Recovery at the post anaesthetic care unit after breast cancer surgery

Extant literature shows that women having undergone breast cancer surgery have substantial problems at the post-anaesthesia care unit (PACU). Based on nursing reports and elements of the discharge scoring system recommended by The Danish Society of Anaesthesiology and Intensive Care Medicine, the present prospective, observational study aims to determine why these patients stayed at PACU.

The study included 116 consecutive patients having undergone surgery for breast cancer. Postoperative nausea and vomiting (PONV), pain, sedation, respiration, oxygen saturation (SpO2), blood pressure and heart rate were scored at the PACU, and nurses were asked why discharge was delayed in case patients were not discharged at the time the discharge criteria were met. The outcome measures were the proportion of patients ready for discharge upon arrival at the PACU, patient time spent until discharge criteria were met, time to actual discharge, and the contribution of each discharge criterion in postponing discharge from the unit, as well as nurse-reported factors for the delay.

31% of the patients were ready for discharge upon arrival at the PACU. The mean time until the discharge criteria were met was 40 min (standard deviation (SD) = 46 min). The actual time spent at the PACU was 110 min (SD = 75 min). A total of 36 patients had low SpO2 (< 90%) upon arrival to the PACU. In 36 cases, discharge was delayed by the workload at the PACU and/or waiting for patient transport to the ward.

Low SpO2 (< 90%), the workload at the PACU and time spent waiting for transport to the ward were the primary reasons why patients stayed at the PACU after breast cancer surgery.