A Study on an Evaluation tool for Post-anesthsia Recovery by Objective Non-invasive Methods

Lee, Hwa In

Abstract

This study was performed to examine the safety of the Aldrete Scoring system and the reliability of 8 objective non-invasive methods in the evaluation of post-anesthesia recovery. Aldrete Score(AS) and Maximum Inspiratory Force(MIF), Hand Muscle Grip Power(HMGP), Respiratory Frequency(RF), Tidal Volume(V(T)), Arterial Oxygen Saturation(SaO2), systolic blood pressure(sBP), heart rate(HR), and orientation were measured in the pre-anesthesia period, at the arrival in recovery room and using the AS 10, in 137 patients during a 3 month in 1998 at K hospital. Data obtained by the objective non-invasive methods of the AS 10 were compared with their relevant recovery criteria to the 8 objective non-invasive methods by the use of the t-test. The results were as follows: 1. The MIF of 63 patients using the AS 10 was below the discharge criteria from recovery room(DCrm), but the mean MIF(-34.6 +/- 23.4 cmH2O) was above the DCrm. Women, over 30 years of age or weighing below 60kg, showed significant differences from those whose MIF was below the DCrm(P<0.05). 2. V(T) of 118 patients at AS 10 was below their DCrm and the mean V(T)(3.5 +/- 1.4ml/kg) was significant 19 lower than difference below the DCrm(P<0.01). Women were more commonly present among those who V(T) was below the DCrm. 3. SaO2 of 2 patients using the AS 10 was below their DCrm, but the mean SaO2(98.0 +/- 0.8%) was above the DCrm. 4. HMGP and orientation using the AS 10 were above their DCrm. 5. RF, systolic blood pressure and pulse rate using the AS 10 were within the range of their DCrm. 6. V(T), MIF and SaO2 of some patients, who complained of general malaise or respiratory difficulty during the postanesthesia 24 hours, were less than DCrm. The Above results showed that AS 10 alone was not enough to fulfil the recovery discharge criteria of MIF, V(T) and SaO2, Hence some objective non-invasive monitorings such as SaO2, MIF and V(T) need to be adopted to secure the safe recovery in the recovery room.