Using Clinical Indicators to Reduce Perianesthesia Recovery Time Following Outpatient Tonsillectomy.

OBJECTIVE: To determine whether we could reduce the time that patients undergoing tonsillectomy are observed postoperatively without decreasing the quality of care, which would eliminate the unnecessary use of resources to monitor those patients.

STUDY DESIGN: Prospective cohort.

METHODS: Patients undergoing tonsillectomy were recruited for the study prior to their operation. Each patient was then monitored in perianesthesia recovery until clinical indicators for discharge readiness were met (baseline respiratory function, afebrile, ambulation per age, adequate consciousness, absence of nausea/vomiting, adequate pain control, no active bleeding, fluid toleration). Patients were then contacted by phone approximately 24 to 72 hours after discharge to determine if they experienced any postoperative complications. Data analyzed included general demographics and surgical case information such as surgical duration, medications, and timeframes during recovery.

RESULTS: Data from 93 patients (age range, 3-34 years) were analyzed. Clinical indicators were met in a mean time of 253.36 (SD ± 79.0) minutes, an average of 93.2 (SD ± 63.4) minutes sooner than average total post-anesthesia recovery time (346.63 minutes). Eight patients experienced minor complications overall (3 in perianesthesia recovery, 5 at home).

CONCLUSION: This study demonstrates that using clinical indicators as discharge criteria is both safe and efficient, with a low rate of postoperative complications.