title: Post-Anaesthetic Discharge Scoring System to assess patient recovery and discharge after colonoscopy.
abstract: OBJECTIVE
  To investigate whether discharge scoring criteria are as safe as clinical criteria for discharge decision and allow for earlier discharge.
  
  
  METHODS
  About 220 consecutive outpatients undergoing colonoscopy under sedation with Meperidine plus Midazolam were enrolled and assigned to 2 groups: in Control-group (110 subjects) discharge decision was based on the clinical assessment; in PADSS-group (110 subjects) discharge decision was based on the modified Post-Anaesthetic Discharge Scoring System (PADSS). Measurements of the PADDS score were taken every 20 min after colonoscopy, and patients were discharged after two consecutive PADSS scores ≥ 9. The investigator called each patient 24-48 h after discharge to administer a standardized questionnaire, to detect any delayed complications. Patients in which cecal intubation was not performed and those who were not found at follow-up phone call were excluded from the study.
  
  
  RESULTS
  Thirteen patients (7 in Control-group and 6 in PADSS-group) were excluded from the study. Recovery from sedation was faster in PADSS-group than in Control-group (58.75 ± 18.67 min vs 95.14 ± 10.85 min, respectively; P < 0.001). Recovery time resulted shorter than 60 min in 39 patients of PADSS-group (37.5%), and in no patient of Control-group (P < 0.001). At follow-up phone call, no patient declared any hospital re-admission because of problems related to colonoscopy and/or sedation. Mild delayed post-discharge symptoms occurred in 57 patients in Control-group (55.3%) and in 32 in PADSS-group (30.7%). The most common symptoms were drowsiness, weakness, abdominal distension, and headache. Only 3 subjects needed to take some drugs because of post-discharge symptoms.
  
  
  CONCLUSIONS
  The Post-Anaesthetic Discharge Scoring System is as safe as the clinical assessment and allows for an earlier patient discharge after colonoscopy performed under sedation.
authors.affiliation: Lucio Trevisani, Viviana Cifalà, Giuseppe Gilli, Vincenzo Matarese, Angelo Zelante, Sergio Sartori, Digestive Endoscopy, Department of Medicine, University Hospital "S. Anna", 44124 Cona (FE), Italy.
authors.forename: Lucio
authors.initials: L
authors.lastname: Trevisani
authors.forename: Viviana
authors.initials: V
authors.lastname: Cifalà
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gilli
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Matarese
authors.forename: Angelo
authors.initials: A
authors.lastname: Zelante
authors.forename: Sergio
authors.initials: S
authors.lastname: Sartori
keywords: Colonoscopy; Complications; Conscious sedation; Patient discharge; Recovery room