Risk factors associated with fast-track ineligibility after monitored anesthesia care in ambulatory surgery patients

Anesthesia and Analgesia
Rebecca S TwerskyBen Toure

Abstract

Fast-tracking after ambulatory anesthesia has been advocated as a pathway to improve efficiency and maximize resources without compromising patient safety and satisfaction. Studies reporting successful fast-tracking focus primarily on anesthesia techniques and not on specific patient factors, surgical procedure, or process variables associated with unsuccessful fast-tracking. We performed this retrospective study to implement a process for improving fast-tracking, measure change over time, and identify variables associated with patients unable to fast-track successfully after monitored anesthesia care. A fast-track protocol for all patients receiving monitored anesthesia care based on the Modified Aldrete Score was instituted. It consisted of written policy changes and weekly review at physician and nursing department meetings for the first month, followed by monthly feedback during a 6-mo intervention period. Data collected for a 3-mo baseline and the consecutive 6-mo intervention period included fast-track status, surgical service and procedure, surgeon and anesthesiology provider, age, gender, ASA status, total time in operating room, and total postoperative time (end of surgery to actual discharge). Three hundred and thirty...Continue Reading

References

Feb 1, 1995·Journal of Clinical Anesthesia·J A Aldrete
Nov 7, 2000·Ambulatory Surgery·G P Joshi, R S Twersky
Dec 9, 2000·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·M Mamaril
Aug 10, 2001·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·P G DuncanL Ainsworth
Aug 19, 2003·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Paul F WhiteAlison Watkins
Dec 12, 2003·Lancet·Henrik Kehlet, Jørgen B Dahl
May 22, 2007·Anesthesia and Analgesia·Paul F WhiteUNKNOWN Fast-Track Surgery Study Group

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Citations

Jun 3, 2014·Anesthesiology Clinics·Hairil Rizal Abdullah, Frances Chung
May 27, 2014·Journal of Perianesthesia Nursing : Official Journal of the American Society of PeriAnesthesia Nurses·Duccio ContiArmando Pedullà
May 5, 2018·Annals of Surgery·Benoit GignouxPhilippe Chasserant
Jul 22, 2014·Anesthesia and Analgesia·Fred E ShapiroRichard D Urman
Sep 9, 2015·Diseases of the Colon and Rectum·Charles A TernentUNKNOWN American Society of Colon and Rectal Surgeons
Sep 21, 2013·American Journal of Physical Medicine & Rehabilitation·Charles A OdonkorPaul G Barash
Dec 19, 2018·Archives of Orthopaedic and Trauma Surgery·Emilio CalvoVictorino Leal
Aug 31, 2021·International Anesthesiology Clinics·Anjum AnwarRenata G Ferreira
May 7, 2009·Current Opinion in Anaesthesiology
Jul 9, 2009·Current Opinion in Anaesthesiology

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