Anesthesia Student Survival Guide.pdf - Index of

442 ● AnesthesiA student survivAl Guide
When can the patient be discharged from the PACU? How would your criteria
differ if the patient were being discharged home after laparoscopy instead?
The patient should be oriented to person, place, time, and situation. Her pain
and nausea should be under reasonable control, but it is not necessary for her
to be completely pain free or to be completely without nausea. These symptoms
may persist for hours or even days in the case of postoperative pain.
The point is to have reached a stable and tolerable equilibrium. She should
be fluid replete, as indicated in part by acceptable urine output, and if bleeding
has been significant, her hemoglobin should be in a range not requiring
transfusion (generally higher than 7 g/dL). Her vital signs should be stable
and there should be no respiratory problems other than a possible requirement
for supplemental oxygen. If she is to be discharged home, she should
have no oxygen requirement, and she should be able to ambulate with minimal
assistance. She must have a competent adult to accompany her home.
Suggested Further Reading
Barash PG, Cullen BF, Stoelting RK (eds) (2006) Clinical anesthesia, 5th edn.
Lippincott, Williams and Wilkins
Morgan GE, Mikhail MS, Murray MJ (eds) (2006) Clinical anesthesiology, 4th
edn. McGraw-Hill
(2002) Practice guidelines for postanesthetic care: a report by the American
Society of Anesthesiologists Task Force on Postanesthetic Care. Anesthesiology
96:742–752
(2000) Practice advisory for the prevention of perioperative peripheral neuropathies:
a report by the American Society of Anesthesiologists Task Force on Prevention
of Perioperative Peripheral Neuropathies. Anesthesiology 92:1168–1182
Gan TJ, Meyers T, Apfel CC et al (2003) Consensus guidelines for managing
post-operative nausea and vomiting. Anesth Analg 97:62–71
(2004) Practice guidelines for acute pain management in the perioperative
setting: an updated report by the American Society of Anesthesiologists Task
Force on Acute Pain Management. Anesthesiology 100:1573–1581