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Determinación del tiempo óptimo de observación postoperatoria para la amigdalectomía pediátrica ambulatoria
Sairisheel Gabbireddy1, Ruifeng Cui1, Zulkifl Jafary2
1Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, 26506, USA.
International journal of pediatric otorhinolaryngology
|August 22, 2025
Resumen
La reducción de la observación postoperatoria para la amigdalectomía ambulatoria de 3 a 2 horas es segura. Este cambio puede acortar las estancias de los pacientes sin perder eventos adversos, apoyando una política de monitoreo de 2 horas.
Área de la Ciencia:
- Cirugía pediátrica
- Anestesiología
- Seguridad del paciente
Sus antecedentes:
- Las directrices de seguimiento postoperatorio para la amigdalectomía ambulatoria carecen de evidencia.
- Los protocolos institucionales actuales a menudo exigen un período de observación de 3 horas.
Objetivo del estudio:
- Evaluar la seguridad y viabilidad de reducir el tiempo mínimo de observación postoperatoria para la amigdalectomía ambulatoria de 3 horas a 2 horas.
- Para comparar la incidencia de eventos adversos en diferentes períodos de observación.
Principales métodos:
- Revisión prospectiva de la cartografía de 223 pacientes pediátricos (3-18 años) sometidos a una amigdalectomía ambulatoria.
- Comparación de la duración real de la estancia en la Unidad de Cuidados Postanestésicos (PACU, por sus siglas en inglés) de 3 horas con una hipotética de 2 horas.
- Análisis de eventos adversos y cumplimiento de los criterios de descarga a las 2 horas frente a las 3 horas.
Principales resultados:
- Un período de observación de 2 horas podría reducir el promedio de LOS PACU en 42 minutos por paciente.
- No se omitieron eventos adversos al adherirse a una política mínima de 2 horas.
- Los pacientes mayores y mujeres tenían más probabilidades de cumplir con los criterios de alta en 2 horas.
Conclusiones:
- Reducir el tiempo mínimo de observación a 2 horas para la amigdalectomía ambulatoria es seguro.
- Las reacciones adversas que ocurren después de 2 horas son raras y es poco probable que se pasen por alto.
- Estos hallazgos apoyan un período de observación de 2 horas, combinado con los criterios de alta clínica.
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