To the Editor:

Although postanesthesia care unit (PACU) management has been considered a standard procedure in most developed countries, the use of PACU in Japanese hospitals has been low (only 16.1% in our previous survey [1]). In that survey, the utility of PACUs in children’s hospitals was higher than in general hospitals. Thus, we conducted a follow-up survey focused on children’s hospitals to guide future directions.

We conducted a questionnaire survey in October 2019 and compared the findings to the 2015 survey. Questionnaires were sent to the chairpersons of all type I and II member hospitals of the Japanese Association of Children’s Hospitals and Related Institutions (JACHRI) (Table 1). The primary outcome of this survey was the number of children's hospitals with a PACU in 2015 and 2019. When the study office did not obtain a reply to the questionnaire in time, the office interviewed the chairperson about the primary outcome.

As shown in Table 2, 19 hospitals in 2015 and 18 hospitals in 2019 were evaluated (1 hospital that had ceased employing a full-time anesthesiologist was excluded). All eligible children’s hospitals provided the primary outcome of our survey. One hospital each did not fully reply to the first and second questionnaires. The number of hospitals with a PACU increased from 8 (42%) to 11 (61%), and no institution discontinued the management of an existing PACU. Table 3 shows the details of the data. The PACU discharge criteria adherence increased from 25 to 64%.

The number of pediatric hospitals with PACUs increased over the last 4 years in Japan. In addition, the discharge criteria adherence was found to be improving, thereby approaching the world standard quality of PACU care.