Chung F
Department of Anaesthesia, Toronto Hospital, University of Toronto, Ontario, Canada.
J Clin Anesth. 1993 Nov-Dec;5(6 Suppl 1):64S-68S. doi: 10.1016/0952-8180(93)90011-3.
The safe and expeditious conduct of ambulatory surgical care can succeed only by careful selection of patients and surgical procedures, appropriate intraoperative and postoperative anesthesia care, and prudent and timely discharge of patients. Practical discharge criteria or a postanesthesia discharge scoring system should be implemented in every ambulatory surgery center to ensure safe recovery and discharge after anesthesia. The PADSS is simple, practical, and easy to remember. It provides an uniform assessment of all patients, it may have added medicolegal value, and it establishes a routine of repeated reevaluation of home readiness. We recommend using the postanesthesia recovery score (Aldrete score) to evaluate the initial recovery of the patient. Once the Aldrete score is met, home readiness can be evaluated by the PADSS or modified PADSS (Tables 3 and 4). If the patient satisfies the criteria of the PADSS or modified PADSS, he or she can be discharged home. At the Toronto Hospital, we have discharged 30,000 patients home safely with the PADSS. However, any discharge criteria scoring system must be used with common sense and clinical judgment. Home readiness does not mean street fitness. Further studies on adverse outcomes after discharge and the return to normal function (e.g., work readiness) are warranted.
门诊手术治疗的安全与快速实施只有通过仔细筛选患者和手术方式、给予适当的术中及术后麻醉护理以及谨慎及时地让患者出院才能成功。每个门诊手术中心都应实施实用的出院标准或麻醉后出院评分系统，以确保麻醉后安全恢复和出院。麻醉后出院评分系统（PADSS）简单、实用且易于记忆。它能对所有患者进行统一评估，可能具有额外的法医学价值，并且建立了对患者回家准备情况进行反复重新评估的常规流程。我们建议使用麻醉后恢复评分（Aldrete评分）来评估患者的初始恢复情况。一旦达到Aldrete评分，就可以通过PADSS或改良的PADSS（表3和表4）来评估患者回家的准备情况。如果患者符合PADSS或改良PADSS的标准，他或她就可以出院回家。在多伦多医院，我们使用PADSS已安全地让30000名患者出院回家。然而，任何出院标准评分系统都必须结合常识和临床判断来使用。患者回家的准备情况并不意味着其已完全恢复正常。有必要进一步研究出院后的不良后果以及恢复正常功能（如恢复工作能力）的情况。
