Regarding discharge criteria after day-care surgery, the Modified Aldrete Score (MAS) of ≥9 allows discharge from the post-anaesthesia care unit (PACU) Phase I to Phase II recovery. Which parameter is UNIQUELY included in the Modified Aldrete Score compared to the original Aldrete score?

• A Blood pressure within 20% of baseline replaces colour assessment
• B Pain score added as a fifth criterion
• C Urine output replaces the activity score
• D Pulse oximetry (SpO2) replaces colour as a criterion ✓

Explanation

The original Aldrete score assessed activity, respiration, circulation, consciousness, and skin colour (pink/cyanotic/pale). The Modified Aldrete Score replaced the skin colour criterion with oxygen saturation (SpO2 ≥92% on room air scores 2; SpO2 ≥90% on supplemental O2 scores 1; SpO2 <90% even with O2 scores 0) because pulse oximetry is a more objective and clinically relevant measure of respiratory adequacy than visual colour assessment. A total score ≥9 is required for PACU Phase I discharge.

Reference: Morgan & Mikhail's Clinical Anesthesiology, 6th ed.

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