OUTCOME FROM DAY-CASE KNEE ARTHROSCOPY IN A MAJOR TEACHING HOSPITAL

Outcome is presented for 465 knee arthroscopies performed under general anesthesia in a public teaching hospital day surgery unit. The unanticipated hospital admission rate on the day of surgery was 1.07%. There were 11 (2.37%) major complications in the combined perioperative and postdischarge periods (up to 4 weeks postdischarge). Surgery-related complications (incidence 1.08%) were more frequent than complications of anesthesia (0.65%). Four patients (0.86%) had delayed complications after discharge that required hospital readmission. Stepwise polychotomous logistic regression showed that these complications were not significantly related to patient age, sex, American Society of Anesthesiologists (ASA) status or type of surgery. Mean recovery times required for patients to sit out of bed and to be ready for discharge were 61 +/- 37 and 142 +/- 52 min, respectively. Both postoperative pain and postoperative nausea and vomiting, present in 76% and 11.5% of patients, respectively, significantly delayed patient recovery, with longer delays associated with nausea and vomiting. Times required for patients to be ready for discharge were not correlated to either patient age (r = 0.07; p = 0.15) or duration of procedure (r = 0.07; p = 0.13). At early follow-up, 4.7% and 2.5% of patients had presented to hospital accident and emergency departments and local family doctors, respectively, usually for minor problems. Ninety-nine percent of all patients were happy with the ambulatory surgery service. With careful patient assessment and selection, day-case knee arthroscopy in a teaching hospital can provide satisfactory outcome.