Anesthesia recovery after ophthalmologic surgery at an ambulatory surgical center

To examine anesthesia recovery duration after ophthalmologic procedures performed at an ambulatory surgical center (ASC) and provide information that could be used to increase postanesthesia recovery unit efficiency.

Ambulatory surgical center at tertiary medical center, Rochester, Minnesota, USA.

Retrospective case series.

Health records of adult patients having ophthalmologic procedures at an ASC from July 1, 2010, through September 30, 2016 were reviewed, and anesthesia recovery duration was calculated. Potential associations were assessed between clinical factors and prolonged recovery (upper 10th percentile of recovery duration by anesthesia type [general, intravenous sedation, or topical]).

Among 20 116 procedures, the median recovery was 36 minutes (interquartile range [IQR], 28 to 48); general anesthesia had the longest recovery (79 minutes; IQR, 52 to 104 minutes) (P < .001). Recovery was longest for orbitotomy and strabismus procedures and shortest for cataract procedures. Female sex, obstructive sleep apnea, greater disease burden, longer procedures, and intraoperative fentanyl administration were associated with prolonged recovery. Patients with prolonged recovery had more severe pain episodes (pain score ≥7 [scale 0 to 10]; 138 patients [6.9%] versus 140 [0.8%]; P < .001) and received opioid analgesics during recovery (278 patients [13.8%] versus 293 [1.6%]; P < .001). Prolonged recovery involved higher rates of emergency department visits and hospitalizations in the first 48 postoperative hours and higher 30-day mortality rates.

Anesthesia recovery after ophthalmologic procedures at an ASC was associated primarily with the procedure and anesthesia type. Prolonged recoveries were associated with intraoperative fentanyl use, severe postoperative pain, and postoperative opioid requirements.