Waddle J P, Evers A S, Piccirillo J F
Department of Anesthesiology, Washington University School of Medicine, St. Louis, Missouri 63110, USA.
Anesth Analg. 1998 Sep;87(3):628-33. doi: 10.1097/00000539-199809000-00026.
Postanesthesia care unit (PACU) monitoring reduces morbidity and is the standard of care for postsurgical patients. PACUs require large nurse to patient ratios, which contributes to the cost of care. Despite the importance and cost of PACU length of stay (LOS), no standards have been established. We performed an observational study of 340 PACU patients to measure actual and medically appropriate PACU LOS (the time required to achieve a medically stable condition for safe PACU discharge), to identify factors related to LOS, and to create a LOS prediction index. Mean (+/- SD) actual LOS was 95+/-43 min, and appropriate PACU LOS was 71+/-37 min. Appropriate PACU LOS predictors were anesthetic time, anesthetic technique, and amount of intraoperative fluids. Actual LOS was >30 min longer than the medically appropriate LOS for 20% (68 of 340) of the patients. Frequent causes of excessive LOS were waiting for physician release or laboratory or radiographic results. Appropriate LOS may be related primarily to anesthetic factors, and nonmedical issues account for a significant amount of PACU LOS.
Most patients are stabilized immediately after surgery in a postanesthesia care unit (PACU) until their discharge to a hospital ward. However, there are no standards for appropriate PACU length of stay (LOS). In this study, we measured actual and appropriate PACU LOSs and evaluated clinical factors that may influence PACU LOS.
麻醉后护理单元（PACU）监测可降低发病率，是术后患者护理的标准。PACU需要较大的护士与患者配比，这增加了护理成本。尽管PACU住院时间（LOS）很重要且成本高昂，但尚未制定相关标准。我们对340名PACU患者进行了一项观察性研究，以测量实际和医学上合适的PACU LOS（达到医学上稳定状态以便安全出院所需的时间），确定与LOS相关的因素，并创建一个LOS预测指数。平均（±标准差）实际LOS为95±43分钟，合适的PACU LOS为71±37分钟。合适的PACU LOS预测因素为麻醉时间、麻醉技术和术中输液量。20%（340名患者中的68名）患者的实际LOS比医学上合适的LOS长30分钟以上。LOS过长的常见原因是等待医生放行或实验室或影像学检查结果。合适的LOS可能主要与麻醉因素有关，非医疗问题占PACU LOS的很大一部分。
大多数患者在麻醉后护理单元（PACU）手术后立即稳定下来，直到出院到医院病房。然而，对于合适的PACU住院时间（LOS）没有标准。在这项研究中，我们测量了实际和合适的PACU LOS，并评估了可能影响PACU LOS的临床因素。
