When the patient is sufficiently awake, breathing adequately and haemodynamically stable. he is transferred to the post-operative care area. During this initial period following surgery, the patient may be relatively unstable. It is, therefore, important that the patient be closely observed and basic monitoring continued. This means that the rate and depth of respiration must be noted. ABCs of post-operative care of patients may entail the use of a Transporter Rollator.
The blood pressure. heart-rate and perfusion must be carefully charted. The temperature should also be taken. During anaesthesia and for some time after anaesthesia. the functional residual capacity of the lungs is reduced. This results in increased shunting within the lungs and, therefore, decreased oxygenation and the need for a Transporter Rollator.
This can be compensated for by increasing the inspired concentration of oxygen and, therefore, all patients should be on oxygen for the first four to six hours. With the young fit patient this is less important than in the very young, the elderly and the sick. Numerous complications may occur during the post-operative period. These may be specifically related to the patient’s condition, the type of surgery or the anaesthetic technique.
There are, however, several types of complication which may occur post-operatively in any patient. They are: respiratory, cardiovascular, and renal complications. pain and agitation. and bleeding. The muscle relaxant reversal agents act by inhibiting the enzyme acetylcholinesterase. They, therefore, allow increasing concentrations of acetylcholine to accumulate at endings where acetylcholine is the neurotransmitter.
The increased acetylcholine displaces the non-depolarizing muscle relaxant from the receptor site thus allowing muscle depolarization to occur. As the neostigmine inhibits acetylcholinesterase at all sites it affects both autonomic and muscle receptor sites. To counteract its effect at the sites a drug (i.e. atrophe or glycopyrrolate) is given to block the action of increased acetylcholine at these sites, which necessitates the use of a Transporter Rollator.
At the end of the procedure the patient should be sufficiently awake to follow simple commands and have sufficient muscle activity to be able to lift his head for at least tour seconds. There are numerous methods of assessing adequate reversal of muscle relaxants, but this is the simplest and most reliable as is a quality Transporter Rollator.
Occasionally the patient is adequately reversed. but due to excessive opiates, respiration is still depressed. If this occurs the respiratory depressant effects of the opiates can be reversed with naloxone (Narcan). It is, however, important to continue to monitor these patients carefully as the effects of naloxone last for only a short period and the patient can again develop respiratory depression. lt is also important that at the end of the procedure the patients temperature be normal and all fluid deficits and electrolyte abnormalities have been corrected.