Discharging select patients without an escort after ambulatory anesthesia: identifying return to baseline function

Area of Science:

• Anesthesiology
• Ambulatory Surgery
• Patient Safety

Background:

• Current protocols mandate patient escorts for discharge after ambulatory surgery.
• Advancements in ultrashort-acting anesthetics minimize residual psychomotor impairment.
• Recovery of baseline driving simulator performance occurs within 1 hour after propofol sedation.

Purpose of the Study:

• To evaluate the safety and feasibility of discharging ambulatory surgical patients without an escort.
• To explore the potential of modern anesthetics to enable safe, unescorted discharge.

Main Methods:

• Analysis of recent reports on patient outcomes after discharge from sedation centers.
• Review of studies assessing psychomotor function and driving simulator performance post-anesthesia.

Main Results:

• Thousands of patients discharged without an escort or self-driving showed no increase in complications.
• Evidence suggests select patients can be safely discharged without an escort, but identification criteria are lacking.

Conclusions:

• Development of a reliable test for return of function could facilitate safe, unescorted discharge.
• Research is ongoing to create inexpensive, easy-to-administer psychomotor tests for residual anesthetic impairment.
• Validated testing may allow adaptation for assessing anesthetic effects on driving ability.