Post-operative recovery of the surgical patient
Abstract
There is a vast amount of research concentrating on improving mortality rates in surgical patients. One study highlights the mortality rates. This is clearly shown by the Confidential Enquiry into Perioperative Small Animal Fatalities (CEPSAF) study carried out in 2006 which demonstrates the percentage of deaths in recovery is higher than that of pre-medication, induction and maintenance periods. The study identified the recovery period as the greatest risk during anaesthesia with most deaths occuring within 3 hours of the procedure. There is constant continuing research to try and minimize this risk, improving mortality rates in the post-operative surgical patient. The main area of focus concentrates on the close monitoring of the surgical patient in the recovery period with efficient nursing care during this time. Using the recommendations highlighted within this article it may be possible to reduce mortality rates while improving nursing care intervention.
The Confidential Enquiry into Perioperative Small Animal Fatalities (CEPSAF), is one of the largest prospective studies in veterinary medicine (Brodbelt et al, 2006). In this study Brodbelt et al (2006) examined perioperative small animal fatalities (Figure 1). The authors defined anaesthetic-related deaths as perioperative deaths within 48 hours following termination of the patient's procedure, except where death was due solely to inoperable surgical or pre-existing medical conditions. Blood and Studdert (1988) define the recovery period as the return to normal after general anaesthesia and surgery, including the patient's requirements for close monitoring to ensure that its return to normal is uneventful. The recovery period ends when a full level of consciousness is present and physiological values have normalized (Holden, 1999).
Hall and Clarke (1991) highlighted in their study that 1:434 dogs and 1:340 cats suffered anaesthetic-related deaths in the UK in 1991. Although mortality has slightly improved since Hall and Clarke's initial study, it is an area where veterinary practices may be able to improve their post-operative recovery nursing care. This article will discuss the areas of the recovery period that may be improved to decrease mortality rates in patients and also discuss improvements to nursing care that could be implemented.
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