Anoxia ; Oxygen* ; Recovery Room*

BACKGROUND: It is one of anesthesiologist's important tasks to know the accurate recovery state of a patient after general anesthesia. Postanesthetic recovery score (PARS) has been widely used as a measure of evaluating recovery state because it is simple, easy to apply and applicapable to all situations. In this study, we investigated whether there were correlations between PARS and PAR-stay time, and examined factors influencing PAR-stay time. METHODS: Two hundreds and five patients were selected randomly. PARS was measured in each patient immediately after he or she arrived at PAR. Correlations between PARS and PAR-stay time were studied. And other variables such as age, sex, physical status, operation site and anesthetic time were studied as influencing factors on PAR-stay time. RESULTS: There were no significant correlations between PARS and PAR-stay time. PARS was influenced by the operation site only. And PAR-stay time was influenced by the patient's age only. CONCLUSIONS: In evaluating the postanesthetic recovery state, it seems to be important to consider not only PARS but also other factors such as patient's age.
Anesthesia, General ; Humans ; Recovery Room*

BACKGROUND: This study was doned to evaluate the rate of awakening after desflurane or isoflurane anesthesia in pediatric tonsillectomy patients. METHODS: Sixty patients, aged 5 10 years undergoing a tonsillectomy with or without an adenoidectomy were randomly assigned to receive either desflurane-N2O (group D) or isoflurane-N2O (group I). A recovery profile was assessed by a 3 point scale for the first 0, 15 and 30 min in the recovery room. RESULTS: It was statistically significant that group D had a shorter extubation time and eye opening time and a less apprehensive score than group I at 0, 15 and 30 min. CONCLUSIONS: We conclude that desflurane-N2O may offer clinical advantages over isoflurane when used for maintenance of anesthesia during a pediatric tonsillectomy.
Adenoidectomy ; Anesthesia ; Humans ; Isoflurane ; Recovery Room ; Tonsillectomy*

A postanesthetic recovery score to provide objective information on the phsical condition of patients arriving in the recovery room after anesthesia. The status of the patients was judged after arriving in the recovery room and every 30minutes thereafter, until their discharge to the ward or Intensive Care Unit. To study this method, 324 patients were selected at random to include as many variants of anesthesia as possible. The patients were transported to the recovery room within 10 minutes of the completion of the anesthesia; Once there, the first score was made by the anesthesiologist. Thereafter, the evaluation was made by the same anesthesiologist. Depending on the length of stay in recovery room, this evaluation was repeated 30, 60, and 90 minutes after the patients arrival. The various signs were evaluated. The independent variables such as age, sex, physical status, anesthetic agents or technics, type of surgery, use of muscle relaxants, duration of anesthesia were correlated with the proportional number of patients receiving top or safe score 10, 9 or 8, and those given 7 or less, which were considered low or dangerous.
Anesthesia ; Anesthetics ; Humans ; Intensive Care Units ; Length of Stay ; Recovery Room*

BACKGROUND: Tramadol is a centrally acting analgesic with weak opioid agonist properties and has effect on the spinal inhibition of pain. This study was designed to evaluate the efficacy of tramadol in the treatment of postanesthetic shivering. METHODS: Sixty patients (ASA class I/II) who showed postanesthetic shivering were randomly assigned into three groups (n=20): Normal saline group; normal saline 10 ml, tramadol (TRD) 0.5 mg/kg group; tramadol 0.5 mg/kg, TRD 1.0 mg/kg group; tramadol 1.0 mg/kg. And all patients received standard postoperative management in the recovery room. Evaluation of the grade of shivering was done at 30 seconds, 2, 5 and 10 minutes from the beginning of the treatment by the same investigator who had injected the drug. The age, sex, weight, duration of anesthesia and axillary temperature were recorded. RESULTS: By 30 seconds, 2 minutes, 5 minutes, and 10 minutes, 0, 4, 9, 9 patients of the 0.5 mg/kg tramadol group (n=20) and 7, 18, 19, 19 patients of the 1.0 mg/kg tramadol group (n=20) stopped the shivering respectively. But in 3 patients of 0.5 mg/kg tramadol group who stopped shivering by 5 minutes, shivering was recurred within 10 minutes and in 3 patients who had not stopped shivering by 5 minutes, shivering stopped by 10 minutes. In the placebo group, only 1 patient stopped shivering by 5 minutes. CONCLUSION: 1.0 mg/kg of tramadol was effective for the treatment of postanesthetic shivering but 0.5 mg/kg of tramadol was ineffective.
Anesthesia ; Humans ; Recovery Room ; Research Personnel ; Shivering* ; Tramadol*

BACKGROUND: Tramadol is a centrally acting analgesic with weak opioid agonist properties and has effect on the spinal inhibition of pain. This study was designed to evaluate the efficacy of tramadol in the treatment of postanesthetic shivering. METHODS: Sixty patients (ASA class I/II) who showed postanesthetic shivering were randomly assigned into three groups (n=20): Normal saline group; normal saline 10 ml, tramadol (TRD) 0.5 mg/kg group; tramadol 0.5 mg/kg, TRD 1.0 mg/kg group; tramadol 1.0 mg/kg. And all patients received standard postoperative management in the recovery room. Evaluation of the grade of shivering was done at 30 seconds, 2, 5 and 10 minutes from the beginning of the treatment by the same investigator who had injected the drug. The age, sex, weight, duration of anesthesia and axillary temperature were recorded. RESULTS: By 30 seconds, 2 minutes, 5 minutes, and 10 minutes, 0, 4, 9, 9 patients of the 0.5 mg/kg tramadol group (n=20) and 7, 18, 19, 19 patients of the 1.0 mg/kg tramadol group (n=20) stopped the shivering respectively. But in 3 patients of 0.5 mg/kg tramadol group who stopped shivering by 5 minutes, shivering was recurred within 10 minutes and in 3 patients who had not stopped shivering by 5 minutes, shivering stopped by 10 minutes. In the placebo group, only 1 patient stopped shivering by 5 minutes. CONCLUSION: 1.0 mg/kg of tramadol was effective for the treatment of postanesthetic shivering but 0.5 mg/kg of tramadol was ineffective.
Anesthesia ; Humans ; Recovery Room ; Research Personnel ; Shivering* ; Tramadol*

BACKGROUND: The cuff pressure (CP) of the laryngeal tube airway (LTA) increases during general anesthesia using nitrous oxide. However, there have been few studies on the relationship between CP and postoperative sore throat (POST). This study evaluated the efficacy of the CP on a POST on the recovery time and postoperative day. METHODS: Forty patients were divided into two groups, group M (n = 20) and group I (n = 20). In all patients, the CP was set to 65 cmH2O at the induction of anesthesia. In group M, the CP was maintained at 60-70 cmH2O during general anesthesia using N2O. However, in group I, the CP was allowed to increase. The CP was measured every 10 minutes during surgery in the two groups. The frequency and intensity (numerical rating scale of 0-100, NRS-101) of the sore throat was measured at recovery room (RR) and on postoperative day 1 (POD1). RESULTS: There was a significant increase in the CP in group I during general anesthesia and the CP was higher in group I than in group M (P < 0.05). The frequency of POST was higher in group I at RR (10% vs 70%) and POD1 (0% vs 35%) than in group M. In addition, the NRS-101 was higher in group I at RR and POD1 than in group M (P < 0.05). CONCLUSIONS: The CP of the LTA needs to be monitored and controlled during surgery in order to reduce POST.
Anesthesia ; Anesthesia, General* ; Humans ; Nitrous Oxide ; Pharyngitis* ; Recovery Room

To investigate the effect of deep breathing and encouraged coughing on the arterial oxygenation in patients following upper abdominal surgery under general anesthesia, 80 patients were chosen and divided into 4 groups according to the therapy modalities given during the recovery mom care ; group 1: spontaneous recovery, group 2: oxygen, group 3: cough with deep breathing, and group 4: oxygen plus cough with deep breathing. Oxygen saturation (SpO2 by pulse oximeter) was monitored before anesthesia (control) and over a 24 hour period after operation. S values decreased on arrival in the recovery room after anesthesia in all groups (p<0.05). As patients awakened from anesthesia in the recovery room, SpO2 values were progressively increased to near preanesthetic values in the non-oxygen groups (Group 1, 3) and increased even above preanesthtic values in the oxygen groups (Group 2, 4) SpO2 values at 24-hours after operation were 97.0% in Group 1, 96.9% in Group 2, 97.8% in Group 3, and 97.5% in GRoup 4; therefore Group 3 had the highest value of SpO2 (p<0.05), In conclusion, deep breathing with cough encouragement in the recovery room seemed to be associated with better oxygenation 24 hours postanesthetically than supplemental oxygen or natural recovery groups.
Anesthesia ; Anesthesia, General ; Cough* ; Humans ; Oxygen* ; Recovery Room ; Respiration*

BACKGROUND: Postanesthetic shivering affects up to 65% of patients after general anesthesia, and it can be very distressing. Various drugs have been used to treat or prevent postanesthetic shivering, but the ideal drug has not yet been found. The aim of this study was to find the minimum dose of ketamine that would show an antishivering effect. METHODS: Ninety patients scheduled for total or subtotal thyroidectomy under general anesthesia were randomly allocated to three groups: Patients received saline 3 cc (Group 1; n = 30), ketamine 0.5 mg/kg (Group 2; n = 30) or ketamine 1.0 mg/kg (Group 3; n = 30) at the end of surgery. The postanesthetic shivering was evaluated by an blind investigator who was "blinded" to the dose of ketamine. The grade of shivering was assessed using a five-point scale at 0, 10, 20 and 30 minutes after the arrival to the recovery room. RESULTS: The number of patients shivering on arrival to the recovery room, and at 10 minutes after the arrival of recovery room was significantly less in Groups 2 and 3 than in Group 1 (P < 0.05). However, at 20 and 30 minutes, the number of patients was not different among the groups. There was no difference within the groups that received ketamine. CONCLUSIONS: The prophylactic use of 0.5 mg/kg intravenous ketamine was effective in preventing shivering after general anesthesia.
Anesthesia, General ; Humans ; Ketamine ; Recovery Room ; Research Personnel ; Shivering ; Thyroidectomy

BACKGROUND: Postoperative residual curarization subsequent to the use of neuromuscular blocking drugs can cause respiratory problems. This study examined the incidence of postoperative residual curarization on the arrival of patients in the recovery room. METHODS: Two-hundred-fifty-nine patients were enrolled in the study. The neuromuscular blockade was maintained with vecuronium or rocuronium and all subjects were reversed with pyridostigmine. The train of four ratios (TR) was quantified by acceleromyography immediately upon their arrival in the recovery room. The residual curarization was defined as a TR of < 0.9. RESULTS: The incidence of residual curarization was 32.8% (84 patients). The time from the last dose of muscle relaxants to the TR assessment in the recovery room was significantly different between those with a TR <0.9 (74.9 +/- 35.3 min) and a TR > 0.9 (104.5 +/- 51.1 min) patients. The total dose of muscle relaxants corrected by the ED95 was significantly different between TR < 0.9 and TR > or = 0.9 patients. The total dose of vecuronium or rocuronium, and the dose of pyridostimine was similar in the TR < 0.9 and TR > or = 0.9 patients. CONCLUSIONS: Significant postoperative residual curarization waspresent in the majority of patients, even with the use of intermediate- acting neuromuscular blocking drugs. In addition, the time from the last dose of muscle relaxants to the TR assessment in the recovery room is a major factor that affects the residual curarization.
Humans ; Incidence ; Neuromuscular Blockade ; Pyridostigmine Bromide ; Recovery Room* ; Vecuronium Bromide*