POST OPERATIVE PERIOD

SYSTEM SPECIFIC COMPLICATIONS

1.RESPIRATORY SYSTEM:
• Airway obstruction
• hypoventilation
• hypoxemia
2. CARDIOVASCULAR SYSTEM
• Hypotension
• Hypertension
• MI
• Arrhythmias
3.RENAL AND URINARY SYSTEM
• Acute kidney injury
• Urinary retention
• Urinary infection
4. CNS
• Postoperative delirium
• Post operative cognitive dysfunction
• Stroke
• seizures
 GENERAL POST-OP COMPLICATIONS
• BLEEDING
• DVT
• PULMONARY EMBOLISM
• FEVER
• WOUND DEHISCENCE
• PRESSURE SOES
 ERAS
• Enhanced recovery is an approach to the
perioperative care of patients undergoing surgery.
• It is designed to speed clinical recovery of the
patient and reduce both the cost and the length of
stay of the patient in the hospital.
• It is achieved by optimising the health of the
patient before surgery through rehabilitation and
then delivering evidence-based best care in the
perioperative period.
• Postoperative strategies advocated by
enhanced recovery protocols include:
• early planned physiotherapy and mobilisation;
• early oral hydration and nourishment;
• opioid-sparing analgesia regimens that include
the use of regional blocks, regular non-
steroidal anti-inflammatory drugs and
paracetamol;
• Early discharge planning (started even before the
patient is admitted to hospital and involving
support from stoma care nurses, physiotherapists
and other community care workers).
• Early mobilisation is encouraged to reduce the
risks of DVT, urinary retention, atelectasis,
pressure sores and faccal impaction. Telephone
follow-up is carried out to make sure that the
patient is recovering well.
 Day care surgery
• Day care surgery is the admission of selected
patients to hospital for a planned surgical
procedure, returning home on the same day.
 Criteria for day care surgery
• SURGICAL
• low risk of significant immediate postoperative
complications, e.g. catastrophic bleeding or airway
compromise.
• should be able to eat and drink or take oral
nutrition postoperatively.
• Postoperative pain needs to be managed by oral
painkillers
• able to mobilise postoperatively with or without
aid.
• Medical:
• Before surgery optimise all comorbidities like
diabetes,epilepsy .
• Obesity is not a contraindication for day car
surgery
• Social :
• Adequate housing
• Patient should live within one hour drive from
hostipal
• Responsible adult –will stay by side of patient
24 hour after surgery
 Delivery of day surgery
• Facilities
• Preoperative assessment
• Admission and list planning
• Anaesthesia and surgery
• Discharge
Facilities
Pre operative evaluation
Discharge