Implementation of Aldrete’S Scoring System Significantly Reduces Recovery Time After Procedural Sedation by more than 20 %

Aims Endoscopic procedures are often performed after administration of procedural sedation and analgesia (PSA) by trained non-anaesthesiologist physicians, followed by monitored observation in a dedicated recovery area. Historically, discharge from this recovery area was based on time parameters (e.g. standard after 1 hour) or clinical assessment by the responsible nurses. The Aldrete’s scoring system is a useful tool (5 parameters, 10 points) to objectivate this clinical ‘gut feeling’ to decide when a patient can be discharged safely.In this study the effect of solely implementation of the Aldrete’s scoring system on recovery time after procedural sedation was analysed in a real-life setting.

Methods Between November 21^st and December 12^th 2019 recovery time after gastroscopy, colonoscopy and endoscopic ultrasound with procedural sedation and analgesia was actively monitored in 231 patients. All procedures were randomly included to represent a real-life situation with different endoscopists, recovery nurses, endoscopy systems and indications. After this observation period all endoscopy nurses were educated to implement the Aldrete’s scoring system when discharging patients. The effect of implementation was monitored in 97 patients between February 13^th and March 11^th 2020.

Results The average time spent in the recovery area was 59 ± 22 minutes after procedural sedation with 3.5 ± 1.3 mg midazolam and 30 ± 19 mg pethidine. After implementation of the Aldrete’s scoring system, the recovery time decreased significantly to 47 ± 25 minutes (p<0.01) with similar doses of procedural sedation (3.5 ± 1.2 mg midazolam and 32 ± 19 mg pethidine). The decrease in time was between 19 % and 35 % for the different endoscopic procedures. No complications related to earlier discharge from the recovery area were observed.

Conclusions Implementation of Aldrete’s scoring system after procedural sedation and analgesia significantly reduces the time spent at the recovery area without increasing complication rate.

Citation: Roelandt P, Haesaerts R, Missotten R et al. OP149 IMPLEMENTATION OF ALDRETE’S SCORING SYSTEM SIGNIFICANTLY REDUCES RECOVERY TIME AFTER PROCEDURAL SEDATION BY MORE THAN 20 %. Endoscopy 2021; 53: S61.

Publication History

Article published online:
19 March 2021