Jaryszak Eric M, Lander Lina, Patel Anju K, Choi Sukgi S, Shah Rahul K
Division of Otolaryngology, Children's National Medical Center, George Washington University School of Medicine, 111 Michigan Av NW, Washington, DC 20010, USA.
Int J Pediatr Otorhinolaryngol. 2011 Apr;75(4):585-8. doi: 10.1016/j.ijporl.2011.01.024. Epub 2011 Feb 15.
To determine variables predictive of recovery room times in pediatric outpatient adenotonsillectomy.
Retrospective case-control.
One-hundred ninety consecutive patients undergoing outpatient adenotonsillectomy at an ambulatory surgery center of a tertiary-care free standing pediatric hospital were grouped into upper and lower deciles of recovery room times. Twenty-one variables were analyzed to determine which variables are predictive of prolonged recovery time. Univariate and multivariate analyses were performed.
Of the 190 patients, mean recovery room time was 103 min (SD 53.1), 22 patients were in the lower decile (mean recovery room time of 63 ± 6 min) and 17 patients were in the upper decile (155 ± 40 min, P<0.0001). Of the 21 variables analyzed, post-anesthesia care unit (PACU) nursing staff was the only significant predictor of prolonged recovery room time. Compared with one PACU nurse, other nurses (N=5) predicted a longer recovery time (OR=10.8, 95% CI 2.0-59.5, P=0.0017). This association remained significant when controlling for anesthesiologist and surgeon (OR=8.8, 95% CI 1.5-50.9, P=0.0072). There were no complications in any patients.
Recovery room times after outpatient adenotonsillectomy vary significantly (mean 103 min (SD 53.1), range 50-241 min). Of potential predictors, only the human factor (PACU nursing staff) was associated with prolonged recovery room times, independent of surgeon and anesthesiologist. Development of standardized protocols for nurses to use for discharge has the potential to increase throughput for adenotonsillectomy patients in an outpatient surgery center setting.
确定小儿门诊腺样体扁桃体切除术恢复室停留时间的预测变量。
回顾性病例对照研究。
在一家独立的三级儿科医院的门诊手术中心，对190例连续接受门诊腺样体扁桃体切除术的患者，按照恢复室停留时间分为上下两个十分位数组。分析21个变量，以确定哪些变量可预测恢复时间延长。进行单因素和多因素分析。
190例患者中，恢复室平均停留时间为103分钟（标准差53.1），22例患者处于下十分位数组（恢复室平均停留时间为63±6分钟），17例患者处于上十分位数组（155±40分钟，P<0.0001）。在分析的21个变量中，麻醉后护理单元（PACU）护理人员是恢复室停留时间延长的唯一显著预测因素。与1名PACU护士相比，其他护士（N = 5）预测恢复时间更长（比值比=10.8，95%置信区间2.0 - 59.5，P = 0.0017）。在控制麻醉医生和外科医生因素后，这种关联仍然显著（比值比=8.8，95%置信区间1.5 - 50.9，P = 0.0072）。所有患者均无并发症。
门诊腺样体扁桃体切除术后恢复室停留时间差异显著（平均103分钟（标准差53.1），范围50 - 241分钟）。在潜在的预测因素中，只有人为因素（PACU护理人员）与恢复室停留时间延长有关，且独立于外科医生和麻醉医生。制定护士用于出院的标准化方案，有可能提高门诊手术中心腺样体扁桃体切除术患者的周转率。
