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1.

Gender

Age

Weight

kg

Height

cm

Education background

1.

ASA Grade

History of anesthesia

Combined diseases and drug use and organ complications

2.

Lactate Ringer's solution

ml

HAES-steril

ml

Name of the operation

Time of the operation start

yyyy-mm-dd-hh-min.

Time of finishing the operation

yyyy-mm-dd-hh-min.

Urine vulume

ml

Time of starting the anaesthesia

yyyy-mm-dd-hh-min.

yyyy-mm-dd-hh-min.

Estimation of total operative bleeding

ml

3.

Pressing times of analgesic pump

Dosage of analgesic pump

ml

Name of other analgesics

Dosage of other analgesics

Residual dosage of analgesic pump

ml

Did intraoperative / postoperative complications occur?

Time of occurrence

Analgesic drugs used or not

Analgesic drug name

Stay in ICU