A post-anesthesia care unit, often abbreviated PACU and sometimes referred to as post-anesthesia recovery or PAR, is a vital part of hospital

Hospital

A hospital is a health care institution providing patient treatment by specialized staff and equipment. Hospitals often, but not always, provide for inpatient care or longer-term patient stays....

s, ambulatory care

Ambulatory care

Ambulatory care is a personal health care consultation, treatment or intervention using advanced medical technology or procedures delivered on an outpatient basis Ambulatory care is a personal health care consultation, treatment or intervention using advanced medical technology or procedures...

 centers, and other medical facilities. It is an area, normally attached to operating theater suites, designed to provide care for patients recovering from anesthesia

Anesthesia

Anesthesia, or anaesthesia , traditionally meant the condition of having sensation blocked or temporarily taken away...

, whether it be general anesthesia

General anaesthesia

General anaesthesia is a state of unconsciousness and loss of protective reflexes resulting from the administration of one or more general anaesthetic agents...

, regional anesthesia

Regional anaesthesia

Regional anaesthesia is anaesthesia affecting only a large part of the body, such as a limb or the lower half of the body. Regional anaesthetic techniques can be divided into central and peripheral techniques. The central techniques include so called neuraxial blocks...

, or local anesthesia

Local anesthesia

Local anesthesia is any technique to induce the absence of sensation in part of the body, generally for the aim of inducing local analgesia, that is, local insensitivity to pain, although other local senses may be affected as well. It allows patients to undergo surgical and dental procedures with...

.

Common activities

The PACU staff, generally composed of highly trained nurses are charged with many vital tasks for the care of post-anesthesia and post-operative patients. These essential activities include:-

• monitoring vital signs (heart rate, blood pressure, temperature and respiratory rate)
• managing post-operative pain
  Pain
  Pain is an unpleasant sensation often caused by intense or damaging stimuli such as stubbing a toe, burning a finger, putting iodine on a cut, and bumping the "funny bone."...
  
  .
• treating symptoms of postoperative nausea and vomiting
  Postoperative nausea and vomiting
  Postoperative nausea and vomiting is an unpleasant complication affecting about a third of the 10% of the population undergoing general anaesthesia each year. This equates to about two million people in the United Kingdom annually.-Impact:...
  
   (or PONV)
• monitoring surgical site(s) for excessive bleeding
  Bleeding
  Bleeding, technically known as hemorrhaging or haemorrhaging is the loss of blood or blood escape from the circulatory system...
  
  , discharge
  Mucopurulent discharge
  Mucopurulent discharge is the emission or secretion of fluid containing mucus and pus from the eye, nose, cervix, vagina or other part of the body due to infection and inflammation....
  
  , swelling
  Swelling (medical)
  In medical parlance, swelling is the transient enlargement or protuberance in the body and may include tumors. According to cause, it may be congenital, traumatic, inflammatory, neoplastic or miscellaneous....
  
  , hematoma
  Hematoma
  A hematoma, or haematoma, is a localized collection of blood outside the blood vessels, usually in liquid form within the tissue. This distinguishes it from an ecchymosis, which is the spread of blood under the skin in a thin layer, commonly called a bruise...
  
  , redness
  Wound healing
  Wound healing, or cicatrisation, is an intricate process in which the skin repairs itself after injury. In normal skin, the epidermis and dermis exists in a steady-state equilibrium, forming a protective barrier against the external environment...
  
  , etc.

These common activities may often need supplementing with more intensive care or treatment. This may require :

• Preparation and education for the use of Patient Controlled Analgesia (PCA) units
• Preparation and establishment of IV, epidural
  Epidural
  The term epidural is often short for epidural analgesia, a form of regional analgesia involving injection of drugs through a catheter placed into the epidural space...
  
   or perineural infusions
• Preparation and establishment of invasive monitoring such as arterial line
  Arterial line
  An arterial line, or art-line, or a-line, is a thin catheter inserted into an artery. It is most commonly used in intensive care medicine and anesthesia to monitor the blood pressure real-time , and to obtain samples for arterial blood gas measurements. It is not generally used to administer...
  
  s, central venous lines
  Central venous catheter
  In medicine, a central venous catheter is a catheter placed into a large vein in the neck , chest or groin...
  
  , ventriculostomies, etc.

Post-operative complications

Occasionally, serious life threatening complications, such as laryngospasm

Laryngospasm

In medicine, laryngospasm is an uncontrolled/involuntary muscular contraction of the laryngeal cords. The condition typically lasts less than 60 seconds, and causes a partial blocking of breathing in, while breathing out remains easier. It may be triggered when the vocal cords or the area of the...

, respiratory arrest

Respiratory arrest

Respiratory arrest is the cessation of breathing. It is a medical emergency and it usually is related to or coincides with a cardiac arrest. Causes include opiate overdose, head injury, anaesthesia, tetanus, or drowning...

, or malignant hyperthermia

Malignant hyperthermia

Malignant hyperthermia or malignant hyperpyrexia is a rare life-threatening condition that is usually triggered by exposure to certain drugs used for general anesthesia; specifically, the volatile anesthetic agents and the neuromuscular blocking agent, succinylcholine...

 can arise post-anesthesia. Patients are cared for with interdisciplinary measures from Anesthesiologists, Certified Nurse Anesthetists

Nurse anesthetist

A nurse anesthetist is a nurse who specializes in the administration of anesthesia.In the United States, a Certified Registered Nurse Anesthetist is an advanced practice registered nurse who has acquired graduate-level education and board certification in anesthesia...

 or CRNA's, PACU nurses and Surgeons. Patients may remain or have to be re-intubated due to anaphylaxis

Anaphylaxis

Anaphylaxis is defined as "a serious allergic reaction that is rapid in onset and may cause death". It typically results in a number of symptoms including throat swelling, an itchy rash, and low blood pressure...

, pulmonary edema

Pulmonary edema

Pulmonary edema , or oedema , is fluid accumulation in the air spaces and parenchyma of the lungs. It leads to impaired gas exchange and may cause respiratory failure...

, pneumothorax

Pneumothorax

Pneumothorax is a collection of air or gas in the pleural cavity of the chest between the lung and the chest wall. It may occur spontaneously in people without chronic lung conditions as well as in those with lung disease , and many pneumothoraces occur after physical trauma to the chest, blast...

, or complications from surgery such as extended operative time and long-term exposure to anesthesia and narcotics. Unless complications occur, most patients will only stay in the PACU for a few hours, before returning home or to another department of the hospital.

See also

• Anesthesia
  Anesthesiologist
  An anesthesiologist or anaesthetist is a physician trained in anesthesia and peri-operative medicine....
  
  
• Certified Nurse Anesthetist
• Operating department practitioner
  Operating department practitioner
  Operating department practitioners are a type of health care provider involved with the overall planning and delivery of a patient's perioperative care. They are mainly employed in surgical operating departments but can be found in other clinical areas including Accident & Emergency , Intensive...
  
  
• Anesthetic technician
  Anaesthetic Technician
  An anaesthetic technician or anesthesia technician is an allied healthcare worker who assists with the administration and monitoring of anaesthesia and has an extensive knowledge of anaesthesia techniques, instruments, supplies, and technology.Anaesthetic technicians are mainly employed by...
  
  

External links

• Ketamine: Emergency Applications (eMedicine.com) - discusses laryngospasm.