Postanesthetic care unit (P.A.C.U.). A necessity for every hospital.
It is of primary importance that all patients awaking from anesthesia are followed in a recovery room. A number of recent publications show clearly that approximately 10% of all anesthetic accidents occur in the recovery period. The most recent study from Buck, Devlin and Lunn shows that most postoperative complications occur during "off hours". Because of inadequate staffing in a great number of hospitals the recovery room is closed at noon and it is not possible to bring all the patients who will then be operated upon to the intensive care unit postoperatively. Besides that, during the last years there is an enormous increase in the number of more serious surgery and also in the number of older and sicker patients. This results in an increasing number of patients requiring postoperative ventilation as medication to support their circulation. Furthermore there is also a new trend for postoperative pain control with continuous epidural administration of local anesthetics and narcotics. This very efficient method of pain control demands closer observation since respiratory depression can occur. In most hospitals, the number of intensive care beds is too small to accommodate the increasing number of those patients. Therefore the original recovery room is gaining a new dimension. It must function now as an intensive care unit setting for short stays. The name "recovery room" is changed into "postanesthetic care unit" (P.A.C.U.).
Van Aken
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Department of Anaesthesiology, Universitaire Ziekenhuizen, Katholieke Universiteit Leuven, Belgium.
Vandermeersch
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D000367:Age Factors; D000758:Anesthesia / Q000009:adverse effects; D006801:Humans; D010149:Postoperative Pain / Q000628:therapy; D011182:Postoperative Care; D011183:Postoperative Complications / Q000175:diagnosis; D011997:Recovery Room