Recovery pattern and home-readiness after ambulatory gastrointestinal endoscopy.
BACKGROUND
Despite increased use of ambulatory gastrointestinal endoscopy, few data exist regarding patient recovery patterns and home-readiness.


OBJECTIVE
The authors prospectively identified the pattern of home-readiness, the persistent symptoms after procedure and the factors that delay discharge after home-readiness criteria are satisfied.


METHODS
Three hundred and sixty nine patients were scored by the investigator using the Modified Post-Anesthetic Discharge Scoring System (PADSS) every 30 min, commencing 30 min after procedure, until the PADSS score was > or =9. The same investigator telephoned each patient 24 hr after discharge to administer a standardized questionnaire so that postoperative symptoms could be identified.


RESULTS
The number of patients who satisfied the PADSS home-readiness criteria was 81.6%, 97.9%, and 100% at 30, 60, and 90 min, respectively. All patients were promptly discharged before two hours. After home-readiness criteria were satisfied, 36% of patients had delayed discharge because of the unavailability of immediate escorts or other non-medical reasons. No patient had persistent symptoms and all patients could achieve a PADSS score > or =9 three hours after anesthesia. The patients undergoing shorter endoscopic procedures, such as EGD or dilated esophagus were discharged faster than patients undergoing colonoscopy or duodenal stent. The 24 hr postoperative symptoms were mainly sore throat, pain, weakness, and abdominal distension. There was no incidence of unanticipated admission.


CONCLUSIONS
Periodic objective evaluation of home-readiness revealed that the majority of patients would achieve a satisfactory score on or before 1 hr after procedure. The time to home-readiness by objective evaluation correlated with the type of procedure. Most delays after satisfactory home-readiness scores were reached, were due to non-medical reasons.
Amornyotin
Somchai
S
Department of Anesthesiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand sisam@mahidol.ac.th
Chalayonnavin
Wiyada
W
Kongphlay
Siriporn
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005767:Gastrointestinal Diseases / Q000175:diagnosis; D006305:Health Status Indicators; D006306:Health Surveys; D006699:Home Care Services; D006801:Humans; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D011446:Prospective Studies; D011795:Surveys and Questionnaires; D013997:Time Factors