Escort accompanying discharge after ambulatory surgery: a necessity or a luxury?
OBJECTIVE
There is a growing demand for greater efficiency in ambulatory surgery. The patient population is increasingly sick which is also undergoing more advanced and complex surgery. This creates a danger in discharging patients without meeting the criterion of requirement of a responsible adult as an escort to accompany the patient home. The purpose of this review is to examine the most recent findings to determine whether an escort for patient discharge is necessary.


RESULTS
Recent studies have outlined the risks of discharging patients without escort after ambulatory anesthesia. There are three aspects that deter discharge of patients without an escort: medication used in general anesthetics or sedation; regional anesthesia; and surgical factors. All these can affect the cognitive, memory and psychomotor function of the patients, deeming them unable to perform normal daily activities such as driving.


CONCLUSIONS
Both clinicians and patients may have underestimated the risks associated with discharging patients without an escort after ambulatory anesthesia. There should be greater awareness of this problem. Patient discharge without an escort after ambulatory surgery under general anesthesia, sedation or premedication can potentially be dangerous and is not recommended.
Ip
Hui Yun Vivian
HY
Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada.
Chung
Frances
F
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D000765:Anesthesia, Conduction; D000768:Anesthesia, General; D018681:Anesthetics, General / Q000009:adverse effects; D000779:Anesthetics, Local / Q000009:adverse effects; D001334:Automobile Driving; D017408:Guidelines as Topic; D006801:Humans; D010349:Patient Compliance; D010351:Patient Discharge / Q000592:standards; D010354:Patient Escort Service / Q000331:legislation & jurisprudence / Q000706:statistics & numerical data; D011182:Postoperative Care
D018681:Anesthetics, General; D000779:Anesthetics, Local