Postoperative Recovery After General and Regional Anesthesia in Patients Undergoing Day Surgery: A Mixed Methods Study

Patient-Centeredness in the Perioperative Period-A Rapid Review of Current Research

PURPOSE

The indication of surgery is a critical moment in a person's life implying different needs, feelings, or fears. The aim of the current literature review was to elucidate the prevailing utilization of the concepts 'patient-centeredness' and 'person-centeredness' within the perioperative period.

DESIGN

A rapid review design.

METHODS

Literature searches were conducted in the databases PubMed, Scopus (Elsevier), American Psychological Association PsychInfo (Ovid), Embase (Ovid), CINAHL (Ovid), and Cochrane Library in December 2022. Rayyan software was used to assess the articles. Joanna Briggs Institute critical appraisal tools were used to evaluate the quality of the included articles. Thematic analysis was used to identify themes across the articles.

FINDINGS

The electronic database searches identified 1,967 articles. A total of 12 articles were assessed in full text against the inclusion and exclusion criteria, and finally, a total of seven articles were included. The articles originated from six countries, employed disparate methodological approaches, and featured a heterogeneous array of participants representing various health care settings. Patient-centeredness held the mantle as the most prominently used concept across the seven articles, whereas person-centeredness emerged as the least frequently explored concept. One theme was identified across the articles; Preparedness. This was related to shared decision-making and information pre, peri- and postoperative.

CONCLUSIONS

This rapid review suggests that patient preparedness, particularly through shared decision-making and providing information, is a recurring theme in the limited studies on patient- or centeredness in the perioperative context. The fact that only one single study focuses on person-centered care underscores the pressing need for a comprehensive re-evaluation of modern perioperative care.

The Effect of Preoperative Anxiety on Motor and Sensory Block Duration and Effectiveness in Spinal Anesthesia

Introduction

The aim was to evaluate the effect of preoperative anxiety on the sympathetic block that developed after spinal anesthesia and therefore the duration of motor and sensory blockade.

Materials and Methods

After the approval of the ethics committee, 90 patients between the ages of 18 and 55 years who were to be operated under spinal anesthesia were included in the study. Preoperative anxiety of the patients was evaluated with the Spielberger trait and State Anxiety Scale and Visual Analog Scale (VAS). The Bromage scores of the patients were followed up intermittently. Onset time of sensory block, onset time of motor block, and motor block recovery time were recorded. Cases with bradycardia and hypotension were noted.

Results

No statistically significant correlation was found between the duration of motor block onset (5.81 ± 4 min), the sensory block onset time (0.89 ± 0.4 min), and the motor block recovery time (92.06 ± 36.9 min) with other variables. VAS (5.81 ± 2.5), STAI-1 (40.4 ± 9.8), and STAI-2 (41.69 ± 8.2) values had a statistically significant effect on the occurrence of bradycardia (14.4%). The variables of VAS, STAI-1, STAI-2, sensory block onset, motor block onset, and motor block recovery time were statistically significantly higher in women (mean 5.24 ± 2.4, 38.97 ± 9.9, 41.43 ± 8.7, 0.89 ± 0.42, 5.64 ± 3.82, and 88.77 ± 38.74 in males and mean 7.15 ± 2.1, 43.74 ± 8.9, 42.30 ± 7.0, 0.88 ± 0.27, 6.20 ± 4.35, and 99.70 ± 31.70 in females, respectively).

Conclusion

It was observed that preoperative anxiety had no effect on motor and sensory block onset and duration.

Utility of spinal anesthesia in plastic surgery and other surgical subspecialties: A literature review

INTRODUCTION

Spinal anesthesia (SA) is commonly used within the specialties of orthopedic surgery, obstetrics and gynecology, spine surgery, and general surgery, and offers several benefits over general anesthesia (GA). However, SA is used much less frequently in plastic surgery. This review analyzed currently existing data on SA use across various surgical specialties and compared the benefits and complications of SA to those of GA, to assess its utility and potential for more widespread use in plastic surgery.

METHODS

A comprehensive literature review was conducted using the PubMed and Cochrane Library databases to evaluate the utility of SA in plastic surgery. Indications, contraindications, and data on the use of SA across various surgical specialties were reviewed. Benefits, complications, and cost-effectiveness were also assessed. Finally, the utility of SA in plastic surgery was evaluated based on the available literature.

RESULTS

SA has been shown to yield several benefits and fewer risks than GA, including a higher possibility of early discharge, decreased costs, better pain and postoperative nausea and vomiting control, and decreased risk of deep venous thrombosis and pulmonary embolism.

CONCLUSION

Although commonly used for procedures across various surgical specialties such as obstetrics and gynecology, urology, and orthopedic surgery, SA is less frequently used within plastic surgery. Plastic surgery procedures that would benefit from the use of SA include those below the umbilicus such as liposuction, lower extremity procedures, and perineal procedures, and owing to its benefits, we recommend that SA be used more often within plastic surgery under appropriate clinical circumstances.

Patients' experiences of day surgery and recovery: A meta-ethnography

AIM

To explore and synthesise findings from qualitative studies on adult patients' experiences of day surgery and the processes of recovery.

BACKGROUND

There has been a shift in the practice of elective surgery, from inpatient to ambulatory treatment. Accordingly, more patients are undergoing day surgery and expected to care for themselves at home. To our knowledge, an updated metasynthesis on patients' experiences of day surgery across diverse contexts and continents is lacking.

DESIGN

Meta-ethnography.

METHODS

MEDLINE, EMBASE and CINAHL were systematically searched for qualitative research in English published between 2006 and 2023. Noblit and Hare's meta-ethnographic approach guided the synthesis of findings from 12 qualitative studies, and the eMERGe Reporting Guidance was used in the writing of this article.

RESULTS

Four themes were revealed: (1) requests for tailored information, (2) challenges of recognising and understanding postoperative symptoms, (3) being dependent on continuous professional and personal support and (4) calling for individual adaptation.

CONCLUSION

Our meta-ethnography indicates there is a need to improve information provision to better prepare patients for the processes of day surgery and recovery and promote their self-care abilities. Our findings highlight the importance of ensuring adequate levels of individualised care and support throughout the treatment process.

RELEVANCE TO CLINICAL PRACTICE

To improve quality of care in day surgery practice, implementation of interventions to enhance information provision and promote self-care during recovery at home may be considered. Pre-admission appointments that incorporate provision of tailored information and assessment of the patients' individual needs of care and support, home conditions and access to assistance from family/friends can be recommended.

Feeling Safe in the Perioperative Period: Experiences from Patients Undergoing Orthopedic Day Surgery

Introduction

Day surgery is often preferred by patients, but it can pose challenges in self-management after discharge. In addition, patients undergoing orthopedic surgery report poorer rates of postoperative recovery than patients undergoing general surgery. Understanding patients' perceptions of feeling safe while undergoing surgery facilitates individualized care and is important since it may affect their recovery.

Objective

The aim of this study was to describe patients' perceptions of feeling safe in the perioperative period when undergoing orthopedic day surgery under regional anesthesia.

Methods

The design was qualitative and descriptive. Data were collected through a cross-sectional questionnaire containing open-ended questions. Qualitative content analysis with an inductive approach was used for data analysis. Participants' characteristics were presented descriptively. The study population consisted of a consecutive sample of 97 patients who had undergone orthopedic day surgery under regional anesthesia between March and October 2022.

Results

The categorization process resulted in the development of two categories describing participants' experience of perioperative feelings of safety when undergoing orthopedic day surgery: having someone near and having a sense of control. The results indicate that the relationship between patients and staff and the perceived feeling of control and participation are factors influencing patients' perception of feeling safe in the perioperative period.

Conclusions

In perioperative care, nurses play a vital role in fostering patients' sense of safety by establishing relationships. This ensures that patients can be actively engaged in their own care. Patients also need access to professional and competent staff who strives to add a personal touch and considers their perspective. Since patients undergoing orthopedic day surgery might face a more demanding postoperative recovery than they had initially anticipated, further research is suggested to explore the association between a perceived feeling of safety and postoperative recovery.

Enhanced recovery protocols for ambulatory surgery

INTRODUCTION

In the United States, ambulatory surgeries account for up to 87% of all surgical procedures. (1) It was estimated that 19.2 million ambulatory surgeries were performed in 2018 (https://www.hcup-us.ahrq.gov/reports/statbriefs/sb287-Ambulatory-Surgery-Overview-2019.pdf). Cataract procedures and musculoskeletal surgeries are the most common surgical interventions performed in ambulatory centers. However, more complex surgical interventions, such as sleeve gastrectomies, oncological, and spine surgeries, and even arthroplasties are routinely performed as day cases or in a model of an ambulatory extended recovery. (2-5) The ambulatory surgery centers industry has grown since 2017 by 1.1% per year and reached a market size of $31.2 billion. According to the Ambulatory Surgery Center Association, there is a potential to save $57.6 billion in Medicare costs over the next decade (https://www.ibisworld.com/industry-statistics/market-size/ambulatory-surgery-centers-united-states/). These data suggest an expected rise in the volume of ambulatory (same day) or extended ambulatory (23 h) surgeries in coming years. Similar increases are also observed in other countries. For example, 75% of elective surgeries are performed as same-day surgery in the United Kingdom. (6) To reduce costs and improve the quality of care after those more complex procedures, ambulatory surgery centers have started implementing patient-centered, high-quality, value-based practices. To achieve those goals, Enhanced Recovery After Surgery (ERAS) protocols have been implemented to reduce the length of stay, decrease costs, increase patients' satisfaction, and transform clinical practices. The ERAS fundamentals for ambulatory surgery are based on five pillars, including (1) preoperative patient counseling, education, and optimization; (2) multimodal and opioid-sparing analgesia; (3) nausea and vomiting, wound infection, and venous thromboembolism prophylaxis; (4) maintenance of euvolemia; and (5) encouragement of early mobility. Those pillars rely on interdisciplinary teamwork led by anesthesiologists, surgery-specific workgroups, and safety culture. (2) Research shows that a team of ambulatory anesthesiologists is crucial in improving postoperative nausea and vomiting (PONV) and pain control. (7) This review will summarize the current evidence on the elements and clinical importance of implementing ERAS protocol for ambulatory surgery.

A quantitative, multicentre, longitudinal study of patient experiences after gynaecological day surgery

AIM

The aim of this study was to explore patients' experiences after gynaecological day surgery one and 30 days postoperatively, as well as potential factors influencing these experiences.

DESIGN

The study had a multicentre, quantitative, longitudinal design.

METHODS

The study was conducted in three different hospitals' day surgical unit and included patients undergoing gynaecological surgery in general anaesthesia. We used a questionnaire including the European Quality of Life tool (EQ5D3L), the Quality-of-Recovery-15 questionnaire (QoR-15) and items relating to patient experiences, the first day (T1, n = 444) and 30 days (T2, n = 193) after surgery. Data were collected in the period March 2019 to March 2020.

RESULTS

Results show that patients mainly had positive experiences and ranged quality of recovery high, even though some areas needed improvement. Patient scores on the QoR-15 relating to their experiences 24 h postoperative were rated higher at T1 than at T2. Twenty per cent of the respondents experienced complications such as infection, haemorrhage and pain. About 1/5 of these contacted healthcare services, and three per cent was hospitalized. EQ5D score was the only factor that made an statistically significant impact on patients' experiences with quality of recovery (R² .169, F = 82.87). However, this effect was weak.

Evaluating the Association of Anesthesia Type With Postoperative Complications in Patients Undergoing Ankle Fracture Repair

General and neuraxial anesthesia are both successful anesthesia techniques used in many orthopedic procedures. The purpose of this study was to compare the complications and length of hospital stay between patients who underwent general anesthesia versus neuraxial anesthesia during the repair of ankle fractures. Patients undergoing open reduction and internal fixation for ankle fracture from 2014 to 2018 were identified in the National Surgical Quality Improvement Program database. Patients were stratified into 2 cohorts: general anesthesia and neuraxial anesthesia. In this analysis, demographics data, comorbidities, and postoperative complications were collected and compared between the two cohorts. Bivariate analyses and multivariable logistical regression were performed. Of 3585 patients who underwent operative treatment for ankle fracture, 3315 patients (92.5%) had general anesthesia and 270 (7.5%) had neuraxial anesthesia. On bivariate analyses, patients who had neuraxial anesthesia were more likely to develop pulmonary complications (p = .173) or extended length of stay more than 5 days (p = .342) compared to the general anesthesia group. Following adjustment on multivariate analyses, the neuraxial anesthesia cohort no longer had increased likelihood of pulmonary complications or extended length of stay compared to the general anesthesia group. Healthy ankle fracture patients could also benefit from neuraxial anesthetic methods, and they should be considered for this anesthetic type regardless of their lack of comorbidities.

Patients' and providers' perspectives on e-health applications designed for self-care in association with surgery - a scoping review

Background

Before and after major surgery, access to information in a user-friendly way is a prerequisite for patients to feel confident in taking on the responsibility for their surgical preparation and recovery. Several e-health applications have been developed to support patients perioperatively. The aim of this review was to give an overview of e-health applications designed for self-care associated with surgery by providing a scoping overview of perspectives from providers and patients.

Methods

We searched the following data sources to identify peer-reviewed quantitative and qualitative studies published between 2015 and 2020: CINAHL, Google Scholar, MEDLINE, PsycInfo, Web of Science, and Scopus. After identifying 960 titles, we screened 638 abstracts, of which 72 were screened in full text. Protocol register: 10.17605/OSF.IO/R3QND.

Results

We included 15 studies which met our inclusion criteria. Data from several surgical contexts revealed that the most common self-care actions in e-health applications were preoperative preparations and self-assessments of postoperative recovery. Motivational factors for self-care were information, combined with supportive reminders and messages, and chat features. Although there was great variance in research designs and technical solutions, a willingness to engage with and adhere to e-health seemed to increase patients’ self-care activities and thereby accelerate return to work and normal activities. In addition, the need for physical visits seemed to decrease. Even though age groups were not primarily studied, the included studies showed that adult patients of any age engaged in surgical self-care supported by e-health. The providers’ perspectives were not found.

Conclusions

E-health applications supporting perioperative self-care indicated a positive impact on recovery. However, experiences of healthcare professionals delivering e-health associated with surgery are missing. Additionally, studies based on patients’ perspectives regarding willingness, adherence, and motivation for self-care supported by e-health are sparse. A need for studies examining the supporting role of e-health for self-care in the surgical context is therefore needed.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-022-07718-8.

High turnover for ambulatory orthopedic surgery

PURPOSE OF REVIEW

The trend in the perioperative management of patients having orthopedic surgery in the ambulatory setting emphasizes time-efficiency and rapid turnovers. Anesthetic techniques and management continue to evolve to increase efficiency and decrease time spent in recovery.

RECENT FINDINGS

Minimizing time patients spend in phase 1 recovery or bypassing phase 1 altogether, known as fast-tracking, has become an important goal in containing costs in high turnover, ambulatory settings. Anesthetic techniques, particularly implementation of regional anesthesia and multimodal analgesia, have evolved to maximize efficiency.

SUMMARY

Anesthetic goals in the setting of high-turnover orthopedic surgery include effective multimodal analgesia, decreasing monotherapy with opioids, and patient education. Regional anesthesia as part of a multimodal analgesic regimen is increasingly used in ambulatory surgery fast-tracking protocols.

Regional anesthesia for nonunion surgery with iliac crest bone grafting results in an increase in same day discharge

INTRODUCTION

The purpose of this study was to evaluate the outcomes of fracture nonunion repair with autogenous iliac crest bone graft (ICBG) under regional anesthesia alone or in combination with other techniques compared to other anesthesia techniques.

MATERIALS AND METHODS

Overall, 137 patients were identified who underwent ICBG as part of a repair of a long bone fracture nonunion between January 1, 2013 and October 1, 2020. Surgical and anesthetic records were reviewed to classify patients by anesthesia type. General, spinal, and regional anesthetics were used as either the primary anesthetic or as a combination of regional nerve block with general or spinal anesthesia.

RESULTS

Administration of regional anesthesia alone or in combination with general or spinal anesthesia (RA) and general or spinal anesthesia only (GS) groups differed in nonunion site distribution (p < 0.001). RA patients were discharged the same day more often than GS patients (30.9% vs 10.0%, p = 0.009) and experienced fewer postoperative complications (p = 0.021). The RA group achieved union sooner than the GS group (by 5.3 ± 3.2 months vs. by 6.8 ± 3.2 months, p = 0.006). Mean morphine equivalent dose was similar between groups (p = 0.23). Regional anesthesia use increased from 2013 to 2020, and same day discharge surgeries simultaneously increased over the same time period.

CONCLUSION

Regional anesthesia use increased in nonunion repair surgery with ICBG from 2013 to 2020. This was associated with an increase in same day discharge, sooner time to union, and decreased postoperative complications. There was not a need for increased opioid prescription in patients that underwent regional anesthesia.

Swedish Web Version of the Quality of Recovery Scale Adapted for Patients Undergoing Local Anesthesia and Peripheral Nerve Blockade (SwQoR-LA): Prospective Psychometric Evaluation Study

BACKGROUND

The frequency and timing of assessing patient symptoms and discomfort during postoperative recovery are goals. Therefore, real-time recovery evaluation has been suggested to identify specific deficits in patient recovery.

OBJECTIVE

This study aimed to psychometrically evaluate the Swedish Web Version of the Quality of Recovery (SwQoR) Scale adapted for patients undergoing local and peripheral nerve block (SwQoR-LA).

METHODS

This was a secondary analysis of a psychometric evaluation of 107 patients aged ≥18 years undergoing day surgery under local or peripheral nerve block anesthesia at 4 different day surgery departments in Sweden. The SwQoR-LA, available through a mobile app called Recovery Assessment by Phone Points (RAPP), was completed daily on postoperative days 1-7.

RESULTS

Some evidence of construct validity was supported, and discriminant validity was found in 7 of 8 items related to general anesthesia. The internal consistency was acceptable (.87-.89), and the split-half reliability was 0.80-0.86. Cohen d effect size was 0.98, and the percentage of change from baseline was 43.4%. No floor nor ceiling effects were found.

CONCLUSIONS

The SwQoR-LA is valid, reliable, responsive, and clinically feasible for digital real-time recovery assessment of patient recovery to identify specific deficits in patient recovery and detect those patients who might benefit from a timely intervention.

TRIAL REGISTRATION

ClinicalTrials.gov NCT02492191; https://clinicaltrials.gov/ct2/show/NCT02492191.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

RR2-10.1136/bmjopen-2015-009901.

A journey to a new stable state-further development of the postoperative recovery concept from day surgical perspective: a qualitative study

OBJECTIVE

This study aims to further develop the concept analysis by Allvin et al in 2007 and Lundmark et al in 2016 from the perspective of day-surgery patients. Also, to describe how patients experience postoperative recovery in relation to the identified dimensions and subdimensions and to interpret the findings in order to get a deeper understanding of the concept postoperative recovery.

DESIGN

Descriptive qualitative design with a theoretical thematic analysis.

SETTING

Six day-surgery departments in Sweden.

PARTICIPANTS

Thirty-eight adult participants who had undergone day surgery in Sweden. Participants were purposively selected.

RESULTS

Four dimensions-physical, psychological, social and habitual-were confirmed. A total of eight subdimensions were also confirmed, two from Allvin et al's study and six from Lundmark et al's study. Recovery included physical symptoms and challenges coping with and regaining control over symptoms and bodily functions. Both positive and negative emotions were present, and strategies on how to handle emotions and achieve well-being were established. Patients became dependent on others. They coped with and adapted to the recovery process and gradually stabilised, reaching a new stable state.

CONCLUSION

Postoperative recovery was described as a process with a clear starting point, and as a dynamic and individual process leading to an experience of a new stable state. The recovery process included physical symptoms, emotions and social and habitual consequences that challenges them. To follow-up and measure all four dimensions of postoperative recovery in order to support and understand the process of postoperative recovery is, therefore, recommended.

Validity and Reliability of the Korean Version of the Anesthesia Surrendering Instrument

This study examined the reliability and validity of the Korean version of the anesthesia surrendering instrument (ASI), which was originally developed to measure anesthesia surrendering in Swedish adults. The study population consisted of 306 patients who received general anesthesia for abdominal, breast, knee, hip, lower back, or shoulder surgery in ten hospitals across five regions of Korea from June to September 2019. The validity of the content, construct, and criterion used, and the reliability of the ASI were assessed. The results showed that the instrument had appropriate content validity; the item-level content validity index ranged between 0.80 and 1.00, and the scale-level content validity index was 0.90. The construct validity test results confirmed four sub-categories with a total of 26 items, and the internal consistency reliability tests showed Cronbach’s alpha values ranging between 0.71 and 0.88. The study findings confirmed the applicability of this instrument for measuring anesthesia surrendering in Korean adults. These results provide a foundation for future studies on anesthesia surrendering in Korean adult patients.

Factors Determining the Choice of Spinal Versus General Anesthesia in Patients Undergoing Ambulatory Surgery: Results of a Multicenter Observational Study

Introduction

Available short-acting intrathecal anesthetic agents (chloroprocaine and prilocaine) offer an alternative to general anesthesia for short-duration surgical procedures, especially ambulatory surgeries. Factors determining the choice of anesthesia for short-duration procedures have not been previously identified.

Methods

This observational, prospective, multicenter, cohort study was conducted between July 2015 and July 2016, in 33 private or public hospitals performing ambulatory surgery. The primary objective was to determine the factors influencing the choice of anesthetic technique (spinal or general anesthesia). Secondary outcomes included efficacy of the anesthesia, time to hospital discharge, and patient satisfaction.

Results

Among 592 patients enrolled, 309 received spinal anesthesia and 283 underwent general anesthesia. In both study arms, the most frequently performed surgical procedures were orthopedic and urologic (43.3% and 30.7%, respectively); 66.1% of patients were free to choose their type of anesthesia, 21.8% chose one of the techniques because they were afraid of the other, 16.8% based their choice on the expected ease of recovery, 19.2% considered their degree of anxiety/stress, and 16.9% chose the technique on the basis of its efficacy. The median times to micturition and to unassisted ambulation were significantly shorter in the general anesthesia arm compared with the spinal anesthesia arm (225.5 [98; 560] min vs. 259.0 [109; 789] min; p = 0.0011 and 215.0 [30; 545] min vs. 240.0 [40; 1420]; p = 0.0115, respectively). The median time to hospital discharge was equivalent in both study arms. In the spinal anesthesia arm, patients who received chloroprocaine and prilocaine recovered faster than patients who received bupivacaine. The time to ambulation and the time to hospital discharge were shorter (p < 0.001). The overall success rate of spinal anesthesia was 91.6%, and no significant difference was observed between chloroprocaine, prilocaine, and bupivacaine. The patients’ global satisfaction with anesthesia and surgery was over 90% in both study arms.

Conclusions

Patient’s choice, patient fear of the alternative technique, patient stress/anxiety, the expected ease of recovery, and the efficacy of the technique were identified as the main factors influencing patient choice of short-acting local anesthesia or general anesthesia. Spinal anesthesia with short-acting local anesthetics was preferred to general anesthesia in ambulatory surgeries and was associated with a high degree of patient satisfaction.

Trial Registration

ClinicalTrials.gov identifier NCT02529501. Registered on June 23, 2015. Date of enrollment of the first participant July 21, 2015.

Impact of Chloroprocaine on the Eligibility for Hospital Discharge in Patients Requiring Ambulatory Surgery Under Spinal Anesthesia: An Observational Multicenter Prospective Study

Introduction

This observational study was designed to assess the use of spinal anesthesia with chloroprocaine in the context of ambulatory surgery.

Methods

A prospective, multicenter, observational study was carried out among 33 private or public centers between May 2014 and January 2015 and adult patients, scheduled for a short ambulatory surgery under spinal anesthesia with chloroprocaine. The primary outcomes were anesthetic effectiveness, defined as performance of the whole surgical procedure without any additional anesthetic agent, and the time to achieve eligibility for hospital discharge. Secondary outcomes were the effect of chloroprocaine on motor and sensory blocks, patients’ satisfaction, and the use of analgesics in the first 24 h after surgery.

Results

Among the 615 enrolled patients, 56% were male, the mean age was 47.2 ± 15.2 years, and most patients had an ASA (American Society of Anesthesiologists) status of 1 (63.7%). Main surgical procedures performed were orthopedic (62.6%) and gynecologic (16.1%), and the mean duration of surgery was 26.7 ± 16.7 min. The overall anesthetic success rate was 93.8% (95% CI [91.5%; 95.6%]) for the 580 patients with available data for primary criteria. The failure rate was lower than 7% for all surgical procedures, except for gynecologic surgery (14.8%; 95% CI [8.1%; 23.9%]). The average times of eligibility for hospital discharge and effective discharge were 252.7 ± 82.7 min and 313.8 ± 109.9 min, respectively. The time of eligibility for hospital discharge is defined as the recovery of the patient’s normal clinical parameters and the time of effective discharge is defined as the time for the patient to leave the hospital after surgery. Eligibility for patient’s discharge was achieved more rapidly in private than public hospitals (236.3 ± 77.2 min vs. 280.9 ± 80.7 min, respectively, p < 0.001).

Conclusions

This study showed positive results on the effectiveness of chloroprocaine as a short-duration anesthetic and could be used to reduce the time to achieve eligibility for hospital discharge.

Trial Registration

ClinicalTrials.gov identifier, NCT02152293. Registered on May 6, 2014. Date of enrollment of the first participant in the trial May 7, 2014.