Incidence and factors associated with post‐anesthesia care unit complications in resource‐limited settings: An observational study

Background and aims: Postoperative complications are frequent encounters in the patients admitted to postanesthesia care units (PACU). The main aim of this study was to assess the incidence of complications and associated factors among surgical patients admitted in limited-resource settings of the PACU.Methods: This is an observational study of 396 surgical patients admitted to PACU.This study was conducted from February 1 to March 30, 2021, in Ethiopia. Study participants' demographics, anesthesia, and surgery-related parameters, PACU complications, and length of stay in PACU were documented. Multivariate and bivariate logistic regression analyses, the odds ratio (OR), and 95% confidence interval (CI) were calculated. p-value < 0.05 was considered as statistically significant.Results: The incidence of complications among surgical patients admitted to PACU was 54.8%. Of these, respiratory-related complications and postoperative nausea/vomiting were the most common types of PACU complications. Being a female (adjusted odds ratio [AOR] = 2.928; 95% CI: 1.899-4.512) was significantly associated with an increased risk of developing PACU complications. Duration of anesthesia >4 h (AOR = 5.406; 95% CI: 2.418-12.088) revealed an increased risk of association with PACU complications. The occurrences of intraoperative complications (AOR = 2.238; 95% CI: 0.991-5.056) during surgery were also associated with PACU complications. Patients who develop PACU complications were strongly associated with length of PACU stay for >4 h (AOR = 2.177; 95% CI: 0.741-6.401). Conclusion:The identified risk factors for complications in surgical patients admitted to PACU are female sex, longer duration of anesthesia, and intraoperative complications occurrences. Patients who developed complications had a long time of stay in PACU. Based on our findings, we recommend the PACU team needs to develop area-specific institutional guidelines and protocols to improve the patients' quality of care and outcomes in PACU.

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Incidence and factors associated with post‐anesthesia care unit complications in resource‐limited settings: An observational study

Abebe

Kifle

Gunta

et al. 2022

Health Science Reports

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The Significance of Nursing Care in the Post-anesthesia Care Unit and Barriers to Care

Mert

2023

Intensive Care Res

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The post-anesthesia care unit (PACU) is the section where the effects of anesthesia are expected to pass following surgery, the patient's vital signs are aimed to be stable, and the prevention of possible complications is aimed. In PACU, patients may encounter many complications after surgery and anesthesia. The most common complications include acute pain, hypoxemia, nausea, vomiting, delirium, hypothermia, etc. It is stated that most of the complications in the post-anesthesia care phase are seen between the first 1 and 5 h. Nursing care is significant in PACU to improve the quality of recovery of patients and to prevent complications that may occur. Nurses must be highly qualified and have knowledge and skills in the treatment and care of patients from different surgeries of varying complexity that require specialized and individualized care. Complications and side effects can be detected early with adequate nursing observation, care, and treatment in PACU, and the incidence of complications, mortality rates, and length of hospital stay can be reduced with timely intervention. However, unexpected increases in patient volume or acuity, prolonged patient stay in the unit, nurses' lack of knowledge and skills in some subjects, lack of staff, excessive workload, communication barriers between surgeons, anesthesiologists, and nurses, the absence of structured information reporting systems, lack of a standard PACU transfer checklist, and inability to allocate sufficient time for nursing care due to heavy administrative burden in addition to psychosocial factors such as high stress, insufficient sleep, and lack of active rest intervals, prevent adequate nursing care in PACU. The existing literature does not offer a comprehensive examination of nursing care in the PACU, the complications arising therein, impediments to nursing care, or recommendations to address these challenges. This review, seeking to elucidate the methodologies of nursing care within the PACU, highlighting its significance, identifying challenges, and proposing solutions, is anticipated to act as a foundational guide for practitioners, administrators, and scholars in the domain, facilitating the resolution of nursing care barriers and enhancing the body of knowledge on this topic.

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An assessment of the role of surgical loupe technique in prevention of postthyroidectomy complications: a comparative prospective study

Nagaty¹,

Shehata²,

Elkady³

et al. 2023

Annals of Medicine &Amp; Surgery

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Objective: The magnification technique offered by surgical loupe is a new method that enhances visualization and helps head and neck surgeons with recurrent laryngeal nerve (RLN) and parathyroid glands identification. This study aimed to assess the safety and efficacy of using binocular surgical loupes in thyroidectomy procedures. Material and Methods: Eighty patients with thyroid nodules who underwent thyroidectomy procedure were divided randomly into two comparable groups, group A subjected to thyroidectomy by using binocular magnification loupe, group B underwent conventional thyroidectomy without using magnification. Patients’ demographics, operation time, and postoperative morbidities were recorded. All cases had preoperative and postoperative vocal cords assessment by video laryngoscopy. Pathology, laboratory, and radiology investigations were also conducted. Results: Out of 80 patients, there were 58 females and 22 males. Benign thyroid pathology was found in 74 patients and malignant pathology in 6 patients. The mean operating time was 106 min in group A compared to 138.5 min in group B. The mean amount of intraoperative bleeding was 30 ml in group A while 50 ml in group B. There were no cases of the external branch of the superior laryngeal nerve in both groups; there was better identification in group A. There was only one patient who suffered from a temporary RLN injury in group A, while three cases of temporary and one case of permanent RLN injury were recorded in group B. Permanent hypoparathyroidism was diagnosed in only one patient in group B. Conclusion: The utilization of binocular surgical loupe magnification in thyroid surgery is considered a safe and effective maneuver that has the advantages of decreasing the overall operating time and significantly reducing postoperative complications.

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Incidence and factors associated with post‐anesthesia care unit complications in resource‐limited settings: An observational study

Cited by 5 publications

References 41 publications