Evaluation of orthostatic blood pressure testing as a discharge criterion from PACU after spinal anesthesia.
Discharge readiness from a Phase I PACU after spinal anesthesia is frequently determined by recovery of sensory/motor function. However, no data exist indicating that recovery of sensory/motor function adequately predicts hemodynamic stability after spinal anesthesia. The conservative practice of waiting until the sensory/motor effects of spinal anesthesia have completely worn off often requires patients to remain in PACU for prolonged periods of time. The purpose of this study was to determine the safety and efficacy of using orthostatic blood pressure (BP) testing as a discharge criterion from PACU after spinal anesthesia. This study used a prospective, descriptive design to measure changes in mean arterial pressure (MAP) during orthostatic BP testing at 30-minute intervals after admission to the PACU following spinal anesthesia. A convenience sample of 121 patients admitted through the Same Day Surgery (SDS) unit was used. Results show that orthostatic BP criterion was safe and effective as an alternative to sensory/motor criteria in assessing hemodynamic stability and reducing the amount of time patients spend in the PACU after spinal anesthesia. This is a U.S. government work. There are no restrictions on its use.
Naval Medical Center San Diego, San Diego, CA 92134-1005, USA.
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Knoerl
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McNulty
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Estes
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Conley
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000451:nursing; D000775:Anesthesia, Spinal / Q000009:adverse effects / Q000451:nursing*; D001795:Blood Pressure Determination / Q000379:methods / Q000451:nursing* / Q000592:standards; D015400:Clinical Nursing Research; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007024:Hypotension, Orthostatic / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008991:Monitoring, Physiologic / Q000379:methods / Q000451:nursing* / Q000592:standards; D009730:Nursing Assessment / Q000379:methods / Q000592:standards; D010351:Patient Discharge / Q000592:standards*; D016528:Postanesthesia Nursing / Q000379:methods*; D011446:Prospective Studies; D011997:Recovery Room / Q000706:statistics & numerical data*; D020127:Recovery of Function; D012449:Safety; D016683:Supine Position; D013997:Time Factors