Postanesthetic recovery score
Ns. Iswenti Novera,M.kep
Aldrete score
• The Aldrete scoring system is the most widely used
tool to clinically assess the physical status of patients
recovering from anesthesia
• 1970 when Dr. J.A. Aldrete developed the post-
anesthesia recovery score (PAR)
• The Aldrete scoring system, as it has come to be
known, is a measurement of recovery after anesthesia
that includes gauging a patient’s consciousness,
activity, respiration, and blood pressure.
• A score of 0-2 is given for each of the five
categories, for a maximum score of 10.
• In general, for discharge criteria, patients with
Scores of 9 or 10 may be discharged to the
ward; those with 8, need further observation;
although those with 7 or less must be
admitted to the ICU.
Modified Aldrete Score
• This health score checks the availability for
discharge of patients from the Post
Anaesthesia Care Unit (PACU).
• It consists of 6 discharge factors, each
accompanied by three differently weighted
answer choices that depict a different patient
status.
• The overall score is then interpreted as to
recommend or not discharge.
• The O2 saturation item is the one that has
been added in the modified version, the rest
of items being present in the original Aldrete
score version as well.
how often to perform these assessments
As a general rule:
• 3 points below baseline: Every 5 minutes with constant
(1:1) monitoring.
• 2 points below baseline: Every 15 minutes with constant
monitoring of vital signs.
• 1 point below baseline: Every 15-30 minutes with vital
signs depending upon patient condition.
• Baseline: Utilize your facility’s protocols for standard post-
procedural care.
Result interpretation
• The total modified Aldrete score values range
from 0 to 12. Scores closer to 0 indicate that
the patient is closest to the anesthesia state.
• Scores of 9 and above indicate that the patient
can be discharged and the closer the score is
to 12, the higher the chances for all
anestethic, regardless of administering
method, to have worn off.
• espite the score, guidelines require the
existence of someone to escort and then
continue to care for the patient after
discharge.
A SIMPLIFIED SCORING SYSTEM FOR THE POST-OPERATIVE
RECOVERY ROOM D.J. STEWARD
• SEVERAL METHODS have been described for
assessing objectively the progress of recovery
from surgical anaesthesia)
• These post-anaesthesia recovery scores are
similar in principle to the Apgar score 4 used
to evaluate the condition of the newborn
• A maximum of two points are allocated under
each of three headings making possible a total
score of six for a fully recovered patient
Bromage scale
most frequently used measure of motor block is
the Bromage scale.
• In this scale, the intensity of motor block is
assessed by the patient's ability to move their
lower extremities
Post anesthesia Discharge scoring system
(PADDS)
• PADDS merupaan suatu system skoring yang
secara objektif menilai kondisi pasien untuk
dipulangkan.
• Modifikasi PADDS menghilangkan ketentuan
mampu makan dan minum pasca bedah-
tidak lagi masuk protocol discharge planning
Monitoring PADDS
• Berdasarakan 5 kriteria
1. Tanda – tanda vital
2. Ambulasi
3. Mual/ Muntah
4. Nyeri
5. Perdarahan akibat pembedahan.
Tugas kelompok
Diskusikan di dalam kelompok tool penilaian
pasca anestesi
1. Aldrete score- anetesi umum
2. Steward score- anestesi umum pada anak
3. Bromage score- anestesi regional
Diskusi sudah harus selesai pukul 9.05 WIB
