Department of Anesthesiology, Liaocheng People's Hospital, Liaocheng, Shandong, China.
Medicine (Baltimore). 2023 Oct 27;102(43):e35447. doi: 10.1097/MD.0000000000035447.
To summarize the characteristics of patients with delayed discharge from the post-anesthesia care unit and to analyze the factors and outcomes of delayed discharge.
Twenty cases of delayed discharge from the PACU (PACU stay >2 hours after surgery) of the main operating room in Liaocheng People's Hospital, a class A tertiary comprehensive hospital, between January 1, 2021, and December 31, 2022, among 28,084 patients who were transferred to the PACU from the operating rooms after surgery, were retrospectively analyzed. The collected data included patient characteristics, American society of anesthesiologists grade, information related to surgery and anesthesia, and outcomes. The factors for delay were assigned to 1 of 6 groups: delayed recovery from anesthesia, surgical complications, cardiovascular instability, hypoxia, inadequate analgesia, and waiting for the operating room.
The incidence of delayed discharge from PACU was 0.7‰. Among 20 patients, more than half of the patients were over 65 years of age, American society of anesthesiologists grade II~III, body mass index <30 kg/m2, and urological surgery (7, 35%), liver surgery (4, 20%), thoracic surgery (4, 20%) accounted for a relatively high proportion. Nineteen (95%) patients received general anesthesia with or without peripheral nerve block. The main factors included delayed recovery from anesthesia (6, 30%), surgical complications (5, 25%), cardiovascular complications (4, 20%), hypoxia (3,15%). After discharge from the PACU, 1 (5%) died in the intensive care unit, and the other 19 (95%) patients were safely discharged from the hospital.
The incidence of delayed discharge from the PACU was low, and it was more likely to occur in the elderly, during major operations, and under general anesthesia. Delayed recovery from anesthesia was the most common factor. Most patients were safely discharged from the hospital.
总结术后恢复室（PACU）延迟出院患者的特征，并分析延迟出院的相关因素及结局。
回顾性分析 2021 年 1 月 1 日至 2022 年 12 月 31 日聊城市人民医院主手术室 28084 例术后转入 PACU 的患者中 20 例（PACU 停留时间>手术后 2 小时）的延迟出院病例。收集患者特征、美国麻醉医师协会（ASA）分级、手术和麻醉相关信息以及结局等数据。将延迟出院的原因分为 6 组：麻醉后恢复延迟、手术并发症、心血管不稳定、缺氧、镇痛不足和等待手术室。
PACU 延迟出院发生率为 0.7‰。20 例患者中，超过一半年龄>65 岁，ASA 分级Ⅱ~Ⅲ级，体重指数（BMI）<30kg/m2，且以泌尿外科手术（7 例，35%）、肝脏手术（4 例，20%）、胸外科手术（4 例，20%）为主。19 例（95%）患者接受全身麻醉联合或不联合外周神经阻滞。主要因素包括麻醉后恢复延迟（6 例，30%）、手术并发症（5 例，25%）、心血管并发症（4 例，20%）、缺氧（3 例，15%）。PACU 出院后，1 例（5%）在重症监护病房死亡，其余 19 例（95%）患者安全出院。
PACU 延迟出院发生率较低，更易发生于老年患者、大手术和全身麻醉患者。麻醉后恢复延迟是最常见的因素。大多数患者安全出院。
