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Canadian Journal of Anesthesia

, Volume 53, Issue 9, pp 858–872 | Cite as

Factors affecting recovery and discharge following ambulatory surgery

  • Imad T. Awad
  • Frances Chung
General Anesthesia

Abstract

Purpose

Recovery and discharge following ambulatory surgery are important components of the ambulatory surgery experience. This review provides contemporary perspectives on the issues of discharge criteria, fast-tracking, patient escort requirements, and driving after ambulatory anesthesia.

Source

A search was performed in the Cochrane Central Registerfor Controlled Trials, MEDLINE®, EMBASE®, CINAHL, and PsycINFO, to review factors delaying discharge following ambulatory surgery. The following subject headings were used: “ambulatory surgery, discharge, recovery, car driving, escort, transport, fast tracking, patient discharge, recovery, transportation of patients, hospital discharge, recovery room, patient transport, hospital discharge, recovery room, anesthetic recovery, patient transport, ambulatory surgical procedures, patient discharge, recovery of function, automobile driving, patient escort service, recovery room”. Using the same search engines, the following keywords were used: “fast tracking, recovery, and discharge”.

Principal findings

The current literature supports that discharge scoring systems may be useful to guide discharge following ambulatory surgery. While fast-tracking has become common in some centres, further studies are required to justify more routine implementation of this practice in the management of patients undergoing ambulatory surgery. Patients at low risk for urinary retention can be discharged home without voiding. Patients should not drive until at least 24 hr postoperatively.

Conclusions

Ensuring rapid postoperative recovery and safe discharge following ambulatory surgery are important components of the ambulatory surgical program. A clearly defined process should be established for each ambulatory surgical unit to ensure the safe and timely discharge of patients after anesthesia, in accordance with current best evidence.

Keywords

Spinal Anesthesia Postoperative Nausea Malignant Hyperthermia Discharge Criterion Local Anesthetic 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Les facteurs influençant la récupération et la sortie après une opération en chirurgie ambulatoire

Résumé

Objectif

La récupération et la sortie, suivant une opération en chirurgie ambulatoire, sont des composantes importantes de la chirurgie d’un jour. La présente revue fournit une nouvelle optique sur les critères de sortie, le mode opératoire rapide, les besoins d’accompagnement et la conduite automobile après une anesthésie ambulatoire.

Source

Une recherche a été réalisée dans le Cochrane Central Register for Controlled Trials, MEDLINE®, EMBASE®, CINAHL et PsycINFO, pour revoir les facteurs qui retardent le départ du service de chirurgie ambulatoire. Les mots-sujets suivants ont été utilisés: «ambulatory surgery, discharge, recovery, car driving, escort, transport, fast tracking, patient discharge, recovery, transportation of patients, hospital discharge, recovery room, patient transport, hospital discharge, recovery room, anesthetic recovery, patient transport, ambulatory surgical procedures, patient discharge, recovery of function, automobile driving, patient escort service, recovery room». Avec les mêmes moteurs de recherches nous avons utilisé: «fast tracking, recovery, and discharge».

Constatations principales

Les publications actuelles appuient le système de notation qui peut aider à décider du moment du départ d’un service de chirurgie ambulatoire. Le mode opératoire rapide est devenu courant dans certains centres, mais de nouvelles études doivent justifier l’application plus fréquente de cette pratique en chirurgie ambulatoire. Les patients à faible risque de rétention urinaire peuvent quitter le service avant une miction. Ils doivent attendre au moins 24 h après l’opération pour conduire une auto.

Conclusion

Garantir une récupération postopératoire rapide et un départ hâtif et sûr après une opération ambulatoire sont des composantes importantes du programme de chirurgie ambulatoire. Un processus clairement défini doit être établi à cet effet.

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Copyright information

© Canadian Anesthesiologists 2006

Authors and Affiliations

  1. 1.Department of Anesthesia and Pain ManagementToronto Western Hospital, University Health Network, University of TorontoTorontoCanada

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