Postanesthesia care unit assessment scales

Introduction Admission to the postanesthesia care unit (PACU) for recovery – after sedation and general or regional anesthesia as an interim step before transfer to an inpatient unit or before discharge home – has long been the standard of care in the United States. From arrival in the PACU until the time of discharge, all patients receive essentially continuous observation, monitoring, and treatment as deemed necessary. The length of stay in a PACU varies, based on the length and complexity of the procedure, the severity of underlying comorbidities, the time to recovery from anesthesia, and the needs for stabilization of any resultant physiologic derangements that would prevent transfer to the appropriate inpatient unit or discharge to home. Just as the length of PACU stay may vary, there may also be a need to vary the intensity of monitoring and the degree of intervention. As a consequence, care in the PACU is frequency divided into two phases. The early recovery phase (i.e. the phase one recovery period), lasts from the time of admission to the PACU until the return of protective airway reflexes, near-normal motor function, and stable respiratory and hemodynamic function. The late recovery phase (i.e. the phase two recovery period) starts from readiness for phase one discharge until readiness for discharge to home or an inpatient unit.