Post-operative

Question 1

requirements for emergence from anaesthesia?

Answer 1

usually rapid (low solubility)

involves but is not limited to reversal of

• muscle relaxant medications
• provision of analgesia
• restoration of spontaneous, independent ventilation

patient progress from physiologic Stage III up to Stage I. (Goudel’s classification?)

Interventions are made w regard to CVS + respiratory threats of Stage II
–> airway is prepped for spontaneous ventilation:
“patent, powered, and protected airway”.

Patency: freeing airway from obstruction (tongue + other soft tissue) w “head-tilt/jaw-thrust” manoeuvre / airway stents + suctioning.
Power is: resumption of the patient’s muscle ability to cough (to clear their airway) AND take deep breaths (to
maintain oxygenation).
Protection is : by resumption of airway reflexes + airway awareness.

Question 2

indications for ongoing sedation

Answer 2

??

Question 3

explain the differences between general anaesthesia and sedation

Answer 3

??

Question 4

observations measured in recovery

Answer 4

blood pressure
pulse
oxygen saturation
temperature (hyperthermic --> blankets + warmed IV fluids) 
urineoutput
surgical drain output

Ifurineoutput< 0.5 mL/kg/hourfor> 6 hours:
–>Check catheter patency.

bowel opening monitoring

Question 5

what are some other management strategies employed in recovery

Answer 5

criteria for dishcharge from recovery

intubated --> supportive care 
pain managenent (WHO analgesia ladder)
Stress ulcer prophylaxis (proton pump inhibitors) 
immobile --> Thrombo prophylaxis (pre+post) (low dose LMWHorUFH)

Incentive spirometry+ breathing exercises–> preventlungatelectasis

Fluids:replacement of ongoing fluid loss+maintenance fluidtherapy
Enteral nutritionstarted asap –>
prevent villousatrophy.

Daily examination of the surgical wound
Early mobilization

Question 6

what are the various levels of post-op recovery

Answer 6

??

Question 7

Define monitoring

Answer 7

making repeated / continuous observations OR measurements of the patient

• • physiological function
• • function of life support equipment –> guides management (e.g. when to make therapeutic interventions + their assessment)

Question 8

What is the main aim of monitoring?

Answer 8

will not prevent all adverse incidents

reduces the risks of incidents / accidents :

1) detecting the consequences of errors,
2) giving early warning that patient condition is deteriorating