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Escort accompanying discharge after ambulatory surgery: a necessity or a luxury?

Ip, Hui Yun Vivian; Chung, Frances

Current Opinion in Anesthesiology: December 2009 - Volume 22 - Issue 6 - p 748–754
doi: 10.1097/ACO.0b013e328331d498
Ambulatory anesthesia: Edited by Girish Joshi

Purpose of review There is a growing demand for greater efficiency in ambulatory surgery. The patient population is increasingly sick which is also undergoing more advanced and complex surgery. This creates a danger in discharging patients without meeting the criterion of requirement of a responsible adult as an escort to accompany the patient home. The purpose of this review is to examine the most recent findings to determine whether an escort for patient discharge is necessary.

Recent findings Recent studies have outlined the risks of discharging patients without escort after ambulatory anesthesia. There are three aspects that deter discharge of patients without an escort: medication used in general anesthetics or sedation; regional anesthesia; and surgical factors. All these can affect the cognitive, memory and psychomotor function of the patients, deeming them unable to perform normal daily activities such as driving.

Summary Both clinicians and patients may have underestimated the risks associated with discharging patients without an escort after ambulatory anesthesia. There should be greater awareness of this problem. Patient discharge without an escort after ambulatory surgery under general anesthesia, sedation or premedication can potentially be dangerous and is not recommended.

Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Ontario, Canada

Correspondence to Dr Frances Chung, FRCPC, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, ON M5T 2S8, Canada Tel: +1 416 603 5118; fax: +1 416 603 6494; e-mail: Frances.chung@uhn.on.ca

© 2009 Lippincott Williams & Wilkins, Inc.