Adopting the day surgery default in the provision of lumbar discectomy and decompressive surgery. Issue 5 (May 2023)

• Record Type: Journal Article
• Authors: Paluch, Anthony J; Matthews, Alexander H; Mullins, Sophie; Vanstone, Ross J; Woodacre, Timothy
• Is Part Of: Journal of perioperative practice. Volume 33:Issue 5(2023)
• Page Start: 139
• Page End: 147
• Publication Date: 2023-05
• Subjects: Spinal surgery -- Day case surgery -- Lumbar microdiscectomy -- Patient pathway -- Multidisciplinary; Operating room nursing -- Periodicals; 617.9192
• DOI: 10.1177/17504589211054360
• Languages: English
• ISSNs: 2515-7949

Abstract

Introduction: Provision of day case spinal procedures in the UK is below expected standards and there is a need for the creation of guidance and patient pathways to address this. Here we present a day case lumbar discectomy protocol and evaluate its impact at our institution. Methods: A new pathway (incorporating defined selection criteria, patient education, anaesthetic protocol and discharge prescriptions) was implemented for all suitable patients within a single surgeon's cohort. Day case rates for lumbar discectomy were compared before and after implementation. Patient feedback was collated using a patient-reported experience measure. Results: Eighteen of 23 patients selected as suitable via the pathway successfully underwent day surgery, leading to an increase in lumbar discectomy day case rates from 25% to 69% at our institution. Nearly all patients were satisfied with their experience, although a significant proportion felt provision of postoperative analgesia could be improved. Conclusion: We present a day surgery pathway for lumbar discectomy that is safe and effective. This could be more widely implemented to increase day case rates.