Factors and Management Strategies in Patients with Delayed Recovery after Anesthesia: A Prospective Observational Study
Hayder Hasan Khudhiar *
Department of Anesthesia Techniques, College of Medical Technology, The Islamic University, Najaf, Iraq.
Alaa Alsafi
Department of Anesthesia Techniques, College of Medical Technology, The Islamic University, Najaf, Iraq.
*Author to whom correspondence should be addressed.
Abstract
Background: Delayed recovery after anaesthesia is a common postoperative complication that can increase patient morbidity and prolong hospital stay. Multiple factors, including age, anaesthesia type, drug effects, and metabolic disturbances, have been reported to influence recovery time.
Objective: This study aimed to assess the factors associated with delayed recovery after anaesthesia and evaluate management strategies in patients undergoing surgery at Al-Almani Hospital from 8 December 2025 to 3 January 2026.
Methods: A total of 35 patients were included in this observational study. Data were collected on age, sex, weight, type of anaesthesia (general or regional), body temperature, random blood sugar (RBS), recovery time, smoking status, reasons for delayed recovery, and management strategies used, including reversal agents. General anaesthesia involved intravenous induction followed by inhalational maintenance, while regional anaesthesia included spinal and other regional techniques. Statistical analysis was performed using SPSS version 28, and descriptive and inferential statistics were applied to evaluate associations.
Results: The mean age of patients was 52.06 ± 14.95 years, and the mean weight was 82.46 ± 24.79 kg. Delayed recovery was observed in 24 patients (68.6%), with prolonged anaesthesia, opioid overdose, residual neuromuscular blockade, hyperglycaemia, hypoglycaemia, electrolyte imbalance, hypothermia, and delayed metabolism recorded as potential contributing factors. Delayed recovery occurred in 87.5% of patients receiving general anaesthesia compared with 52.6% of those receiving regional anaesthesia, and this association was statistically significant (Fisher’s exact test, p = 0.035). Management strategies included supportive care, reversal agents (naloxone, neostigmine + atropine), active warming, insulin therapy, and electrolyte correction.
Conclusion: Delayed recovery after anaesthesia was associated with multiple perioperative factors in this study. Anaesthesia type showed a statistically significant association with recovery outcome, whereas age was not significantly associated with delayed recovery. Given the relatively small sample size and observational design, these findings should be interpreted with caution. Timely recognition and appropriate management of potentially reversible factors may support improved postoperative recovery.
Keywords: Delayed recovery, general anesthesia, regional anesthesia, postoperative complications, reversal agents, metabolic disturbances