[Fast-tracking and regional anaesthesia: preliminary feasibility study].
OBJECTIVE
The monitoring in the post-anaesthesia care unit (PACU) improves the safety, the comfort and the analgesia of patients. At present, studies suggest the possibility to bypass the PACU according to the principle of fast-tracking (FT). The aim of this study was to evaluate the feasibility and the safety of a simulated protocol of FT after a regional anaesthesia.


METHODS
Seven hundred patients were prospectively included in this study over a period of 6 months.


METHODS
The Withes' scoring system was used for determining when patients could be safely discharged from PACU. We added a variable concerning the monitoring of surgical site. A minimum score of 14 was required on arrival to the PACU to consider a FT. The success rate of blocks, the use of sedation or general anaesthesia were noted. Adverse events were recorded.


RESULTS
The success rate of blocks was 93 %. The score was higher than 14 in 98 % of case on arrival to the PACU. Thirteen adverse events were reported before surgery and/or operating room. No adverse events were reported during the stay in the PACU.


CONCLUSIONS
Regional anaesthesia seems to be an appropriate principle to fast-track the PACU. It could be a way to reduce health care costs, and can offer solution for the PACU congestion problem. In France, the fast-tracking is a marginal concept without any support regulatory. An evolution to such a practice could be considered.
Bloc
S
S
Service d'anesthésie-réanimation, hôpital privé Claude-Galien, 20 route de Boussy, Quincy-Sous-Sénart, France.
Mercadal
L
L
Cuny
P
P
Renault
F
F
Dessieux
T
T
Garnier
T
T
Komly
B
B
Leclerc
P
P
Morel
B
B
Dhonneur
G
G
Ecoffey
C
C
D000761:Anesthesia Department, Hospital / Q000458:organization & administration*; D000765:Anesthesia, Conduction / Q000592:standards; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies