Recovery Room: Evaluation of Efficacy and Safety in a Cancer Center after 13 Years of Activity - Abstract
The aim of this study was to assess the characteristics of patients admitted to a recovery room [RR] in an oncological department. The secondary outcomes were to evaluate how RR was able to prevent immediate postoperative complications and which are the principal factors influencing RR stay.
A consecutive sample of cancer patients who were admitted in RR was surveyed. Patients who received some form of anesthesia by specialized staff were included. Patients were discharged to their ward when they achieved a safety score and adequate symptom control. The patient’s level of consciousness, respiration, hemodynamics, mobility of the extremities, oxygen saturation [SO2] were recorded, on a scale from 0 to 2 [modified Aldrete score], as well as pain intensity, vomiting, shivering, and drugs administered in RR. Patients, who were expected to need respiratory support for the subsequent 24-48 hours after evaluation in RR, were discharged to continue non-invasive ventilatory support [NIV] in a sub-acute unit, according to local policy.
1185 patients were surveyed. The mean age was 59.4 yrs [SD 14]. At RR admission, the mean SO2 was 98.1 [SD 2.2], with 10[0.8%] patients having a SO2 of less than 90%. The level of consciousness was normal in 847 patients, patients were sedated [score 1] in 246 cases, and 8 patients had more profound level of unconsciousness [score 2]. (NOTE: this does not make sense – do you mean unconsciousness?). On admission to RR, 1079 patients were spontaneously breathing, one patient was intubated and breathing spontaneously, three patients had a laryngeal mask airway, 87 were intubated and manually ventilated a but extubated shortly after arriving to RR. Seven patients were intubated on arrival to the RR and received CPAP.One patient underwent controlled ventilation. Two patients had to be re-intubated in RR, and one patient needed alaryngeal mask airway to be inserted. The mean duration of RR stay was 61.3 minutes [SD 54].Using an univariate analysis, the duration of RR stay was correlated to age, duration of surgery, ASA, gender [male], obesity, cardiovascular disease, renal disease, and abdominal surgery. Significant correlation was found only with gender, ASA, obesity, cardiovascular disease, and duration of surgery. In order to maintain respiratory support mainly through non-invasive ventilation [NIV], 51 patients [4.3%] were discharged from RR to a sub-intensive Care unit for a median duration of 1 day.
RR is of paramount importance for the management of cancer patients undergoing different types of surgery. Patients can be monitored and stabilized after an appropriate treatment until the best balance is achieved.Thus, admission to RR improves patient safety and efficacy of treatment.