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Measuring immediate recovery from general anaesthesia using a scoring system

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Abstract

The study describes the design and testing of a scoring system to measure immediate recovery from anaesthesia. The scoring system which measures the patient’s cognitive, motor, haemodynamic and respiratory recovery, was applied in 1,626 patients. The score was measured at five minute intervals and the results were plotted on recovery graphs for each patient.

The analysis shows that patients who had received automatic ventilation during their anaesthetic were likely to arrive in the recovery room with a score of 14 or 15 (the top score), while other patients were likely to arrive with lower scores and progressed in their recovery at 0.9 (SD 0.6) score units per minute.

Multivariate analysis confirms that the anaesthetist’s decision to employ automatic or spontaneous ventilation is the most important single factor in determining the rate of increase of the recovery score.

It is suggested that this scoring system, which fits well with the clinical appreciation of the case, is a useful tool in the hands of the recovery nurse.

Résumé

On décrit ici un système de pointage permettant la mesure de l’émergence de l’anesthésie en salle de réveil et l’on présente une évaluation de la méthode. Un score est établi à partir de l’évaluation des fonctions cognitive, motrice, respiratoire et hémodynamique.

On a étudié ce système chez 1626 opérés. Les évaluations étaient faites à l’arrivée des patients en salle de réveil et répétées aux cinq minutes jusqu’à atteinte du score maximal (15). On inscrivait les résultats en fonction du temps sur des graphiques individuels.

L’analyse des résultats indique que les patients ventilés mécaniquement avaient tendance à arriver à la salle de réveil avec un score de 14 ou 15 (score maximal), alors que les autres arrivaient en général avec des scores inférieurs et progressaient vers la récupération complète au rythme de 0.9 ± 0.6 point par minute. L’analyse multifactorielle des résultats a confirmé que la décision de l’anesthésiste d’utiliser la respiration contrôlée ou la respiration spontanée étaient le facteur individuel le plus important pour prédire la vitesse de remontée du score d’éveil.

Il est suggéré que ce système, qui présente une bonne corrélation avec la clinique, est un outil utile pour l’infirmière de la salle de réveil.

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Correspondence to A. J. Asbury.

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Asbury, A.J. Measuring immediate recovery from general anaesthesia using a scoring system. Canad. Anaesth. Soc. J. 28, 567 (1981). https://doi.org/10.1007/BF03007154

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Key Words

  • Recovery
  • General Anaesthesia
  • Scoring System