Fast-track ambulatory anesthesia: impact on nursing workload when analgesia and antiemetic prophylaxis are near-optimal.

摘要

To the Editor: We were very interested in reading the excellent publications of Dr. Song et al. and Dr. Awad et at. from Dr. Chung's research group addressing bypass of the postanesthesia care unit (PACU bypass) after ambulatory surgery. Specifically, they advise that PACU bypass may merely shift nursing workload from the PACU to the phase 2 recovery unit (P2RU). As background, we originally reported in knee surgery outpatients that in addition to PACU bypass [odds ratio (OR) = 2.9], other factors were independently associated with the need for at least one P2RU nursing intervention, including general anesthesia with volatile agents (OR = 1.5), and receiving indicated nerve blocks (OR = 0.6). We later reported that PACU bypass was independently associated with approximately dollar400 cost savings to the hospital, per knee surgery outpatient having undergone anterior cruciate ligament reconstruction.