Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-24T12:33:38.996Z Has data issue: false hasContentIssue false

A prospective evaluation of the feasibility of day-case microlaryngeal surgery

Published online by Cambridge University Press:  29 June 2007

K. W. Ah-See
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary University NHS Trust, Glasgow, UK.
G. Kelly
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary University NHS Trust, Glasgow, UK.
J. G. Todd
Affiliation:
University Department of Anaesthetics, Western Infirmary University NHS Trust, Glasgow, UK.
K. MacKenzie*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Glasgow Royal Infirmary University NHS Trust, Glasgow, UK.
*
Address for correspondence: Mr K. MacKenzie, Department of Otolaryngology – Head and Neck Surgery, Glasgow Royal Infirmary University NHS Trust, Alexandra Parade, GlasgowG31 2ER. Fax: 0141-211-4896

Abstract

An increasing number of surgical procedures are being performed on a day-case basis. In the UK otolaryngologists have been reluctant to introduce same day discharge in microlaryngeal surgery (MLS). The reason for this is the perceived risk to the airway from bleeding and oedema after MLS. The aim of this study was to investigate the feasibility of establishing a same day discharge service for MLS patients. One hundred consecutive patients under the care of one consultant otolaryngologist were recruited. A clinical street-fit assessment and objective measures of peak expiratory flow rate (PEFR) and oxygen saturation (SaO2) were recorded pre- and post-operatively. Results indicate that the PEFR and SaO2 did not change significantly during the course of the study. The street-fit criteria for discharge were satisfied in 80 per cent of patients following surgery. By combining the ASA score (American Society of Anaesthesiologists) with street-fitness 63 per cent of our patients were eligible for same day discharge.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1998

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Audit Commission for local authorities and the NHS in England and Wales (1990) A Short Cut to Better Services – Day Surgery in England and Wales, HMSO.Google Scholar
Buckley, J. G., Mitchell, D. B., Hickey, S. A., Connor, A. F. (1991) Submucous resection of the nasal septum as an outpatient procedure. Journal of Laryngology and Otology 105: 544546.CrossRefGoogle ScholarPubMed
Forbes, R. B. (1983) General anaesthesia for day care surgery patients. Canadian Anaesthetics Society Journal 30(5): 545547.CrossRefGoogle ScholarPubMed
Hanning, C. D., Alexander-Williams, J. M. (1995) Pulseoximetry: a practical review. British Medical Journal 311: 367370.CrossRefGoogle Scholar
Hendrix, R. A., Ferouz, A., Bacon, C. K. (1994) Admission planning and complications of direct laryngoscopy. Otolaryngology - Head and Neck Surgery 110: 510516.CrossRefGoogle ScholarPubMed
Kaddour, H. S. (1992) Rapid communication myringoplasty under local anaesthesia: day case surgery. Clinical Otolaryngology 11: 239246.Google Scholar
Lesser, T. H. J., Al-Jassim, A. H. H. (1994) Day case surgery in otolaryngology: The setting up and first year of a freestanding unit. Journal of Laryngology and Otology 108: 406409.CrossRefGoogle ScholarPubMed
Pineault, R., Constandriopoulos, A. P., Valois, M., Bastion, M. L., Lance, J. M. (1985) Randomized clinical trial of one-day surgery: patient satisfaction, clinical outcomes and costs. Medical Care 23: 171182.CrossRefGoogle ScholarPubMed
Reilly, C. S. (1991) Day case surgery. Surgery 98: 23322335.Google Scholar
Royal College of Surgeons of England (1985) Commission on the provision of surgical services. Guidelines for day case surgery.Google Scholar
Sear, W. J. (1995) Total intravenous anaesthesia. In A Practice of Anaesthesia. 6th Edition. Edward Arnold, London, pp 690707.Google Scholar
White, M., Kenny, G. N. C. (1994) Intravenous anaesthetic agents: Delivery systems. In Anaesthesia vol. 1, 2nd Edition, Blackwell Scientific Publications, London, pp 106118.Google Scholar
Yardley, M. P. J. (1992) Tonsillectomy, adenoidectomy and adenotonsillectomy: are they safe day case procedures? Journal of Laryngology and Otology 106: 299300.CrossRefGoogle ScholarPubMed
Yardley, M. P. J. (1995) Is it appropriate to perform adenoidectomy tonsillectomy or adenotonsillectomy on a day case basis? Clinical Otolaryngology 20: 9596.CrossRefGoogle ScholarPubMed