Evidence-based clinical practice manual: Postoperative controls

Abstract

a b s t r a c t Introduction: Post-anesthetic care reduces the anesthesia-related postoperative complications and mortality, shortens the length of stay at the postoperative care units and improves patient satisfaction.Objective: To establish a set of recommendations for immediate post-anesthetic care of patients that received general/regional anesthesia or profound/moderate sedation at the postoperative care units.Methodology: This is a process of "rapid" clinical practice guidelines adaptation, including systematic search. The illegible guidelines for adaptation were rated using AGREE II. The guideline selected to be adapted as the clinical practice handbook was Practice guidelines for post-anesthetic care of the American Society of Anesthesiologists. The manual was evaluated in terms of implementation ability, up-to-date information, relevancy, ethical considerations and patient safety by the group of anesthesiologists and epidemiologists based on Delphi. Result:The manual kept the recommendations on evaluation and monitoring, pharmacological management of postoperative nausea and vomiting, antagonistic actions for sedatives and analgesics and neuromuscular block agents, emergency management and anesthesia recovery, as well as the criteria for discharge from the unit. Indications about the conditions and requirements of the unit and patient admission were also included.

Perioperative safety indicators: surgery cancellation and immediate postoperative complications

“…As for complications such as hypothermia, hypovolemia, fever or kidney failure, they were observed by other authors but are not among the ones reported in this research. However, the "pain" variable, despite being the second most frequent complication, was not prevalent compared to the findings of other authors, whose study results presented 75% of patients reporting pain in the postoperative period (Caro et al, 2015). It is important to point out that, for the highest rate of performed procedures, 39.6% (143), no mentions of presence or absence of complications were found in the patients' medical records, which suggests a need for greater caution and attention from health professionals as to adding this information to said documents.…”

“…In this research, the most frequent postoperative complication was hypotension, with 8.6% (31), followed by pain, with 6.4% (23), twice the percentage reported by Caro et al (2015) in their study.…”

“…General complications includes respiratory, cardiovascular, such as hypotension, which 3% of patients in postoperative care present, hypovolemia, systemic and asymptomatic arterial hypertension, hypothermia (Benavides et al, 2015). Besides, hypotension, hemorrhage, thromboembolic disorders, kidney failure are worth highlighting, along with various problems such as headache, heartburn, hiccups, cough and lower urine output (Caro et al, 2015).…”