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Postoperative Anesthesia Care

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Basic Clinical Anesthesia

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Abstract

Anesthesia care has evolved over time. Considerable importance is now given to postoperative care, rather than just good pre/intraoperative care. As the number of operations is increasing, it has become important for patients to recover rapidly without side effects. This has lead to the development of newer anesthesia techniques and recovery protocols. Complications in the postanesthesia care unit (PACU) are frequent, and therefore, identification and timely management of these complications decreases patient morbidity and mortality. Standards of postoperative care are summarized below.

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Author information

Authors and Affiliations

  1. Department of General Anesthesiology, Celeveland Clinic, Main Campus, Mail Code G30, 9500 Euclid Avenue, Cleveland, OH, 44195, USA

    Maged Argalious M.D.

Authors
  1. Maged Argalious M.D.
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Corresponding author

Correspondence to Maged Argalious M.D. .

Editor information

Editors and Affiliations

  1. Department of Anesthesia and Perioperative Medicine, Emerson Hospital (former faculty Brigham and Women’s Hospital, Harvard Medical School), Concord, Massachusetts, USA

    Paul K. Sikka

  2. Associate Professor, Associate Residency Program Director, Director of Trauma Anesthesiology, Department of Anesthesiology-Presbyterian Hospital, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA

    Shawn T. Beaman

  3. Chair, Department of Anesthesia and Perioperative Medicine, Emerson Hospital; Associate Professor, Northeastern University, Boston, MA (former faculty Brigham and Women’s Hospital, Harvard Medical School), Concord, Massachusetts, USA

    James A. Street

Clinical Review

Clinical Review

  1. 1.

    The most frequent cause of delayed emergence in the PACU is

    1. A.

      Hypotonia

    2. B.

      Hypoventilation

    3. C.

      Hypotension

    4. D.

      Hypothermia

  2. 2.

    Criteria for transporting a patient out of the operating room include all, except

    1. A.

      Patient with an LMA still in place

    2. B.

      TV of 300 ml/breath and respiratory rate of 25 breaths/min in a 65 kg patient

    3. C.

      Patient with a blood pressure of 84/32

    4. D.

      Oxygen saturation of 96 %

  3. 3.

    Extrapyramidal reactions are most likely to occur with the administration of

    1. A.

      Ondansetron

    2. B.

      Metoclopramide

    3. C.

      Droperidol

    4. D.

      Promethazine

  4. 4.

    A 35-year-old patient is brought to the PACU after undergoing an appendectomy. His anesthetics included propofol 140 mg, isoflurane 2.0 MAC, vecuronium 6 mg, and morphine 6 mg. In the PACU the patient’s temperature is 33.5 C and is shivering. The most likely cause of his shivering is

    1. A.

      Use of isoflurane

    2. B.

      Presence of infection and dehydration

    3. C.

      Use of unwarmed fluids

    4. D.

      Use of morphine

  5. 5.

    A 47-year-old patient is brought to the PACU after drainage of a gluteal abscess under MAC anesthesia. The patient is not fully responsive and has labored and sonorous breathing. His BP is 136/82, HR is 89/min and O2 saturation is 92 %. Your initial step in management would be to

    1. A.

      Change the nasal cannula to a non-rebreathing bag

    2. B.

      Increase the FiO2

    3. C.

      Do a jaw thrust and head-tilt maneuver

    4. D.

      Use a ambu bag

  6. 6.

    A 29-year-old patient is undergoing a left knee hardware removal under general endotracheal anesthesia. At the end of the procedure the patient is extubated. A few moments later you hear high-pitched crowing noises from the patient’s airway. The BP is 140/86, HR is 92/min and the O2 saturation is 88 % and dropping. Your initial response would be to

    1. A.

      Insert an oral airway

    2. B.

      Suction the airway to remove secretions

    3. C.

      Give succinylcholine

    4. D.

      Positive airway pressure with a mask

  7. 7.

    The most common cause of postoperative hypoxemia following general anesthesia is a decrease in

    1. A.

      Functional residual capacity

    2. B.

      Tidal volume

    3. C.

      Residual volume

    4. D.

      Inspiratory capacity

Answers: 1. B, 2. C, 3. C, 4. A, 5. C, 6. D, 7. A

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Argalious, M. (2015). Postoperative Anesthesia Care. In: Sikka, P., Beaman, S., Street, J. (eds) Basic Clinical Anesthesia. Springer, New York, NY. https://doi.org/10.1007/978-1-4939-1737-2_41

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  • DOI: https://doi.org/10.1007/978-1-4939-1737-2_41

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4939-1736-5

  • Online ISBN: 978-1-4939-1737-2

  • eBook Packages: MedicineMedicine (R0)

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