Fast-Tracking Ambulatory Surgery Patients Following Anesthesia

Rice, Andi N.; Muckler, Virginia C.; Miller, Warren R.; Vacchiano, Charles

doi:10.1016/j.jopan.2014.01.006

Cited by 17 publications

(9 citation statements)

References 13 publications

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“…[ 10 ] There is plenty of literature demonstrating fast tracking of patients from OR directly to PACU Phase II without affecting their safety. [ 14 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

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A prospective observational study comparing criteria-based discharge method with traditional time-based discharge method for discharging patients from post-anaesthesia care unit undergoing ambulatory or outpatient minor surgeries under general anaesthesia

et al. 2018

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Background and Aims:Mostly, institutions in India have single post-anaesthesia care unit (PACU) which follows traditional time-based discharge (TBD) method. Recently, it has been classified into PACU Phase I and Phase II, and criteria-based discharge (CBD) method has been used. This study primarily compares CBD versus TBD methods in moving patients through PACU, and other non-clinical factors causing delay in shifting.Methods:One hundred patients, aged 18–65 years, American Society of Anesthesiologist's physical status I and II, scheduled for elective minor surgeries under general anaesthesia were studied. White's fast-track score in operating room (OR) and modified Aldrete's score (CBD time) in PACU were recorded. Patients were scheduled to discharge at 60 min based on TBD method. The mean CBD time and actual discharge time from PACU were statistically compared with TBD time. Other non-clinical factors delaying the discharge were also studied.Results:Eighty-five percent of patients achieved acceptable White's fast-track score in OR. The TBD time (60 min) was compared with the mean CBD time (10.70 ± 2.56 min) and actual discharge time (79.75 ± 12.98 min), which were found to be statistically significant. Primarily, anaesthesiologists' busy schedule was accountable for delay in discharge.Conclusion:The study concluded that in patients undergoing ambulatory minor surgeries, discharge times based on Criterion Based Discharge scoring systems such as modified Aldrete's and White's-fast are significantly lower in PACU Phase I as compared to the traditional Time Based Discharge method.

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“…[ 10 ] There is plenty of literature demonstrating fast tracking of patients from OR directly to PACU Phase II without affecting their safety. [ 14 15 16 17 ]…”

Section: Discussionmentioning

confidence: 99%

“…Other studies have also concluded that fast tracking is a suitable intervention to increase workflow efficiency and decrease both patient and hospital costs while promoting a more rapid discharge from the facility. [ 17 ]…”

Section: Discussionmentioning

confidence: 99%

A prospective observational study comparing criteria-based discharge method with traditional time-based discharge method for discharging patients from post-anaesthesia care unit undergoing ambulatory or outpatient minor surgeries under general anaesthesia

et al. 2018

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“…The minimum follow-up PACU duration for this phase varies according to the anesthesia technique and anesthetic agents used. 10 Commonly, the depth of general anesthesia is estimated through evaluation and trends of changes in heart rate, blood pressure, physiological response to surgical stimulation, and the end-tidal measurement of inhaled anesthetics, if used. 11 Both volatile and intravenous anesthetics induce characteristic electroencephalographic (EEG) changes that are used to assess the depth of anesthesia.…”

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confidence: 99%

Effect of Patient State Index Monitoring on the Recovery Characteristics in Morbidly Obese Patients: Comparison of Inhalation Anesthesia and Total Intravenous Anesthesia

Demirel

Altun

Bolat

et al. 2021

Journal of PeriAnesthesia Nursing

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Obese patients have a significantly higher risk of adverse effects associated with general anesthesia. The purpose of this study was to evaluate the effects of Patient State Index (PSI) monitoring on recovery from anesthesia and the incidence of any postoperative complications among patients undergoing bariatric surgery with total intravenous anesthesia (TIVA) and inhalational anesthesia. Design: This prospective, double-blind, and randomized controlled trial was conducted between February 2017 and August 2017 and included 120 morbidly obese patients (body mass index >40 kg/m 2 ). Methods: Patients were randomly divided into four groups; group P-PSI (n ¼ 30): TIVA with PSI monitoring; group P (n ¼ 30): TIVA without PSI monitoring; group D-PSI (n ¼ 30): desflurane with PSI monitoring; and group D (n ¼ 30): desflurane without PSI monitoring. The discharge time from the postanesthesia care unit (PACU), postoperative complications, and hemodynamic parameters were recorded and evaluated. Findings: No significant differences were found in demographic data, duration of anesthesia, admittance to PACU, discharge from PACU, modified Aldrete scores, and perioperative mean blood pressure and heart rate. Nausea and vomiting scores were significantly lower in group P-PSI, group P, and group D-PSI compared with group D. Conclusions: Although TIVA and inhalational anesthesia can be safely used for obese patients, intraoperative PSI monitoring may decrease the discharge time from PACU and reduces incidence of postoperative nausea and vomiting caused by inhalation anesthetics.

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“…1 Studies of PACU hold can use a sample size of days not patients because of statistical correlation between successive patients' chance of PACU hold. 6 For example, when we tested the effect of a decision support system on patients held in the OR, the analysis was by day.…”

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confidence: 99%

Statistical Analysis of PACU Fast-Tracking Bypass

Dexter

2015

Journal of PeriAnesthesia Nursing

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Fast-Tracking Ambulatory Surgery Patients Following Anesthesia

Cited by 17 publications

References 13 publications

A prospective observational study comparing criteria-based discharge method with traditional time-based discharge method for discharging patients from post-anaesthesia care unit undergoing ambulatory or outpatient minor surgeries under general anaesthesia

A prospective observational study comparing criteria-based discharge method with traditional time-based discharge method for discharging patients from post-anaesthesia care unit undergoing ambulatory or outpatient minor surgeries under general anaesthesia

Effect of Patient State Index Monitoring on the Recovery Characteristics in Morbidly Obese Patients: Comparison of Inhalation Anesthesia and Total Intravenous Anesthesia

Statistical Analysis of PACU Fast-Tracking Bypass

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