Yoeri Bemelmans

Chapter 6 82 Results Forty patients were recruited for this study, 20 patients in each group. No patients were lost to follow-up. Baseline demographics and operative data are summarized in Table 3. Table 3. Baseline demographics were not significant different between the groups. Baseline RR pathway OS pathway p-value Age, years, at index surgery 61.2 (5.15) 60.5 (5.65) n.s. BMI, kg/m 2 27.7 (3.27) 29.1 (3.85) n.s. Gender, male 11 (55) 13 (65) n.s. ASA classification I/II/III 6/13 /1 10 /10/0 n.s. Operative data General/ Spinal/ Spinal +Sedation 4/12/4 1/19/0 n.s. OR time, min 48.0 (8.5) 57 (15.3) n.s. Secondary disorders and concomitant diseases Cardial (heart failure, hypertension) 1 3 n.s. Pulmonal (bronchitis, COPD) 2 3 n.s. Other* 6 3 n.s. *Autoimmune diseases, renal function disorders, diabetes mellitus type 2, sleep apnea. All patientsweredischarged to theirhomeenvironment, accompaniedbyapersonal coach or relative. Seventeen patients (85%) in the OS pathway were discharged on the day of surgery as scheduledwhereas in the RR pathway 95%of the patients were discharged<3 days postoperative. Prolongedhospital staywas not significantly different. Three patients in the OS pathway had a prolonged hospital stay; 2 patients suffered from high pain intensity (NRS >5) and both were discharged on postoperative day 2, as 1 other patient had a fear to go home and was discharged on postoperative day 1. In the RR pathway, 1 patient was suspicious for a DVT and therefore discharge was delayed (discharged on postoperative day 3). However, DVT was not diagnosed with echo duplex. EarlymobilizationwascomparablebetweentheRRandOSpathway(n.s.). Inbothpathways, 1 patient was not able tomobilize due to high pain intensity<6hrs and<4hrs respectively. Delayed first mobilization occurred in 1 patient (RR) because of PONV, as another patient in the RR pathway had to copewith vasovagal syncope. Time between hospital admission and discharge was significantly different (p<0.00) between both pathways: 2.6 days (1.2 – 4.1) in the RR pathway compared to 0.5 day (0.4 – 2.2) in the OS pathway. NRS pain scores were not significantly different preoperatively and <48hrs postoperative, measured on fixed time points throughout the day. Overall, median postoperative pain scores did not exceed a NRS score of 5 during the first 48hrs (Figure 2).