The Postanesthetic Score System of Montreal's Notre Dame Hospital can be used to assess patients following anesthesia.
Schedule: Patients are scored on the second, fifth and fifteenth day following surgery.
Organ System |
Finding |
Points |
Circulatory |
blood pressure stable; pulse always < 100 |
0 |
|
blood pressure change less than 30%; pulse 100 - 120 |
1 |
|
vasopressors or digitalis therapy |
2 |
|
blood pressure < 100 despite treatment |
3 |
|
decompensated |
4 |
|
severe shock |
5 |
Respiratory |
rate under 15; breath holding more than 25 seconds |
0 |
|
rate 15 - 20; productive cough |
1 |
|
rate over 20; rales or temperature up to 100°F |
2 |
|
temperature over 100 °F, partial atelectasis |
3 |
|
major atelectasis |
4 |
|
pneumonia |
5 |
CNS |
amnesic, satisfied |
0 |
|
confused or recalls induction |
1 |
|
dissatisfied with anesthesia for any reason |
2 |
|
extrapyramidal signs |
3 |
|
major neurological complications |
4 |
|
coma |
5 |
Gastrointestinal |
nothing |
0 |
|
no more than 3 episodes of nausea |
1 |
|
nausea, vomited once only |
2 |
|
vomiting |
3 |
|
ileus |
4 |
|
evisceration or perforation |
5 |
Renal |
voids over 800 mL |
0 |
|
over 800 mL per catheter |
1 |
|
voids 500 - 800 mL |
2 |
|
500 - 800 mL per catheter |
3 |
|
under 500 mL |
4 |
|
anuria |
5 |
where:
• Blood pressure is assumed to refer to systolic blood pressure.
• Urine output is assumed to be 24 hour volume.
postanesthesia score =
= SUM (points for each organ system)
Interpretation:
• minimum score 0
• maximum score 25
• The lower the score the better.
Limitations:
• This is a fairly complex scoring system compared to other systems.
• Since many patients are discharged soon after surgery, reassessments several days after surgery have little meaning in all but the most serious cases.
Purpose: To use the postanesthetic scoring system of Montreal's Notre Dame Hospital to assess a patient after anesthesia.
Specialty: Anesthesiology
Objective: other testing, surgery
ICD-10: ,