Systematic review and analysis of postdischarge symptoms after outpatient surgery.

OVER the past decade, the percentage of surgical procedures being performed in outpatient centers has increased. In response, outpatient anesthetic practice and research have focused on providing anesthetics that minimize symptoms (e.g., nausea and vomiting) in the postanesthesia care unit and hasten time to discharge. Much effort has been placed on development of newer agents with a more favorable recovery profile. Similarly, examination of the economic parameters (e.g., length of recovery room stay, cost-effectiveness of drugs) after ambulatory surgery has focused on the immediate predischarge, postoperative period. A significant portion of research in this area has concentrated on minimizing immediate postoperative symptoms to facilitate patient discharge from the hospital. On the other hand, relatively few studies have evaluated the impact of patient-reported symptoms after discharge from the postanesthesia care unit. Postdischarge symptoms (those occurring after discharge from the ambulatory surgical unit) may have an important impact on patient recovery after ambulatory surgery and the economic burden on patients and their caregivers; however, there has not been a systematic examination of postdischarge symptoms. It is important to know the frequency with which patients experience postdischarge symptoms so that providers can better inform patients and researchers can better estimate the burden of these symptoms and potential for the incidence of postdischarge symptoms to serve as a measure of quality of care. Quantification of the incidence of postdischarge symptoms would be the first step in the process in determining the extent of the problem and if perioperative interventions (e.g., intraoperative anesthetic technique, multimodal analgesia, or pharmacologic agents) would be effective in diminishing the impact of these patient-related symptoms on functional recovery and health-related quality of life. Therefore, we conducted a systematic review and analysis to evaluate the incidence of patient-reported symptoms after outpatient surgery.