ABSTRACT
OBJECTIVES: 1. To introduce use of the postanesthesia recovery score (assessing consciousness, mobility, ventilation, hemodynamics and blood analysis) as a good method for evaluating and classifying recovery from anesthesia in the postoperative care unit. 2. To determine overall patient progress and assess the influence of various patient, anesthetic and surgical factors. PATIENTS AND METHODS: This was a multicenter study of 1,227 patients. We excluded all patients who were to be transferred to intensive care units after surgery. A score of 10 or more, with no single item score equal to 0, was considered optimal for discharge from the postanesthesia care unit. RESULTS: The lowest score upon admission to the unit was among patients who had undergone high abdominal surgery (16.4%). Scores over 9 belonged to patients who had undergone lower abdominal and perineal surgery (87.5 and 95.3%, respectively). Scores were < or = 9 in patients who received inhaled anesthetics (42%). Intravenous anesthesia patients (84.4%) had scores over 9. The local-regional anesthetic procedures with the best scores were axilar blocks and local infiltrations. Patients staying longer in the recovery unit were those classified as ASA III, those whose procedures lasted longer than 120 minutes, those undergoing surgery on the upper abdomen or on extremities, those receiving isoflurane and pancuronium, and those suffering adverse events during and after the procedure. Factors influencing perioperative events were age, duration of procedure and history of intraoperative events.
Subject(s)
Anesthesia Recovery Period , Severity of Illness Index , Adolescent , Adult , Aged , Anesthesia/methods , Child , Child, Preschool , Consciousness , Female , Hemodynamics , Humans , Incidence , Infant , Intraoperative Complications/epidemiology , Male , Middle Aged , Movement , Postoperative Complications/epidemiology , Respiration , Time FactorsSubject(s)
Intraoperative Complications , Laparoscopy , Needles , Vena Cava, Inferior/injuries , Adolescent , Female , HumansABSTRACT
Of 73 limb lengthening patients, 35 were treated with distraction of the growth epiphysis, and 38 under diaphyseal-metaphyseal corticotomy. In all cases the lineal fixator and T-shaped fixator with spadai triplanar system invented by the author were used, achieving lengthenings up to 18 cm, the average being 6 cm. The anatomic and functional results show the efficiency of the method as well as the advantages of this external fixator, which can be used as neutralize^ distractor, compressor or bone carrier.
