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Curr Opin Anaesthesiol. 2019 Dec;32(6):698-702. doi: 10.1097/ACO.0000000000000784.

Recovery and discharge criteria after ambulatory anesthesia: can we improve them?

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1
Anaesthesia and Intensive Care, Institution for Clinical Sciences, Karolinska Institutet, Danderyds University Hospital, Stockholm, Sweden.

Abstract

PURPOSE OF REVIEW:

Day surgery coming and leaving hospital day of surgery is growing. From minor and intermediate procedure performed on health patient, day surgery is today performed on complex procedures and elderly patient and on patients with comorbidities. Thus, appropriate discharge assessment is of huge importance to secure safety and quality of care.

RECENT FINDINGS:

Discharge has since decades been assessed on a combination of stable vital signs, control of pain and postoperative nausea and vomiting and securing that patients can stand walk unaided. There is controversy around whether patients must drink and void before discharge. The absolute need for escort when leaving hospital and someone at home first night after surgery is argued but it does support safety. Discharge is not being 'street fit,' it merely allows patients to go back home for further recovery in the home environment. A structured discharge timeout checklist securing that patients are informed of further plans, signs, and symptoms to watch out for and what to do in case recovery don't follow plans facilitate safety.

SUMMARY:

Discharge following day surgery must be based on appropriate assessment of stable vital signs and reasonable resumption of activity of daily living performance. Rapid discharge must not jeopardize safety. Classic discharge criteria are still basis for safe discharge, adding a structured discharge checklist facilitates safe discharge.

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