Establishment and clinical evaluation of modified Steward recovery scoring in post-anesthesia care unit
Objective To observe the occurrence of hypoxemia after Steward recovery score is over 4 within 24 h after the removal of endotracheal intubation or laryngeal mask(after extubation)in post-anesthesia care unit(PACU)patients after surgery under general anesthesia,to establish and validate a modified Steward recovery scoring,and to explore safer PACU discharge criteria.Methods From February to June 2020,601 patients undergoing surgery under general anesthesia were admitted to PACU in Henan Provincial People's Hospital.The occurrence of hypoxemia after Steward recovery score reaching over 4 within 24 h after extubation and the period from Steward recovery score reaching over 4 to the first occurrence of hypoxemia were recorded,by which the modified Steward recovery scoring method was established.Another 1 156 patients in PACU after surgery under general anesthesia in Henan Provincial People's Hospital from October to December 2020 were randomly and equally divided into the Steward group and the modified Steward group.The Steward recovery score reaching over 4 and modified Steward recovery scoring method were used as PACU discharge criteria respectively.The occurrence of hypoxemia after meeting the PACU discharge criteria within 24 h after extubation was recorded in two groups.Results In 601 patients,the surgery time was(145.6±98.8)min,the intrasurgical sufentanil dosage was(40.8±6.8)μg,and 101 patients(16.81％)developed hypoxemia after Steward recovery score reaching over 4 within 24 h after extubation,including 17 cases(16.83％)of mild hypoxemia and 84 cases(83.17％)of moderate or severe hypoxemia.It took(4.21±1.89)min(all＜10 min)from Steward recovery score reaching over 4 within 24 h after extubation to the first occurrence of hypoxemia.The modified Steward recovery scoring method for establishing PACU discharge criteria was awake+moving limbs purposefully+no occurrence of hypoxemia within 10 min after extubation without oxygen inhalation.After meeting the PACU discharge criteria within 24 h after extubation,mild hypoxemia occurred in 8 cases in the modified Steward group and 137 cases in the Steward group.The incidence of hypoxemia was lower in the modified Steward group(1.38％)than that in the Steward group(23.70％)(x2=131.225,P＜0.001).Conclusion The modified Steward recovery scoring method is superior to Steward recovery scoring method for establishing the PACU discharge criteria in patients after surgery under general anesthesia,and can reduce the incidence of hypoxemia within 24 h after surgery.
anesthesia quality controlpost-anesthesia care unit discharge criteriaSteward recovery scoring methodmodified Steward recovery scoring methodhypoxemia
NETL
NSTL
万方数据
