a difficult airway are widely available (87.7 %), specific recommendations for a difficult airway in thoracic anaesthesia are uncommon (4.8 %). Laryngeal mask airways (90.9 %) and videolaryngoscopy (88.8 %) are the primary adjuncts in store for a difficult airway. While hospitals with a lower level of care admitted patients routinely (92.3 %) to an intensive care unit after thoracic surgery, larger clinics used the postanaesthesia recovery room (12.5 %) and intermediate care units (14.6 %) more frequently for further surveillance. Thoracic epidural catheters (85.6 %) are predominantly chosen for peri- and postoperative analgesia, in contrast to paravertebral blockade (single shot: 8.6 %; catheter: 8.0 %) (multiple answers possible). Ultrasound is generally accessible (84.5 %) and mostly employed for the placement of central venous (81.3 %) and arterial (43.9 %) lines as well as a diagnostic tool for pulmonary pathology (62.0 %). The study reveals considerable differences in the anaesthetic practice in thoracic surgery. These focus mostly on the postoperative surveillance, the availability of bronchial blockers, and the use of regional anaesthetic techniques. Furthermore, it is evident that specific algorithms are needed for the difficult airway in thoracic anaesthesia. A recommendation for the high-tech work environment of thoracic anaesthesia could enhance the structural quality and optimize patient outcomes. Independent of a hospital's level of care, uniform requirements could help establish national quality standards in thoracic anaesthesia.

Outpatient Laparoscopic Appendectomy: Is It Time to End the Discussion?

Laparoscopic appendectomy is typically associated with inpatient hospitalization averaging between 1 and 2 days. In July 2010, a prospective protocol for outpatient laparoscopic appendectomy was adopted at our institution. Patients were dismissed from the post-anesthesia recovery room or day surgery if they met certain predefined criteria. Patients admitted to a hospital room as either full admission or observation status were considered failures of outpatient management. An IRB-approved, retrospective review of a prospective database was performed on all patients having laparoscopic appendectomy for uncomplicated appendicitis from July 2010 through December 2014. Study exclusions included age younger than 17 years, pregnancy, interval appendectomy, and gangrenous or perforated appendicitis. Patient demographics, success with outpatient management, morbidity, and readmissions were analyzed. Five hundred and sixty-three patients underwent laparoscopic appendectomy for uncomplicated appendicitis during this time frame. There were 281 men and 282 women, with a mean age of 35.5 years. Four hundred and eighty-four patients (86%) were managed as outpatients. Seventy-nine patients were admitted for pre-existing conditions (32 patients), postoperative morbidity (10 patients), physician discretion (6 patients), or lack of transportation or support at home (31 patients). Thirty-eight patients (6.7%) experienced postoperative morbidity. Seven patients (1.2%) were readmitted after outpatient management for transient fever, nausea/vomiting, migraine headache, urinary tract infection, partial small bowel obstruction, and deep venous thrombosis. There were no mortalities or reoperations. Including the readmissions, overall success with outpatient management was 85%. Outpatient laparoscopic appendectomy can be performed with a high rate of success, low morbidity, and low readmission rate. This protocol has withstood the test of time. Widespread adoption has the potential for substantial health care savings.

Predictors of Delayed Postoperative Respiratory Depression Assessed from Naloxone Administration.

The aim of this study was to identify patient and procedural characteristics associated with postoperative respiratory depression or sedation requiring naloxone intervention. We identified patients who received naloxone to reverse opioid-induced respiratory depression or sedation within 48 hours after discharge from anesthetic care (transfer from the postanesthesia care unit or transfer from the operating room to postoperative areas) between July 1, 2008, and June 30, 2010. Patients were matched to 2 control subjects based on age, sex, and exact type of procedure performed during the same year. A chart review was performed to identify patient, anesthetic, and surgical factors that may be associated with risk for intervention requiring naloxone. In addition, we identified all patients who developed adverse respiratory events (hypoventilation, apnea, oxyhemoglobin desaturation, pain/sedation mismatch) during phase 1 anesthesia recovery. We performed conditional logistic regression taking into account the 1:2 matched set case-control study design to assess patient and procedural characteristics associated with naloxone use. We identified 134 naloxone administrations, 58% within 12 hours of discharge from anesthesia care, with an incidence of 1.6 per 1000 (95% confidence interval [CI], 1.3-1.9) anesthetics. The presence of obstructive sleep apnea (odds ratio [OR] = 2.45; 95% CI, 1.27-4.66; P = 0.008) and diagnosis of an adverse respiratory event in the postanesthesia recovery room (OR = 5.11; 95% CI, 2.32-11.27; P < 0.001) were associated with an increased risk for requiring naloxone to treat respiratory depression or sedation after discharge from anesthesia care. After discharge from anesthesia care, patients administered naloxone used a greater median dose of opioids (10 [interquartile range, 0-47.1] vs 5 [0-24.8] IV morphine equivalents, P = 0.020) and more medications with sedating side effects (n = 41 [31%] vs 24 [9%]; P < 0.001). Obstructive sleep apnea and adverse respiratory events in the recovery room are harbingers of increased risk for respiratory depression or sedation requiring naloxone after discharge from anesthesia care. Also, patients administered naloxone received more opioids and other sedating medications after discharge from anesthetic care. Our findings suggest that these patients may benefit from more careful monitoring after being discharged from anesthesia care.

Nursing care in the immediate postoperative period: a cross-sectional study

Problem: Nursing care requires attention and systematized care in the immediate postoperative period in order to prevent complications. Aim: To characterize the care provided to patients in the immediate postoperative period; to identify the care offered by nurses to patients and correlate the difficulties of nurses in terms of the use of nursing care systematization. Method: This was a cross-sectional study that used a quantitative approach, conducted between May and June 2013 in an Emergency Hospital in Fortaleza, Ceara, Brazil. The sample consisted of 13 nurses working in the post-anaesthetic recovery room. Result: There was a predominance of care directed to the respiratory and cardiovascular system. There was an association between the large number of patients and the non-use of nursing care systematization. Conclusion: Care is not fully offered and nurses have difficulties in using nursing care systematization.

Early extubation and fast-track management of off-pump cardiac patients in the intensive care unit.

Off-pump surgery was the original approach to treating patients with cardiac disease in the era before cardiopulmonary bypass. With the advent and refinement of cardiopulmonary bypass, the use of this technique fell out of favor and was quickly surpassed by on-pump techniques. However, the limitations of bypass surgery, especially for coronary artery bypass procedures, was still significant, leading to renewed interest in this technique. Postoperative care for off-pump coronary artery bypass (OPCAB) surgery presents both a challenge and opportunity to the intensivist. OPCAB patients can be treated in a fast-track manner allowing rapid recovery and early extubation and discharge from the intensive care unit. This is supported through the use of protocols that help standardize care and set expectations for the post-cardiac care team. Importantly, complications that may delay recovery including hypothermia, hypotension, and bleeding must be recognized early and treated aggressively to prevent unwanted complications and intensive care delays. Finally, care of these patients has shifted to the post-anesthesia recovery room, making knowledge of the care of these patients in the early postoperative period essential for cardiac anesthesiologists. This article will discuss the care of OPCAB patients following surgery and include approaches to managing patients who return both intubated and extubated.

Intravenous lidocaine for postmastectomy pain treatment: randomized, blind, placebo controlled clinical trial

Background and objectivePostoperative pain treatment in mastectomy remains a major challenge despite the multimodal approach. The aim of this study was to investigate the analgesic effect of intravenous lidocaine in patients undergoing mastectomy, as well as the postoperative consumption of opioids. MethodsAfter approval by the Human Research Ethics Committee of the Instituto de Medicina Integral Prof. Fernando Figueira in Recife, Pernambuco, a randomized, blind, controlled trial was conducted with intravenous lidocaine at a dose of 3mg/kg infused over 1h in 45 women undergoing mastectomy under general anesthesia. One patient from placebo group was. ResultsGroups were similar in age, body mass index, type of surgery, and postoperative need for opioids. Two of 22 patients in lidocaine group and three of 22 patients in placebo group requested opioid (p=0.50). Pain on awakening was identified in 4/22 of lidocaine group and 5/22 of placebo group (p=0.50); in the post-anesthetic recovery room in 14/22 and 12/22 (p=0.37) of lidocaine and placebo groups, respectively. Pain evaluation 24h after surgery showed that 2/22 and 3/22 patients (p=0.50) of lidocaine and placebo groups, respectively, complained of pain. ConclusionIntravenous lidocaine at a dose of 3mg/kg administered over a period of an hour during mastectomy did not promote additional analgesia compared to placebo in the first 24h, and has not decreased opioid consumption. However, a beneficial effect of intravenous lidocaine in selected and/or other therapeutic regimens patients cannot be ruled out.

Lidocaína intravenosa en el tratamiento del dolor posmastectomía: ensayo clínico aleatorizado, encubierto, placebo controlado

Background and objectivePostoperative pain treatment in mastectomy remains a major challenge despite the multimodal approach. The aim of this study was to investigate the analgesic effect of intravenous lidocaine in patients undergoing mastectomy, as well as the postoperative consumption of opioids. MethodsAfter approval by the Human Research Ethics Committee of the Instituto de Medicina Integral Prof. Fernando Figueira in Recife, Pernambuco, a randomized, blind, controlled trial was conducted with intravenous lidocaine at a dose of 3mg/kg infused over one hour in 45 women undergoing mastectomy under general anesthesia. One patient from placebo group was ResultsGroups were similar in age, body mass index, type of surgery, and postoperative need for opioids. Two of 22 patients in lidocaine group and 3 of 22 patients in placebo group requested opioid (P=.50). Pain on awakening was identified in 4/22 of lidocaine group and 5/22 of placebo group (P=.50); in the post-anesthetic recovery room in 14/22 and 12/22 (P=.37) of lidocaine and placebo groups, respectively. Pain evaluation 24h after surgery showed that 2/22 and 3/22 patients (P=.50) of lidocaine and placebo groups, respectively, complained of pain. ConclusionIntravenous lidocaine at a dose of 3mg/kg administered over a period of an hour during mastectomy did not promote additional analgesia compared to placebo in the first 24h, and has not decreased opioid consumption. However, a beneficial effect of intravenous lidocaine in selected and/or other therapeutic regimens patients can not be ruled out.

Incidence of urinary retention in a tertiary post operative hospital

Patients in the immediate post-operative period have several clinical features and when they are admitted in the post-anesthetic recovery room the signs and symptoms that affect the patient physically and psychologically resulting of surgical procedures begin to emerge. Urinary retention occurs frequently in these patients, as some anesthetics contribute to the development of this clinical condition. This research aims to analyze the incidence of urinary retention after surgery of patients of various specialties, correlating the type of anesthesia and the need for urinary catheterization. This study is characterized as exploratory, descriptive, with quantitative approach and was performed in a hospital of high complexity in Juazeiro do Norte. The sample was composed of the patients admitted to the post-anesthetic recovery room and during that time they presented urinary retention. Data analysis was demonstrated by the tables relating to the literature. The study contributed to the growth of scientific knowledge for hospital staff under study, as there were a large number of species records about urinary retention of patients undergoing surgical procedures that were admitted to the patient unit, especially in surgical units. That worried the nursing staff on the efficiency of systematization so there was an improvement in the quality of care, as many times, such deductions were accompanied by distension and suprapubic pain. Through these results, we could identify some interventions that have contributed to solve this nursing diagnosis, involving the whole multidisciplinary team and ensure the patient unit staff understood holistically the issues involved in this clinical condition and to be more involved in this process.

Caudal epidural blockade for major orthopedic hip surgery in adolescents.

Background:There continues to be a significant focus on the value of regional and neuraxial anesthesia techniques for adjunctive use when combined with general anesthesia. The reported advantages include decreased patient opiate exposure, decreased medication-related adverse effects, decreased postanesthesia recovery room time and hospital stay, and increased patient satisfaction.Materials and Methods:The authors present a case-controlled series evaluating the use of a single caudal epidural injection prior to incision as an adjunct to general anesthesia for the open repair of slipped capital femoral epiphysis. Opiate consumption, pain scores, and hospital stay were compared between the two cohorts of 16 adolescent patients. All patients received a demand-only patient-controlled opiate delivery system.Results:Although the failed block rate was high (31%), there was decreased opioid use in the perioperative arena as well as during the first 24 postoperative hours in patients who had a successful caudal epidural block. Furthermore, discharge home was possible in 27% of patients who received a caudal epidural block compared to 0% of patients who did not receive a caudal block.Conclusion:The potential utility of caudal epidural block as an adjunct to general anesthesia during major hip surgery in adolescents is presented. Factors resulting in a failed block in this patient population as well as the use of the ultrasound as an added modality to increase block success are reviewed.

Hipotermia em pacientes na recuperação pós-anestésica: Hipotermia em pacientes na recuperação pós-anestésica:

The objective of this research was to analyze the efficacy of heated venous infusion in controlling hypothermia in patients during the period of anesthesia recovery. This is an experimental, comparative, and field study of a quantitative method performed at a federal public hospital in the city of Belo Horizonte. The sample consisted of 44 adults divided into control and experimental groups who had a body temperature lower than 36 °C when entering the post-anesthesia recovery room. The results showed no significant difference between the groups over time, and the interaction time and group was not statistically significant (p = 0.940). Body temperature rose by 1.3 °C every hour of the patient's stay regardless of the group, demonstrating that the interaction between time and body temperature was significant (p <0.001). The conclusion is that to achieve normothermia, the patient should be kept with passive heating for at least one hour in the post-anesthesia recovery room. doi: 10.5216/ree.v16i4.24222.

Association of clonidine and ropivacaine in brachial plexus block for shoulder arthroscopy

Background and objectivesArthroscopy for shoulder disorders is associated with severe and difficult to control pain, postoperatively. The addition of clonidine to local anesthetics for peripheral nerve block has become increasingly common, thanks to the potential ability of this drug to reduce the mass of local anesthetic required and to prolonging analgesia postoperatively. The present study aimed to evaluate the success of brachial plexus block for arthroscopic rotator cuff surgery using local anesthetic with or without clonidine. Method53 patients of both genders, between 18 and 70 years old, American Society of Anesthesiologists I or II, who were scheduled to undergo arthroscopic shoulder surgery were selected. Patients were then randomized into two groups. The verbal numerical pain scale and the presence of motor block were obtained in the post-anesthetic recovery room and 6, 12, 18 and 24h postoperatively. ResultsThe association of clonidine (0.15mg) to a solution of 0.33% ropivacaine (30mL) in brachial plexus block for shoulder arthroscopy has not diminished the visual numeric pain scale values, nor the need for opioid rescue postoperatively. There was a lower incidence of nausea/vomiting postoperatively and a significant motor block time prolongation in the group of patients who received clonidine as adjuvant. ConclusionsThe use of brachial plexus block with local anesthetic for analgesic postoperative control is well established in the literature. The addition of clonidine in the dose proposed for prolongation of the analgesic effect and reduction of opioid rescue proved unhelpful.

Acrocyanosis - An uncommon event at post anaesthesia recovery room- A case report

A healthy patient of aged 26 years underwent left ureter-lithotomy and cystostomy under general anesthesia. In post-operative ward, both extremities were cold &amp; nailed were cyanosed. This cyanosis persisted for as long as 8-10 hours. No abnormality was detected in arterial blood gas analysis. This is not a simple peripheral cyanosis induced by cold environment of operation theatre, as warming usually reverses the phenomenon within a short period. But in this case, peripheral cyanosis persisted for as long as 8-10 hours. Therefore, this is a case of acrocyanosis. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19819 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 58-60

Análise dos registros da pressão arterial na sala de recuperação pós-anestésica

Objetivo Analisar os registros da pressão arterial e sua acurácia na pontuação do item circulação na sala de recuperação pós-anestésica.Métodos Estudo transversal que incluiu os registros pós-operatórios de 23 prontuários de pacientes admitidos na sala de recuperação pós-anestésica após cirurgias de pequeno e médio porte. Foi utilizado o índice de Aldrete e Kroulik. Foi realizada análise estatística numérica e percentual.Resultados Na admissão dos pacientes, 48% dos registros do item circulação não mostraram acurácia. Na avaliação da alta do paciente, 39% deles foram avaliados de forma imprecisa.Conclusão Em alguns casos, não foram observadas a qualidade do registro e a acurácia da pontuação do item circulação do índice de Aldrete e Kroulik, comprometendo a segurança do paciente.

The effect of patient sex on the incidence of early adverse effects in a population of elderly patients.

Patient sex is known to influence the response to general and regional anaesthesia and recovery after surgery. However, most studies come from analyses carried out on middle-aged patients. As most of the patients admitted to the post-anaesthesia recovery room in our institution are elderly, we took the opportunity to investigate the association between sex and incidence of early adverse events in this older population of patients after major surgery. Consecutive patients undergoing general, orthopaedic, urological and gynaecological surgery, admitted to the recovery room of our institution over a 15-month period, were retrospectively studied. The following adverse events were considered in the analysis: shivering, postoperative nausea and vomiting, hypotension and hypertensive responses, new arrhythmias requiring treatment, acute respiratory failure and desaturation. A total of 1347 patients (mean age 73.3±15.1 years, 61.4% women) were included. Women showed a higher incidence of shivering (relative difference +48%, P=0.0003), postoperative nausea and vomiting (+91%, P<0.0001), hypotension (+32%, P=0.044) and desaturation (+60%, P=0.0030) than men. The incidence of hypertensive response, arrhythmias and acute respiratory failure were not statistically significantly different. The findings of this exploratory study suggest that women have a higher risk of early postoperative adverse events even in a more elderly population.

Aplicação do checklist para cirurgia segura: Relato de experiência

Objective: to report the experience in applying the safe surgery checklist proposed by the World Health Organization (WHO). Method: a descriptive, narrative, level 1 study, of experience report type, with the application of the safe surgery checklist, following the three stages recommended by WHO, to 30 anesthetic and surgical procedures carried out in a teaching hospital in Sao Paulo state in the second semester of 2011. Conclusion: we identified the need to include and change some items in the checklist and fill in the items in the post-anesthetic recovery room. It’s important that the nurse or the checklist coordinator are able to master the checking, know how to conduct all the proposed items responsibly and ethically, and emphasize the responsibility of each participant professional. Communication is essential for the proper conduct of this procedure and the checklist guarantees its best performance.

Outpatient laparoscopic appendectomy should be the standard of care for uncomplicated appendicitis

In 2012, a protocol for routine outpatient laparoscopic appendectomy for uncomplicated appendicitis was published reflecting high success, low morbidity, and significant cost savings. Despite this, national data reflect that the majority of laparoscopic appendectomies are performed with overnight admission. This study updates our experience with outpatient appendectomy since our initial report, confirming the efficacy of this approach. In July 2010, a prospective protocol for outpatient laparoscopic appendectomy was adopted at our institution. Patients were dismissed from the postanesthesia recovery room or day surgery if they met predefined criteria for dismissal. Patients admitted to a hospital room as either full admission or observation status were considered failures of outpatient management. An institutional review board-approved retrospective review of patients undergoing laparoscopic appendectomy for uncomplicated appendicitis from July 2010 through December 2012 was performed to analyze success of outpatient management, postoperative morbidity and mortality, as well as readmission rates. Three hundred forty-five patients underwent laparoscopic appendectomy for uncomplicated appendicitis during this time frame. There were 166 men and 179 women, with a mean age of 35 years. Three hundred five patients were managed as outpatients, with a success rate of 88%. Forty patients (12%) were admitted for preexisting comorbidities (15 patients), postoperative morbidity (6 patients), or lack of transportation or home support (19 patients). Twenty-three patients (6.6%) experienced postoperative morbidity. There were no mortalities. Four patients (1%) were readmitted for transient fever, nausea/vomiting, partial small bowel obstruction, and deep venous thrombosis. Outpatient laparoscopic appendectomy can be performed with a high rate of success, a low morbidity, and a low readmission rate. This study reaffirms our original pilot study and should serve as the basis for a change in the standard of care for appendicitis. Therapeutic study, level V.

Análise das complicações em pacientes no período de recuperação anestésica

Objective: To analyze patient complications during post-anesthesia recovery. Method: This non-experimental, comparative, prospective field study used a quantitative methodological approach. The sample consisted of 42 adults who had undergone elective surgery with general anesthesia, classified as I or II according to the American Society of Anesthesiologists (ASA). Data collection occurred from February to June 2013. Results: The most common complications were hypothermia, pain and hypoxemia. Statistically significant association was observed between the Aldrete Kroulik Index with bradipnea (p=0.038) and hypoxemia (p=0.025), when patients entered the post-anesthesia recovery room; and with hypertension (p=0.023) and tachycardia (p=0.048), after 60 minutes in the room. Conclusion: Considering the findings, nurses should implement effective measures to prevent and manage patient complications during post-anesthesia recovery.

Efficiency of Calatonia on clinical parameters in the immediate post-surgery period: a clinical study

To assess the efficiency of the Calatonia technique about clinical parameters and pain in the immediate post-surgical phase. A randomised study was carried out with 116 patients subjected to a cholecystectomy, by laparoscopy, divided into an experimental group (58 patients) and a placebo group (58 patients). The experimental group received the Calatonia technique, while the placebo was only subjected to non-intentional touches. The placebo group and the experimental group were considered homogeneous in terms of the variables: sex, age, physical status classification, duration of surgical procedures and also the time spent recovering in the Post-Anaesthetic Recovery Room. The only variable to show a statistically significant difference was the axillary temperature of the body. In relation to pain, the experimental group showed significant results, and hence it is possible to deduce that the relaxation caused by the Calatonia technique brought some relief of the general situation of pain. The application of Calatonia can take up the function of a resource complementary to assistance in the period immediately after surgery. Brazilian Register of Clinical Trials, UTN U1111-1129-9629.