Intraoperative Awareness
   HOME

TheInfoList



OR:

The perioperative period is the period of a patient's
surgical procedure Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions (e.g., trauma, disease, injury, malignancy), to alter bodily functions (e.g., malabsorption created by bariatric surgery s ...
. It commonly includes ward admission,
anesthesia Anesthesia (American English) or anaesthesia (British English) is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia (relief from or prev ...
, surgery, and recovery. Perioperative may refer to the three phases of surgery: preoperative, intraoperative, and postoperative, though it is a term most often used for the first and third of these only - a term which is often specifically utilized to imply 'around' the time of the surgery. The primary concern of perioperative care is to provide better conditions for patients before an operation (sometimes construed as during operation) and after an operation.


Perioperative care

Perioperative care is the care that is given before and after surgery. It takes place in hospitals, in surgical centers attached to hospitals, in freestanding surgical centers, or health care providers' offices. This period prepares the patient both physically and psychologically for the surgical procedure and after surgery. For emergency surgeries this period can be short and the patient may be oblivious to this; for elective surgeries 'preops', as they are called, can be quite lengthy due to a multitude of factors including for
surgical clearance Preoperative care refers to health care provided before a surgical operation. Preoperative care aims to do whatever is right to increase the success of the surgery. At some point before the operation, the healthcare provider will assess the fitne ...
. Information obtained during preoperative assessment is used to create a care plan for the patient. Findings from a systematic review of perioperative
advance care planning Advance care planning is a process that enables individuals with decisional mental capacity to make plans about their future health care. Advance care plans provide direction to healthcare professionals when a person is not in a position to make ...
suggest the importance and value that various types of decision aids have for patients to clarify their goals and specify others who can make decisions for them in case of unexpected surgical difficulties.


Phases


Preoperative

The preoperative phase is used to perform
surgical clearance Preoperative care refers to health care provided before a surgical operation. Preoperative care aims to do whatever is right to increase the success of the surgery. At some point before the operation, the healthcare provider will assess the fitne ...
, attempt to limit
preoperational anxiety Preoperational anxiety, or preoperative anxiety, is a common reaction experienced by patients who are admitted to a hospital for surgery. It can be described as an unpleasant state of tension or uneasiness that results from a patient's doubts or fea ...
and may include the
preoperative fasting Preoperative fasting is the practice of a surgical patient abstaining from eating or drinking ("nothing by mouth") for some time before having an operation. This is intended to prevent stomach contents from getting into the windpipe and lungs (kn ...
.


Intraoperative

The intraoperative period begins when the patient is transferred to the
operating room Operation or Operations may refer to: Arts, entertainment and media * ''Operation'' (game), a battery-operated board game that challenges dexterity * Operation (music), a term used in musical set theory * ''Operations'' (magazine), Multi-Man ...
table and ends with the transfer of a patient to the
Post Anesthesia Care Unit A post-anesthesia care unit (PACU) and sometimes referred to as post-anesthesia recovery or PAR, or simply recovery, is a part of hospitals, ambulatory care centers, and other medical facilities. Patients who received general anesthesia, regiona ...
(PACU). During this period the patient is monitored, anesthetized, prepped, and draped, and the operation is performed. Nursing activities during this period focus on safety, infection prevention, opening additional sterile supplies to the field if needed and documenting applicable segments of the intraoperative report in the patients
Electronic Health Record An electronic health record (EHR) is the systematized collection of electronically stored patient and population health information in a digital format. These records can be shared across different health care settings. Records are shared thro ...
. Intraoperative
radiation therapy Radiation therapy or radiotherapy (RT, RTx, or XRT) is a therapy, treatment using ionizing radiation, generally provided as part of treatment of cancer, cancer therapy to either kill or control the growth of malignancy, malignant cell (biology), ...
and
intraoperative blood salvage Intraoperative blood salvage (IOS), also known as cell salvage, is a specific type of autologous blood transfusion. Specifically IOS is a medical procedure involving recovering blood lost during surgery and re-infusing it into the patient. It is ...
may also be performed during this time.


Postoperative

The postoperative period begins after the transfer to the
Post Anesthesia Care Unit A post-anesthesia care unit (PACU) and sometimes referred to as post-anesthesia recovery or PAR, or simply recovery, is a part of hospitals, ambulatory care centers, and other medical facilities. Patients who received general anesthesia, regiona ...
(PACU) and terminates with the resolution of the surgical
sequela A sequela (, ; usually used in the plural, sequelae ) is a pathological condition resulting from a disease, injury, therapy, or other trauma. Derived from the Latin word meaning "sequel", it is used in the medical field to mean a complication or ...
e. It is quite common for the last of this period to end outside of the care of the surgical team. It is uncommon to provide extended care past the discharge of the patient from the PACU. When stable at PACU, the patient is usually admitted to the surgical ward for continued postoperative care and recovery. Postoperative recovery is commonly used as a concept and can mean different things in different contexts and to different actors such as healthcare professionals and patients. Postoperative recovery is an energy-requiring complex process of returning to normality and wholeness that starts immediately after surgery and continues long after discharge. For patients recovery includes different turning points such as regaining independence and control over physical, psychological, social, and habitual functions and well-being.


See also

*
Pre-anesthesia checkup Preanesthetic assessment (also called preanesthesia evaluation or pre-op evaluation) is a final medical evaluation conducted by an anesthesia provider before a surgery or medical procedure to ensure anesthesia can be administered safely. The anes ...


References

{{reflist


External links


AORN - Association of periOperative Registered Nurses

AfPP - Association for Perioperative Practice

Evidence Based Perioperative Medicine
Surgery