For ambulatory (day-care) surgery, which criterion MOST strongly predicts the need for unplanned hospital admission after discharge?
- A Duration of anaesthesia >2 hours
- B Use of general anaesthesia versus regional anaesthesia
- C Inadequately controlled postoperative pain and PONV at home visit threshold ✓
- D Age >65 years regardless of comorbidities
Correct answer: C. Inadequately controlled postoperative pain and PONV at home visit threshold
Explanation
The most common and clinically significant reasons for unplanned hospital admission following ambulatory surgery are uncontrolled pain and PONV that cannot be managed at home. These dominate outcome data from day-surgery audit studies. Multimodal analgesia (paracetamol + NSAID + opioid if needed) and aggressive PONV prophylaxis proportional to Apfel score are therefore central to ERAS day-surgery protocols. Age alone and anaesthesia type are less predictive when appropriately managed; anaesthesia duration is relevant but secondary to symptom control at discharge.
Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.