The need for continued vigilance in the post-anaesthetic recovery period following general or regional anaesthesia is paramount. This book brings together in one volume the major issues that one should consider in the management of the patient during this period. Improvements in modern surgical techniques continue to stimulate great advances in anaesthetic management. Large groups of patients who until recently would not have been candidates for surgery are now able to benefit from such surgery because of improved know­ ledge of anaesthetic pharmacology, the physiology of pain transmis­ sion and cardiopulmonary monitoring. The first chapter concentrates on the organisation of the recovery room; it deals with management from the standpoint of the United Kingdom but is equally applicable to the rest of the world. The nursing and medical procedures for normal recovery are discussed in Chapter 2. In the later chapters there is a comprehensive review of complications in the post-anaesthetic' period and a discussion of specific aspects of recovery from specialised surgical procedures. Finally, a unique chapter deals with the pre-operative factors that will affect the recovery period.

1. Organisation.- Role of the Recovery Room.- Site.- Design.- Equipment.- Safety.- Staffing.- Policies of a Recovery Unit.- Further Reading.- 2. Normal Recovery.- Progress of Normal Recovery.- Care Plan Nursing.- Reception of the Patient.- Basic Nursing Position and Safety.- Routine Observations.- Assessment of Colour.- Assessment of Respiratory Function.- Assessment of Cardiovascular Function.- Assessment of Level of Consciousness.- Recognition of Blood Loss.- Maintenance of the Airway.- Insertion of Oropharyngeal Airway.- Insertion of Nasopharyngeal Airway.- Suction of Upper Airway.- Care of the Intubated Patient.- Extubation.- The Ventilated Patient.- Oxygen Therapy.- Administration of Oxygen.- Maintenance of Fluid Balance.- Intravenous Infusion Drip Rates.- Intravenous Fluid Therapy.- Intravenous Injections.- Blood Transfusion.- Drainage Systems.- Pain Relief.- Record Keeping and Charting.- Criteria for Discharge.- Transfer of Patient to Ward Staff.- Further Reading.- 3. Complications.- Respiratory Complications.- Upper Airway Obstruction.- Inadequate Ventilation (Hypoventilation).- Hypoxaemia.- Bronchospasm.- Aspiration of Gastric Contents.- Pneumothorax and Haemothorax.- Tension Pneumothorax.- Cardiovascular Complications.- Hypotension.- Hypertension.- Bradycardia.- Tachycardia.- Dysrhythmias.- Cardiac Arrest.- Miscellaneous Complications.- Delayed Return of Consciousness.- Restlessness, Excitement and Delirium.- Nausea and Vomiting.- Shivering.- Convulsions.- Hypothermia.- Hyperthermia.- Blood Transfusion Reactions.- Problems Associated with Massive Blood Transfusion.- Failure of Coagulation.- Oliguria.- Further Reading.- 4. Recovery in Different Branches of Surgery.- Emergency Surgery.- Gastro-enterology.- Orthopaedic Surgery.- Obstetrics and Gynaecology.- Ear, Nose and Throat Surgery.- Thyroid Surgery.- Dental and Faciomaxillary Surgery.- Ophthalmic Surgery.- Neurosurgery.- Thoracic Surgery.- Vascular Surgery.- Genito-urinary Surgery.- Paediatric Surgery.- Further Reading.- 5. Pre-existing Factors Affecting Recovery.- Premedication.- Anaesthetic Technique.- Pre-operative Drug Therapy.- Respiratory Disease.- Cardiovascular Disease.- Neuromuscular Disease.- Liver Disease.- Renal Disease.- Endocrine Disorders.- Porphyria.- Haematological Disease.- Musculoskeletal Disease.- Geriatric Patients.- Pregnancy.- Malnourishment.- Obesity.- Further Reading.- Appendix A. Drugs Commonly Used in a Recovery Room.- Appendix B. Translations of Standard Recovery Phrases.