Post-Anaesthetic Discharge Scoring System to assess patient recovery and discharge after colonoscopy

摘要

AIM: To investigate whether discharge scoring criteria are as safe as clinical criteria for discharge decision and allow for earlier discharge.METHODS: About 220 consecutive outpatients undergoing colonoscopy under sedation with Meperidine plus Midazolam were enrolled and assigned to 2 groups: in Control-group(110 subjects) discharge decision was based on the clinical assessment; in PADSS-group(110subjects) discharge decision was based on the modified Post-Anaesthetic Discharge Scoring System(PADSS).Measurements of the PADDS score were taken every20 min after colonoscopy, and patients were discharged after two consecutive PADSS scores ≥ 9. The investigator called each patient 24-48 h after discharge to administer a standardized questionnaire, to detect any delayed complications. Patients in which cecal intubation was not performed and those who were not found at follow-up phone call were excluded from the study.RESULTS: Thirteen patients(7 in Control-group and6 in PADSS-group) were excluded from the study. Recovery from sedation was faster in PADSS-group than in Control-group(58.75 ± 18.67 min vs 95.14 ± 10.85min, respectively; P < 0.001). Recovery time resulted shorter than 60 min in 39 patients of PADSS-group(37.5%), and in no patient of Control-group(P < 0.001).At follow-up phone call, no patient declared any hospital re-admission because of problems related to colonoscopy and/or sedation. Mild delayed post-discharge symptoms occurred in 57 patients in Control-group(55.3%)and in 32 in PADSS-group(30.7%). The most common symptoms were drowsiness, weakness, abdominal distension, and headache. Only 3 subjects needed to take some drugs because of post-discharge symptoms.CONCLUSION: The Post-Anaesthetic Discharge Scoring System is as safe as the clinical assessment and allows for an earlier patient discharge after colonoscopy performed under sedation.