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A prospective evaluation of the feasibility of day-case microlaryngeal surgery
K W Ah-See1, G Kelly, J G Todd
1Department of Otolaryngology, Glasgow Royal Infirmary University NHS Trust, UK.
Abstract:
An increasing number of surgical procedures are being performed on a day-case basis. In the UK otolaryngologists have been reluctant to introduce same day discharge in microlaryngeal surgery (MLS). The reason for this is the perceived risk to the airway from bleeding and oedema after MLS. The aim of this study was to investigate the feasibility of establishing a same day discharge service for MLS patients. One hundred consecutive patients under the care of one consultant otolaryngologist were recruited. A clinical street-fit assessment and objective measures of peak expiratory flow rate (PEFR) and oxygen saturation (SaO2) were recorded pre- and post-operatively. Results indicate that the PEFR and SaO2 did not change significantly during the course of the study. The street-fit criteria for discharge were satisfied in 80 per cent of patients following surgery. By combining the ASA score (American Society of Anaesthesiologists) with street-fitness 63 per cent of our patients were eligible for same day discharge.
Insights
Same day discharge is feasible for microlaryngeal surgery (MLS). Objective measures and clinical assessment showed low risk, making 63% of patients eligible for discharge on the day of their MLS procedure.
Area of Science:
- Otolaryngology
- Ambulatory Surgery
- Anesthesiology
Background:
- Day-case surgeries are increasing, but UK otolaryngologists hesitate with microlaryngeal surgery (MLS) due to airway risks.
- Perceived risks include bleeding and edema following MLS, hindering same-day discharge adoption.
Purpose of the Study:
- To assess the feasibility of implementing a same-day discharge service for patients undergoing microlaryngeal surgery (MLS).
- To evaluate patient safety and readiness for discharge after MLS.
Main Methods:
- One hundred consecutive MLS patients were studied.
- Pre- and post-operative assessments included clinical 'street-fit' evaluation, peak expiratory flow rate (PEFR), and oxygen saturation (SaO2).
- American Society of Anaesthesiologists (ASA) scores were also considered.
Main Results:
- No significant changes in PEFR and SaO2 were observed post-operatively.
- Eighty percent of patients met the 'street-fit' criteria for discharge.
- Combining 'street-fitness' with ASA scores made 63% of patients eligible for same-day discharge.
Conclusions:
- Microlaryngeal surgery (MLS) can be safely performed with same-day discharge for a significant proportion of patients.
- Objective measures and clinical assessments support the safety of this approach.
- This study supports the establishment of a same-day discharge service for MLS.