Postanesthesia Scoring Methods: An Integrative Review of the Literature

Abstract

Purpose: Internationally there is no consensus on the indicators essential for determining safe recovery from anesthesia and patient readiness for discharge from the postanesthesia care unit (PACU).

Design: Integrative review.

Methods: Using the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) as a search strategy, the literature related to PACU discharge scores were evaluated and organized into themes.

Findings: The traditional components of airway support, oxygenation, sedation, and circulation are common within many first stage PACU discharge scores. However, there is strong support from the literature for components such as heart rate, temperature, pain, postoperative nausea and vomiting (PONV), urine output, and surgical site assessment to also be included. The review revealed that there is no standardized time frequency in applying a first stage PACU discharge score to patients within the PACU environment.

Conclusions: There is a need for the development and trial of an evidence based first stage PACU discharge score.

Keywords: PACU; patient discharge criteria; postanesthesia indicators; scoring tool; surgical recovery.