Specialized ambulatory anesthesia teams contribute to decreased ambulatory surgery recovery room length of stay.
BACKGROUND
Many institutions have organized specialized groups of ambulatory surgery anesthesiologists with the aim of improving ambulatory surgery patient care and efficiency. We hypothesized that specialized ambulatory anesthesia teams produce better patient outcomes such as lower postoperative nausea and vomiting (PONV) rates, lower postoperative pain scores, and shorter postanesthesia care unit (PACU) lengths of stay (LOS).


METHODS
In this prospective observational study, we collected outcomes data on 1,299 patients including incidence of PONV, PACU LOS, maximum and average pain scores, amount of postoperative opioid use, and rescue antiemetic use.


RESULTS
Ambulatory anesthesiologists had statistically shorter phase 2 PACU LOS times (P < .05) and overall recovery times (P < .01). The PONV incidence odds ratio for ambulatory versus nonambulatory anesthesiologists was 1.31 (95% CI 1.01-1.72). We found no significant difference in the amount of postoperative opioid use, maximum postoperative pain scores, or PACU phase 1 LOS time.


CONCLUSIONS
The decreased PACU LOS for the study group's patients occurred despite the increased incidence of PONV. Ambulatory anesthesiologists contributed to decreased PACU LOS while practicing evidence-based anesthesia with regard to PONV and pain control. Ambulatory subspecialization may benefit institutions as a way to increase perioperative efficiency and improve surgeon and patient satisfaction.
Pankaj
P
Sarin
Beverly K
BK
Philip
Aya
A
Mitani
Sunil
S
Eappen
Richard D
RD
Urman