Skip to main content Accessibility help
  • Print publication year: 2012
  • Online publication date: October 2012

18 - Postanesthesia care unit management

from Section 3 - Surgical and anesthesia practice management


1. American Society of Anesthesiologists. Postanesthesia Care Standards for 2009. (last accessed May 10, 2012).
2. J. Boncyk, J. Fitzpatrick. Discharge Criteria. In: S. R. Springman, ed. Ambulatory Anesthesia: The Requisites in Anesthesiology. Philadelphia: Mosby Elsevier, 2006; 109–17.
3. J. A. Aldrete, D. Kroulik. A post anesthetic recovery score. Anesth Analg 1970; 49: 924–34.
4. J. A. Aldrete. The post anesthesia recovery score revisited [letter]. J Clin Anesth 1995; 7: 89–91.
5. F. Chung, V. Chan, D. Ong. A post anaesthetic discharge scoring system for home readiness after ambulatory surgery. J Clin Anesth 1995; 7: 500–6.
6. P. White, D. Song. New criteria for fast-tracking after outpatient anesthesia: a comparison with the Modified Aldrete’s scoring system. Anesth Analg 1999; 88: 1069–72.
7. M. S. Schreiner, S. C. Nicholson, T. Martin, et al. Should children drink before discharge from day surgery? Anesthesiology 1992; 76: 528–33.
8. W. T. Fritz, L. George, N. Krull, J. Krug. Utilization of a home nursing protocol allows ambulatory surgery patients to be discharged prior to voiding [abstract]. Anesth Analg 1997; 84: S6.
9. F. L. Jin, A. Norris, F. Chung, T. Ganeshram. Should adult patients drink fluids before discharge from ambulatory surgery? Can J Anaesth 1998; 87: 306–11.
10. H. Ead. From Aldrete to PADSS: reviewing discharge criteria after ambulatory surgery. J Perianesth Nurs 2006; 21: 259–67. Review. Erratum in: J Perianesth Nurs 2007; 22: 154.
11. K. Korttila. Recovery from outpatient anesthesia: factors affecting outcome. Anesthesia 1995; 50(Suppl): 22–8.
12. International Association for Ambulatory Surgery. Discharge Criteria Following Day Surgery. Available online at:
13. E. Marcon, S. Kharraja, N. Smolski, et al. Determining the number of beds in the postanesthesia care unit: a computer simulation flow approach. Anesth Analg 2003; 96: 1415–23.
14. American Society of PeriAnesthesia Nurses. Practice Recommendation 1: Patient Classification/Recommended Staffing Guidelines. 2010–2012 Perianesthesia Nursing Standards and Practice Recommendations. (last accessed May 10, 2012).
15. F. Dexter, H. Rittenmeyer. Measuring productivity of the phase I postanesthesia care unit. J Perianesth Nurs 1997; 12: 7–11.
16. M. E. Mamaril, E. Sullivan, T. L. Clifford, et al. Safe staffing for the post anesthesia care unit: weighing the evidence and identifying the gaps. J Perianesth Nurs 2007; 22: 393–9.
17. F. Dexter, Why calculating PACU staffing is so hard and why/how operations research specialists can help. J Perianesth Nurs 2007; 22; 357–9.
18. E. Marcon, F. Dexter, An observational study of surgeons’ sequencing of cases and its impact on postanesthesia care unit and holding area staffing requirements at hospitals. Anesth Analg 2007; 105: 119–26.
19. M. J. Tessler, L. Mitmaker, R. M Wahba, C. R. Covert. Patient Flow in the Post Anesthesia Care Unit: an observational study. Can J Anesth 1999; 46(4): 348–51.
20. A. Macario, D. Glenn, F. Dexter. What can the postanesthesia care unit manager do to decrease costs in the postanesthesia care unit? J Perianesth Nurs 1999; 14: 284–93.
21. F. Dexter, J. H. Tinker. Analysis of strategies to decrease postanesthesia care unit costs. Anesthesiology 1995; 82: 92–101.
22. F. Dexter, R. E. Wachtel, R. H. Epstein. Impact of average patient acuity on staffing of the phase I PACU. J Perianesth Nurs 2006; 21: 303–310.
23. A. Ziser, M. Alkobi, R. Markovits, B. Rozenberg. The postanaesthesia care unit as a temporary admission location due to intensive care and ward overflow. Br J Anaesth 2002; 88: 577–79.
24. M. F. Watcha, P. F. White. Economics of anesthetic practice. Anesthesiology 1997; 86: 1170–96.
25. American Society of PeriAnesthesia Nurses. A position statement for medical-surgical overflow patients in the PACU and ambulatory care unit. J Perianesth Nurs 2003; 18: 301–2.
26. E. Marcon, F. Dexter. Impact of surgical sequencing on postanesthesia care unit staffing. Health Care Manage Sci 2006; 9: 87–98.
27. J. P. Waddle, A. S. Evers, J. F. Piccirillo. Postanesthesia care unit length of stay: quantifying and assessing dependent factors. Anesth Analg 1998; 87: 628–33.
28. P. Saastamoinen, M. Piispa, M. M. Niskanen. Use of postanesthesia care unit for purposes other than postanesthesia observation. J Perianesth Nurs 2007; 22: 102–7.
29. K. Samad, M. Khan, Hameedullah, et al. Unplanned prolonged postanesthesia care unit length of stay and factors affecting it. J Pak Med Assoc 2006; 56; 108–12.
30. F. Dexter, D. H. Penning, R. D. Traub. Statistical analysis by Monte-Carlo simulation of the impact of administrative and medical delays in discharge from the postanesthesia care unit on total patient care hours. Anesth Analg 2001; 92: 1222–5.
31. B. A. Williams, M. L. Kentor, M. T. Vogt, et al. Economics of nerve block pain management after anterior cruciate ligament reconstruction. Anesthesiology 2004; 100: 697–706.
32. W. S. Sandberg, T. Canty, S. M. Sokal, B. Daily, D. L. Berger. Financial and operational impact of a direct-from-PACU discharge pathway for laparoscopic cholecystectomy patients. Surgery 2006; 140: 372–8.
33. M. Schuster, T. Standl. Cost drivers in anesthesia: manpower, technique and other factors. Curr Opin Anesthesiol 2006; 19: 177–84.
34. D. Song, F. Chung, M. Ronayne, et al. Fast-tracking (bypassing the PACU) does not reduce nursing workload after ambulatory surgery. Br J Anaesth 2004; 93: 768–74.
35. F. Dexter, A. Macario, P. J. Manberg, D. A. Lubarsky. Computer simulation to determine how rapid anesthetic recovery protocols to decrease the time for emergence or increase the phase I postanesthesia care unit bypass rate affect staffing of an ambulatory surgery center. Anesth Analg 1999; 88: 1053–63.
36. F. Chung. Discharge criteria – a new trend. Can J Anaesth 1995; 42: 1056–8.
37. R. I. Patel, S. T. Verghese, R. S. Hannallah, et al. Fast-tracking children after ambulatory surgery. Anesth Analg 2001; 92: 918–22.