Delayed discharge from post-anesthesia care unit: A 20-case retrospective series.

OBJECTIVE: To summarize the characteristics of patients with delayed discharge from the post-anesthesia care unit and to analyze the factors and outcomes of delayed discharge. METHODS: Twenty cases of delayed discharge from the PACU (PACU stay >2 hours after surgery) of the main operating room in Liaocheng People's Hospital, a class A tertiary comprehensive hospital, between January 1, 2021, and December 31, 2022, among 28,084 patients who were transferred to the PACU from the operating rooms after surgery, were retrospectively analyzed. The collected data included patient characteristics, American society of anesthesiologists grade, information related to surgery and anesthesia, and outcomes. The factors for delay were assigned to 1 of 6 groups: delayed recovery from anesthesia, surgical complications, cardiovascular instability, hypoxia, inadequate analgesia, and waiting for the operating room. RESULTS: The incidence of delayed discharge from PACU was 0.7‰. Among 20 patients, more than half of the patients were over 65 years of age, American society of anesthesiologists grade II~III, body mass index <30 kg/m2, and urological surgery (7, 35%), liver surgery (4, 20%), thoracic surgery (4, 20%) accounted for a relatively high proportion. Nineteen (95%) patients received general anesthesia with or without peripheral nerve block. The main factors included delayed recovery from anesthesia (6, 30%), surgical complications (5, 25%), cardiovascular complications (4, 20%), hypoxia (3,15%). After discharge from the PACU, 1 (5%) died in the intensive care unit, and the other 19 (95%) patients were safely discharged from the hospital. CONCLUSION: The incidence of delayed discharge from the PACU was low, and it was more likely to occur in the elderly, during major operations, and under general anesthesia. Delayed recovery from anesthesia was the most common factor. Most patients were safely discharged from the hospital.

Retrospective study of perioperative cardiac arrest from a Chinese tertiary hospital.

ABSTRACT: Studies on perioperative cardiac arrest in Chinese hospitals have rarely been retrieved from international journals. This survey evaluated the incidence, causes, and outcomes of perioperative cardiac arrests in a Chinese tertiary general hospital between July 2013 and December 2020. The incidence of cardiac arrest within 24 hours of anesthesia administration was retrospectively identified using an anesthesia database in Liaocheng People's Hospital. During the study period, there were 118,152 anesthetics. Data collected included patient characteristics, surgical procedures (elective or emergency), American Society of Anesthesiologists (ASA) physical status score, type of surgery, anesthesia technique, and outcome. Cardiac arrests were grouped into one of 3 groups: totally anesthesia-related, partially anesthesia-related, or anesthesia-unrelated. In total, 41 cardiac arrests (3.5:10,000) and 26 deaths (2.2:10,000) were found. Major risk factors for cardiac arrest were children under 1 year, adults between 19 and 65 years, and the elderly (>80 years) (P < .001), male patients (P = .02), emergency surgery (P < .001), and ASA grade V patients without anesthesia (P = .009). There were 19 anesthesia-related cardiac arrests (1.6:10,000) - 2 were totally related, and 17 were partially related to anesthesia. There were 9 anesthesia-related deaths (0.8:10,000), all of which were partially related to anesthesia. Perioperative cardiac arrests were correlated with age, gender, ASA grade and surgical procedures. The 2 most important patient factors leading to cardiac arrest were hemorrhagic shock from trauma and septic shock, respectively.