The recovery room, also called a post-anesthesia care unit (PACU), is a space a patient is taken to after surgery to safely regain consciousness from anesthesia and receive appropriate postoperative care.
Patients who have had surgery or diagnostic procedures requiring anesthesia or sedation are taken to the recovery room, where their vital signs (e.g., pulse, blood pressure, temperature, blood oxygen levels) are monitored closely as the effects of anesthesia wear off. The patient may be disoriented when he or she regains consciousness, and the recovery room nursing staff will work to ease their anxiety and ensure their physical and emotional comfort.
The recovery room staff will pay particular attention to the patient’s respiration, or breathing, as the patient recovers from anesthesia. A pulse oximeter, a clamp-like device that attaches to a patient’s finger and uses infrared light to measure the oxygen saturation level of the blood, is usually used to assess respiratory stability. If the oxygen saturation level is too low, supplemental oxygen may be administered through a nasal cannula or face mask. Intravenous fluids are also frequently administered in the recovery room.
Because general anesthesia can cause a patient’s core body temperature to drop several degrees, retaining body heat to prevent hypothermia and encourage good circulation is also an important part of recovery room care. Patients may be wrapped in blankets warmed in a heater or covered with a forced warm-air blanket system to bring body temperature back up to normal. They may also receive heated intravenous fluids.
The amount of time a patient requires in the recovery room will vary by surgical or diagnostic procedure and the type of anesthesia used. As the patient recovers from anesthesia, their postoperative condition is assessed by the recovery room nursing staff. A physician may order analgesic or antiemetic medication for any
Fast track— A protocol for postoperative patients with projected shorter recovery times. Fast-tracking a patient means that they will either bypass PACU completely, or spend a shorter time there with less intensive staff intervention and monitoring.
Hypothermia— Low core body temperature of 95°F (35°C) or less.
Nasal cannula— A piece of flexible plastic tubing with two small clamps that fit into the nostrils and provide supplemental oxygen flow.
pain or nausea and vomiting, and the surgeon and/or anesthesiologist may come by to examine the patient.
Both hospitals and ambulatory surgical centers have recovery room facilities, which are generally located in close proximity to the operating room. A recovery room may be private, or it may be a large, partitioned space shared by many patients. Each patient bay, or space, is equipped with a variety of medical monitoring equipment. To keep the area sterile and prevent the spread of germs, outside visitors may be required to don a gown and cap or may be prohibited completely. Spouses or partners of women who are recovering after caesarean section and the parents of children recovering from surgery are typically excluded from any visitor prohibitions in the recovery room. In fact, parents are usually encouraged to be with their child in recovery to minimize any emotional trauma.
In some ambulatory surgery facilities, patients may have a different postoperative experience if they receive short-acting anesthetic drugs for their procedure. This protocol, known as “fast tracking,” involves either shortening the time spent in the PACU or, if clinically indicated, bypassing the PACU altogether and sending the patient directly to what is known as a phase II step-down unit. A step-down unit is a transitional care area where patients can rest and recover before discharge with a lesser degree of monitoring and staff attention then in a PACU.
After the effects of anesthesia have worn off completely and the patient’s condition is considered stable, he or she will either be returned to their hospital room (for inpatient surgery) or discharged (for outpatient surgery ). Patients who are discharged will be briefed on postoperative care instructions to follow at home before they are released.
Miller, R. D. Miller’s Anesthesia. 6th ed. Philadelphia: Elsevier, 2005.
Kain, Z. N. “Family-centered preparation for surgery improves perioperative outcomes in children: a randomized controlled trial.” Anesthesiology 106 (2007): 65.
American Society of Anesthesiologists. 520 N. Northwest Highway Park Ridge, IL 60068-2573. (847) 825-5586. Fax: (847) 825-1692. http://www.asahq.org.
Rectal artificial sphincter seeArtificial sphincter insertion