Key result
The mean time to meet physiological-based discharge criteria was significantly shorter than the actual PACU discharge time (12.6 vs 65.1 minutes, mean difference 52.5 minutes) for low-risk surgeries.
Why the study?
The efficacy of using only physiological-based discharge criteria rather than time-based criteria to determine PACU discharge remains unclear.
Does physiological-based discharge criteria alone reduce PACU stay time compared to time-based criteria in in-patients undergoing low-risk surgery with general anesthesia?
Observational (n=532)
No
Does physiological-based discharge criteria alone reduce PACU stay time compared to time-based criteria in in-patients undergoing low-risk surgery with general anesthesia?
Mean Difference: 52.5 (95% CI 51.1–54)
Absolute Event Rate: 12.6% vs 65.1%
p-value: p=<0.001
Using physiological-based criteria alone for PACU discharge in low-risk surgical patients significantly reduces PACU stay time by nearly an hour without increasing severe complications.
Physiological criteria may enable earlier PACU discharge after low-risk surgery; hypothesis-generating for prospective trials on implementation.
Objective: All postanesthesia patients must be monitored in the postanesthesia care unit (PACU) until they meet PACU discharge protocols. These included both physiological-based discharge (PBD) criteria and time-based discharge (TBD) criteria. The efficacy of using only PBD criteria to determine PACU discharge remains unclear. Therefore, this study aimed to determine the optimal timing for PACU discharge using PBD criteria alone for in-hospital patients undergoing low-risk surgeries. Material and Methods: This was a prospective observational study, involving 532 patients who had undergone elective low-risk surgery under general anesthesia (GA). At the PACU, the following data points were recorded: patient demographics, anesthesia and surgical data, the time required to meet PBD criteria, the actual PACU discharge time, complications during PACU admission, and causes of delayed PACU discharge. This study analyzed the comparison between the average time to meet PBD criteria and the ‘actual’ PACU discharge time. Results: A total of 532 patients admitted to the PACU were enrolled in this study. The mean PBD time was 12.6± 8.4 minutes, and the mean actual PACU time was 65.1±15.5 minutes: a difference that was statically significant [mean difference 52.5 (51.1, 54.0) minutes, p-value<0.001]. No severe complications were observed. Severe pain was the most recorded complication during PACU admission. The highest cause of delayed PACU discharge was the unavailability of hospital patient transporters. Conclusion: The PACU discharge time for in-hospital patients undergoing low-risk surgery under GA, based on PBD criteria, was significantly shorter than that based on TBD criteria; additionally, no severe complications were reported.
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Taesiri et al. (2024) conducted an observational in In-patients undergoing low-risk surgery with general anesthesia (n=532). Physiological-based discharge (PBD) criteria vs. Actual PACU discharge time (including time-based criteria) was evaluated on Time to meet physiological-based discharge criteria compared to actual PACU discharge time (MD 52.5, 95% CI 51.1-54.0, p=<0.001). The mean time to meet physiological-based discharge criteria was significantly shorter than the actual PACU discharge time (12.6 vs 65.1 minutes, mean difference 52.5 minutes) for low-risk surgeries.
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