A 55-year-old diabetic patient scheduled for day-care inguinal hernia repair under spinal anaesthesia is cleared fit for day surgery. Which criterion is essential before discharging home after spinal anaesthesia?

• A Resolution of all sensory block before discharge
• B 4-hour mandatory observation period regardless of block regression
• C Complete return of motor function and ability to void spontaneously (or documented voiding failure evaluation) ✓
• D Urinary catheterisation and documented output >500 mL

Explanation

Post-spinal discharge criteria require: return of motor function (to prevent falls), regression of sensory block to an acceptable level (L3–L4 dermatomal level or lower), and ability to void — urinary retention is a common complication of spinal anaesthesia particularly with hyperbaric bupivacaine or opioid additives, and is the most common reason for delayed discharge. Mandating complete sensory block resolution or a fixed 4-hour observation is unnecessarily restrictive. Routine catheterisation is not required — the criterion is the ability to void or documented evaluation confirming no retention. The modified Aldrete or PADSS score is used for day-care discharge.

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

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.