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Part 5. Postoperative Care of the Anesthesia Patient
Chapter 73. Postoperative Complications
Edward A. Bittner, MD, PhD, Loreta Grecu, MD, and Edward George, MD
1. Complications in the postanesthesia care unit (PACU) are common. Despite pharmacologic and medical advances over the last 10 years, the incidence of postoperative complications appears largely unchanged. Even minor postoperative complications are important to patients, and greater efforts at preventing and treating such complications should lead to improved postoperative recovery and patient satisfaction.
2. Knowledge of the expected postoperative course for a given operation is essential to identifying and managing problems when they occur. Awareness of the temporal patterns of complications is important to anticipating periods of increased perioperative risk.
3. Airway obstruction is common in the postoperative period. Upper airway obstruction arises in the pharynx (posterior tongue displacement, soft tissue collapse), larynx (laryngeal edema, laryngospasm, vocal cord paralysis), or trachea due to extrinsic compression. Anesthetics, and even minimal residual neuromuscular blockade, may lead to upper airway obstruction.
4. Hypoxemia is common in postoperative patients not receiving supplemental oxygen.
5. Following general anesthesia or sedation all patients should receive supplemental oxygen (O
) during their transport from the operating room and during their initial PACU stay. Continuous monitoring of oxygen..."
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