Vol 92, No 3 (2021)
Research paper
Published online: 2021-03-08

open access

Page views 847
Article views/downloads 705
Get Citation

Connect on Social Media

Connect on Social Media

The impact of multimodal therapies on the comfort and safety of patients in the immediate post-anaesthetic period following gynaecological procedures — part II

Agnieszka Biskup1, Katarzyna Plagens-Rotman2, Maria Polocka-Molinska2, Piotr Merks34
Pubmed: 33751506
Ginekol Pol 2021;92(3):175-182.

Abstract

Objectives: The second part of the study was to assess the effects of the types of anaesthesia along with multimodal analgesia on the stability of vital functions at the critical moment of awakening from anaesthesia. Material and methods: The material comprised the medical records at the Department of Anaesthesiology and Intensive Care in Szczecin. The anaesthesia record forms and recovery room observation charts of 150 patients from the Gynaecology Clinic who had undergone category III and IV surgical procedures between October 2018 and January 2019 were selected for analysis. The patients were divided into three groups: 1. Patients given multimodal analgesia with non-opioid and opioid analgesics. 2. Patients given multimodal analgesia with non-opioid analgesics and adjuvants. 3. Patients given multimodal analgesia with non-opioid and opioid analgesics, as well as neuraxial anaesthesia. Results: The average minimum heart rate in the operating room was 63.92 in group I, 61.48 in group II, and 62.34 in group III. The most common cause of bradycardia during surgery was insufflation. The average SBP prior to surgery was similar in groups I and II — 128.74 and 128.66, respectively. The average maximum values during surgery were 135.24 in group I, 139.34 in group II, and 142.32 in group III. At the time of discharge from the post-anaesthetic care unit, all the patients from the study group had achieved an Aldrete score of 10. Following the anaesthesia, 24% of the patients in group I, 22% in group II, and 28% in group III required oxygen therapy. Conclusions: When using multimodal analgesia, the time required to fully awaken even after extensive surgical procedures was no longer than two hours.

Article available in PDF format

View PDF Download PDF file

References

  1. El-Gamal N, Elkassabany N, Frank SM, et al. Age-related thermoregulatory differences in a warm operating room environment (approximately 26 degrees C). Anesth Analg. 2000; 90(3): 694–698.
  2. Torossian A. Thermal management during anaesthesia and thermoregulation standards for the prevention of inadvertent perioperative hypothermia. Best Pract Res Clin Anaesthesiol. 2008; 22(4): 659–668.
  3. Hasiak J. Stres okołooperacyjny – operacja Część I: Geneza. Przegląd Urologiczny. 2012; 72(2).
  4. Ziębicka J, Gajdosz R. Wybrane aspekty lęku u chorych oczekujących na operację. Anest Inten Terap. 2006; 1: 41–44.
  5. Wadełek J. Risk assessment and monitoring in an adult patient for analgosedation during colonoscopy. Nowa Med. 2017; 24(2): 73–85.
  6. Sioma-Markowska U, Kubaszewska S, Nowak-Brzezińska A, et al. Lęk przed operacją ginekologiczną a przebieg okresu pooperacyjnego. Oncology and Radiotherapy. 2017; 3(41): 062–069.
  7. Carr ECJ, Nicky Thomas V, Wilson-Barnet J. Patient experiences of anxiety, depression and acute pain after surgery: a longitudinal perspective. Int J Nurs Stud. 2005; 42(5): 521–530.
  8. Van den Bosch JE, Moons KG, Bonsel GJ, et al. Does measurement of preoperative anxiety have added value for predicting postoperative nausea and vomiting? Anesth Analg. 2005; 100(5): 1525–32, table of contents.
  9. Lewicka M, Sulima M, Brukwicka I, et al. The intensity of pain in female patients after gynaecological surgeries. J Publ Health Nurs Med Rescue. 2014; 1: 32–36.
  10. Levandovski R, Ferreira MB, Hidalgo MP, et al. Impact of preoperative anxiolytic on surgical site infection in patients undergoing abdominal hysterectomy. Am J Infect Control. 2008; 36(10): 718–726.
  11. Manias E, Bucknall T, Botti M. Nurses' strategies for managing pain in the postoperative setting. Pain Manag Nurs. 2005; 6(1): 18–29.
  12. Delgado-Herrera L, Ostroff RD, Rogers SA. Sevoflurance: approaching the ideal inhalational anesthetic. a pharmacologic, pharmacoeconomic, and clinical review. CNS Drug Rev. 2001; 7(1): 48–120.
  13. Eger E. The pharmacology of inhaled anesthetics. Seminars in Anesthesia, Perioperative Medicine and Pain. 2005; 24(2): 89–100.
  14. Hasiak J. Stres okołooperacyjny – operacja Część II: Operacja. Przegląd Urologiczny. 2013; 73(3).
  15. Larsen R. Anestezjologia Tom 1. Wyd. 3 pod red. A. Kublera. Elsevier Urban & Partner, Wrocław 2010.