ABSTRACT

Two decades ago, it was common practice to admit patients undergoing head and neck cancer surgery to intensive care units. With the growing shortage of intensive care beds and the definition of critical care pathways, PACUs almost completely replaced intensive care units and took over responsibilities like stabilization of airway edema, tracheostomy care, and management of pain and hemodynamic status within the first 24- 48 hours.

The PACU is the natural place for the postoperative care of emergency upper airway obstructions, which may be due to anaphylaxis, tumors or trauma. As for elective surgeries, head and neck cancer with reconstructive flap surgery is the single most important surgery which requires and benefits from the PACU. As for patient characteristics, symptoms of obstructive sleep apnea syndrome and reduced cardiovascular and respiratory capacity due to advanced age are important determinants of the need for the PACU.

Keywords: head and neck neoplasms; laryngectomy; neck dissection; postoperative care; postoperative complications