Impact of an Anesthesia Discharge Scoring System on Postoperative Monitoring after Circumcision in Children: A Randomized Trial

Abstract

Background: Ambulatory surgery in children, combined with new anesthetic methods, leads to shorter hospital stays and an increase in patient and parental satisfaction.

Aim: Aim of the study was to determine the feasibility and safety of transferring children directly to the ward without a previous stay in a post anesthesia care unit (PACU), after undergoing circumcision for phimosis under regional anesthesia and non-opioid analgesia.

Methods: 187 healthy children undergoing circumcision were studied in a randomized manner. After surgery, children who met predefined inclusion criteria in the operating room were randomly assigned to one of two groups. Children in the first group (Group A) bypassed the PACU and were admitted directly to the ward, after undergoing assessment using the White and Song scoring system. Children in the second group (Group B) were first transferred to a PACU and then to the ward. The children in Group A who did not meet the criteria of the White and Song scoring system represent the level of risk associated with direct transfer to the ward and no PACU stay. Recovery in the PACU and the ward, parental satisfaction, number of readmissions and the number of parental contacts for medical problems after discharge were recorded and compared between the two study groups.

Results: 157 children were randomly assigned into two groups (79 children in Group A and 78 in Group B). Demographic data, the duration of surgery, and recovery in the PACU or the ward were similar for the two groups. No readmissions were observed and most parents were very satisfied with the procedure.

Conclusion: Children undergoing circumcision do not routinely require admission to a PACU and if the appropriate criteria are met, it is safe to transfer them directly to the ward.

Key words

post anesthesia care unit - circumcision - children - discharge scoring

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