Symptoms, Surgical Events, and Length of Stay of Surgical Oncology Outpatients

This study examined the incidence of postanesthesia symptoms, postoperative events, and length of stay (LOS) for surgical oncology outpatients in Phase II recovery during three time periods: before, one-month post, and one-year after the implementation of revised PACU I to PACU II transfer procedures and discharge criteria.

Data for this retrospective analysis was obtained from the organizations' electronic medical records during the timeframe April 3, 2017 through August 5, 2018 after enhanced PACU I to PACU II transfer procedures were implemented on June 5, 2017. Records of surgical outpatients transferred from PACU I to PACU II who received regional pain control or preoperative anti-emetics were excluded from the analysis.

Study approval was obtained through the Institutional Review Board [#19-308]. The records [n = 1091] were sorted and analyzed according to symptoms, events, and length of recovery. Incidence of symptoms, use of IV fluids, and medications administered in PACU II was tabulated for each time-period. Kruskal-Wallis tests were used to detect differences in length of stay variables across the three time periods.

A significant decrease in PACU II LOS was observed following the implementation of revised PACU I to PACU II transfer criteria (P< .001). Although blood pressure changes decreased between each time period: 1.4% (T-1), 0.3% (T-2), and 0.2% (T-3), postanesthesia symptoms [dizziness, pain, and nausea] decreased from T-1 to T-2, with a small increase in T-3. The use of fentanyl and continuous IV fluids decreased between all time periods.

Monitoring key variables related to patient outcomes involving LOS and symptom management ensures sustained practice changes, improves care, and optimizes surgical outpatient experience.