Os eventos adversos relacionados à anestesia como fatores determinantes para internação em uti no pós-operatório.

Abstract

Introduction: Anesthesia is essential for performing surgical procedures, but it is associated with risks that may result in complications in the immediate postoperative period. Adverse events such as hypoxemia, bronchoaspiration, and acute respiratory failure may require intensive support and admission to the Intensive Care Unit (ICU), especially within the first 48 hours after surgery. Early identification of these complications and nursing care are fundamental to patient safety. Objective: To analyze, through an integrative literature review, the main anesthesia-related adverse events associated with the transfer from the Post-Anesthesia Care Unit (PACU) to the ICU, highlighting nursing interventions in prevention and early management. Methodology: An integrative review was conducted with searches in national and international scientific databases, using descriptors related to anesthesia, postoperative complications, adverse events, ICU, and nursing. Studies published between 2001 and 2024 that addressed respiratory complications in the immediate postoperative period and their relationship with the need for mechanical ventilation or intensive support were included. Results and discussion: The results show that hypoxemia is the most frequent complication in the post-anesthetic period, often associated with residual respiratory depression and opioid use. Bronchoaspiration, although less prevalent, has a high severity potential and may progress to acute respiratory failure requiring mechanical ventilation. Failures in preoperative assessment and PACU monitoring were identified as contributing factors to ICU admission. The strategic role of nursing in continuous monitoring, protocol application, and early intervention stands out, contributing to the reduction of complications and to patient safety. Conclusion: It is concluded that anesthesia-related adverse events, especially respiratory complications, are determining factors for ICU admission in the immediate postoperative period, many of which are preventable through vigilant, qualified, and systematized nursing care. The role of nurses in the PACU, combined with the implementation of care protocols, the Perioperative Nursing Care Systematization (PNCS), and continuing education, is essential to reduce morbidity and mortality, optimize intensive care resources, and promote surgical patient safety.