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*

PURPOSE: This study was conducted to compare the effects of simulation-based training on knowledge, self-efficacy and clinical performance, underwent before or after the clinical practice for the nursing students. METHOD: A comparison group design was established with pre-clinical practice group (n=34) and post-clinical practice group (n=34). Both groups participated in simulation-based training before or after the clinical practice at the recovery room. Chi-square test, t-test and paired t-test were performed to analyze the data. RESULTS: Both groups showed significantly higher post-test scores in knowledge and self-efficacy than pre-test scores (p<.001). The group with simulation training performed before their clinical practice (pre-clinical practice group) showed significantly higher self-efficacy (p=.044) than the group with simulation training done after their clinical practice (post-clinical practice group). However, there was no significant difference in the knowledge (p=.922) and clinical performance (p=.887). CONCLUSION: These findings of the study suggest that simulation based training in pre-clinical practice is effective to enhance the self-efficacy and to improve knowledge and clinical performance of the nursing students.
Education ; Humans ; Patient Simulation ; Recovery Room ; Students, Nursing*

BACKGROUND: Sevoflurane is commonly used anesthetics for pediatric surgical patients. Emergence delirium is more frequent when recovering from sevoflurane anesthesia than other anesthetics. In this study, we evaluated the effect of remifentanil to reduce emergence delirium after sevoflurane anesthesia in pediatric patients. METHODS: Children (3-7 yrs) were randomly assigned to three groups: sevoflurane with normal saline in group N (0.06 ml/kg/ hr), sevoflurane with remifentanil (0.1microgram/kg/min) in group R, and sevoflurane with remifentanil (0.1microgram/kg/min) and remifentanil (0.05microgram/kg/min) till the recovery room in group RC. Time to extubation, Pediatric Anesthesia Emergence Delirium Scale (PAEDS), Objective Pain Scale (OPS), Modified Aldrete Score (MAS), and postoperative side effects in the recovery room were compared among three groups. RESULTS: Time to extubation (N; 9.3 +/- 3.5, R; 12.2 +/- 6.4, RC; 12.7 +/- 5.3 min) in R and RC group was prolonged compared with N group (P < 0.05). There were no differences among three groups in MAS. OPS has variable differences among the groups (P < 0.05). PAEDS was significantly reduced in RC group compare with R and N group (P < 0.05). CONCLUSIONS: Remifentanil did not reduce the incidence of emergence delirium after sevoflurane anesthesia in pediatric tonsillectomy. Emergence delirium after sevoflurane anesthesia was reduced by remifentanil infusion till the recovery room.
Anesthesia* ; Anesthetics ; Child ; Delirium* ; Humans ; Incidence ; Pediatrics ; Recovery Room ; Tonsillectomy

Two cases of subdural tension pneumocephalus were introduced after posterior fossa surgery in the sitting position. The possible mechanism for entry of air into the subdural space is explained as the fluid pours out air bubbles to the top of the container. All of two cases manifested generalized seizure at recovery room and were diagnosed with plain skull series and computed tomogram. Subdural air evacuated patient fail to recover as expected, following posterior fossa surgery in sitting position.
Humans ; Pneumocephalus* ; Recovery Room ; Seizures ; Skull ; Subdural Space

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: 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*

For the evaluation of the correlation between the ETCO2 and the PaCO2 in post-extubated spontaneously breathing patients, we tested 30 patients in recovery room with Salter Divided Nasal Cannula, which have permanent bamer in the face piece and a dual tubing set that allows end tidal sampling from one nare and oxygen delivery to the other. When the wave form of capnogram looked regular and normal, the value of ETCO2 was recorded and the arterial blood was taken from the radial artery to analize blood gas immediately. The results were as following; 1. The mean value of PaCO2 was 42.0+/-4.8 mmHg. 2. The mean value of P(ET)CO2 was 39.3+/-5.1 mmHg. 3. The value of P(ET)CO2 acquired with Salter Divided Nasal Cannula hase close positive correlation with the values of the PaCO2. (PaCO2=0.75 x P(ET)CO2+/-12.64, r=0.79, p<0.001)
Catheters* ; Humans ; Oxygen ; Radial Artery ; Recovery Room ; Respiration*

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