Evaluation of Unanticipated Admissions Following Paediatric Day-Case Surgery in the University of Ilorin Teaching Hospital

Abstract

Paediatric patients scheduled for ambulatory surgery in our environment has been on the increase. These patients would undergo different surgical procedures with the intent of going home after the surgery with little or no complications. This study was a retrospective evaluation of unanticipated admission following paediatric day-case surgery.

 A retrospective data of ambulatory paediatric surgeries done between 2015 and 2016 was collected; unanticipated hospital admission and the reason for admission were analysed.  A total of 69 (7.40%) patients out of the total number of 932 paediatric general surgery cases had day-case surgery within the period under study, 13 (18.90%) of the patients were less than 1 year, while 56 (81.10%) of the patients were above one-year-old. Herniotomy was the most common surgical procedure in 57 (82.60%) of the day case procedures, 43 (62.30%) of the cases were completed in less than one hour while 26 (37.70%) of the surgical procedures were completed between one and three hours. None of the patients had a post anaesthesia discharge score (PADS) below 8. General anaesthesia with a facemask or laryngeal mask airway with or without caudal block was the most common anaesthetic technique in 58 (79.60%) of cases, while general anaesthesia with relaxant technique with or without caudal block was the anaesthetic technique in 8 (11.50%) of cases. There were no recorded cases of unanticipated postoperative admission. In conclusion, there was no incidence of unanticipated hospital admission following day-case surgery in our centre because of proper patient selection, team cooperation, safe anaesthetic and surgical practice with proper discharge criteria.

Keywords: ambulatory surgery, complications, admission.