Tesis

Comparison of Postoperative Care Outcomes in the Identification and Management of Complications Between the Post-Anesthesia Care Unit and the High Care Unit

Pendahuluan : Perawatan pasca pembedahan di rumah sakit mencakup fase kritis yang membutuhkan observasi intensif untuk mencegah dan menangani komplikasi. Dua unit yang umum digunakan adalah Post-Anesthesia Care Unit (PACU) dan High Care Unit (HCU). Namun, efektivitas PACU dibandingkan HCU dalam tatalaksana komplikasi pascaoperatif masih menjadi perdebatan. Metode : Penelitian ini merupakan studi observasional retrospektif yang melibatkan 304 pasien dewasa pasca pembedahan elektif di RSCM yang dirawat di PACU (n=153) dan HCU (n=151) antara Juli hingga Desember 2025. Data dikumpulkan dari rekam medis, meliputi karakteristik demografik, jenis anestesi, jenis pembedahan, dan keberhasilan penatalaksanaan komplikasi pascaoperasi. Analisis non-inferiority digunakan untuk membandingkan efektivitas antara PACU dan HCU. Hasil : Karakteristik usia, jenis kelamin, dan status ASA relatif seimbang antara dua kelompok. Komplikasi pascaoperasi yang diteliti meliputi gangguan kardiovaskular, respiratori, PONV, dan nyeri. Tatalaksana komplikasi nyeri dan PONV di PACU masing-masing mencapai 100% dan 93%, sedangkan di HCU masing-masing 100% dan 100%. Untuk komplikasi kardiovaskular dan respiratori, tatalaksana di PACU adalah 100% dan 83%, sementara di HCU adalah 89% dan 81%. Hasil uji non-inferiority menunjukkan bahwa PACU tidak inferior dibandingkan HCU dalam penatalaksanaan semua jenis komplikasi tersebut (UCL tertinggi 0,4996). Simpulan : Perawatan pasca pembedahan di PACU tidak inferior dibandingkan HCU dalam pemberian tatalaksana terhadap komplikasi umum seperti nyeri, PONV, respiratori, dan kardiovaskular. PACU dapat menjadi alternatif aman dan efektif untuk pasien pascaoperasi dengan risiko rendah hingga sedang.
Kata kunci : PACU, HCU, komplikasi pasca pembedahan


Background: Postoperative care is a critical phase in surgical recovery, requiring close monitoring to prevent and manage complications. The Post-Anesthesia Care Unit (PACU) and High Care Unit (HCU) are commonly used for this purpose. However, the effectiveness of PACU compared to HCU in managing postoperative complications remains a subject of debate. Methods: This retrospective observational study involved 304 adult patients who underwent elective surgery at RSCM and received postoperative care in either PACU (n=153) or HCU (n=151) between July and December 2025. Data were collected from medical records, including demographic characteristics, anesthetic techniques, types of surgery, and the success of postoperative complication management. A non-inferiority analysis was performed to compare PACU and HCU outcomes. Results: Patient age, gender, and ASA status were comparable between the two groups. The main postoperative complications assessed were cardiovascular, respiratory, postoperative nausea and vomiting (PONV), and pain. Management of pain and PONV in PACU reached 100% and 93%, respectively, compared to 100% and 100% in HCU. For cardiovascular and respiratory complications, PACU achieved 100% and 83% management, while HCU reached 89% and 81%. The noninferiority test indicated that PACU was not inferior to HCU in handling all complication types (highest 95% UCL: 0.4996). Conclusion: PACU was not inferior to HCU in managing common postoperative complications, including pain, PONV, respiratory, and cardiovascular issues. PACU can be considered a safe and effective alternative for postoperative care, especially in patients with low to moderate risk profiles
Keywords : PACU, HCU, post operative complications