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Adult tonsillectomy: what proportion would accept same day discharge?

Day case surgery is increasing to improve health care cost efficiency. The economic benefits of day surgery depend on how many patients accept same day discharge. This study aims to investigate what proportion of adults undergoing tonsillectomy would accept same day discharge and reasons for refusal. Fifty consecutive adults undergoing in-patient tonsillectomy who satisfied criteria for day surgery were prospectively studied. All patients had the same day case; anaesthetic, tonsillectomy technique, analgesia and antiemetic. Eight hours after surgery patients were given discharge information and asked whether they would accept discharge. Those patients who refused discharge were asked to specify why. Additional morphine requirements were noted. Fifty-two percent of patients would accept same day discharge. Reasons for refusal were; pain 46%, nausea 33%, dizziness 13% and pain and nausea 8%. Those refusing discharge were three times more likely to have received additional morphine. These results compare unfavourably with oversees studies and this may be due to sampling bias. Further studies are required.