Optimal Timing for Postanesthesia Care Unit Discharge Using Physiological-Based Criteria in In-Patients Undergoing Low-Risk Surgery with General Anesthesia: A Prospective Observational Study

Objective: All postanesthesia patients must be monitored in the postanesthesia care unit (PACU) until they meet PACU discharge protocols. These included both physiological-based discharge (PBD) criteria and time-based discharge (TBD) criteria. The efficacy of using only PBD criteria to determine PACU discharge remains unclear. Therefore, this study aimed to determine the optimal timing for PACU discharge using PBD criteria alone for in-hospital patients undergoing low-risk surgeries. Material and Methods: This was a prospective observational study, involving 532 patients who had undergone elective low-risk surgery under general anesthesia (GA). At the PACU, the following data points were recorded: patient demographics, anesthesia and surgical data, the time required to meet PBD criteria, the actual PACU discharge time, complications during PACU admission, and causes of delayed PACU discharge. This study analyzed the comparison between the average time to meet PBD criteria and the ‘actual’ PACU discharge time. Results: A total of 532 patients admitted to the PACU were enrolled in this study. The mean PBD time was 12.6± 8.4 minutes, and the mean actual PACU time was 65.1±15.5 minutes: a difference that was statically significant [mean difference 52.5 (51.1, 54.0) minutes, p-value<0.001]. No severe complications were observed. Severe pain was the most recorded complication during PACU admission. The highest cause of delayed PACU discharge was the unavailability of hospital patient transporters. Conclusion: The PACU discharge time for in-hospital patients undergoing low-risk surgery under GA, based on PBD criteria, was significantly shorter than that based on TBD criteria; additionally, no severe complications were reported.