Roger Eltringham – författare

Developments in surgery have enabled more ambitious operations to be attempted than ever before, while similar advances in anaesthesia and monitoring have meant that many patients who were previously considered unfit now undergo surgery. It is essential that standards of patient care during surgery are continued post-operatively until the depressant effects of anaesthesia have worn off and it is safe for patients to return to the wards or to their homes. The importance of adequate supervision by well-trained nurs­ ing staff in properly equipped surroundings has been recognised by the introduction of recovery rooms in most hospitals. Despite this, many patients still emerge from anaesthesia in wards or departments where they are supervised by inexperienced nursing staff in unfamiliar surroundings. Recovery from anaesthesia may be accompanied by a variety of dangerous and potentially fatal complications, many of which can be avoided by the detection of early warning signs and the institution of appropriate therapy before an irreversible situation is allowed to develop. This book describes the major complications liable to be encountered and suggests how they may be avoided by careful monitoring, vigilant nursing and sound organisation. The patient''s behaviour at recovery is influenced by his pre-operative condition, by drug therapy pre- and intra-operatively and by the nature of the surgery, and sections have been devoted to these aspects since a basic understanding of them is essential in anticipating events in the recovery room.

The need for continued vigilance in the post-anaesthetic recovery period following general or regional anaesthesia is paramount. This book brings together in one volume the major issues that one should consider in the management of the patient during this period. Improvements in modern surgical techniques continue to stimulate great advances in anaesthetic management. Large groups of patients who until recently would not have been candidates for surgery are now able to benefit from such surgery because of improved know­ ledge of anaesthetic pharmacology, the physiology of pain transmis­ sion and cardiopulmonary monitoring. The first chapter concentrates on the organisation of the recovery room; it deals with management from the standpoint of the United Kingdom but is equally applicable to the rest of the world. The nursing and medical procedures for normal recovery are discussed in Chapter 2. In the later chapters there is a comprehensive review of complications in the post-anaesthetic'' period and a discussion of specific aspects of recovery from specialised surgical procedures. Finally, a unique chapter deals with the pre-operative factors that will affect the recovery period.