COMPARISON OF MODIFIED ALDRETE SCORE AND FAST-TRACK CRITERIA FOR ASSESSING RECOVERY AFTER GENERAL ANAESTHESIA IN LAPAROSCOPIC SURGERY: A PROSPECTIVE OBSERVATIONAL STUDY

Dr. Farhana Bashir; Dr. Syed Vaseem Aadil. K; Dr. Naaz afrin; Dr. yasir wani

Authors

Dr. Farhana Bashir Assistant professor, Department of Anesthesiology and critical care government medical college Srinagar, Jammu and Kashmir, India. Author
Dr. Syed Vaseem Aadil. K Resident, Department of Anesthesiology and critical care government medical college Srinagar, Jammu and Kashmir, India. Author
Dr. Naaz afrin MBBS, International Education College, jiangxi university of Chinese medicine. Nanchang, jiangxi province, china. Author
Dr. yasir wani Head Department of pediatrics, District Hospital Pulwama, Jammu and Kashmir, India. Author

Keywords:

Modified Aldrete Score, Fast-Track Criteria, Pacu, Laparoscopic Surgery, Recovery, General Anaesthesia.

Abstract

Background: Accurate assessment of recovery following general anaesthesia is essential for safe and timely discharge from the post-anaesthesia care unit (PACU). The Modified Aldrete Score (MAS) and Fast-Track Criteria (FTC) are widely used tools, but their comparative effectiveness in laparoscopic surgery remains uncertain.

Aim: To compare the Modified Aldrete Score and Fast-Track Criteria in assessing recovery and determining discharge readiness following general anaesthesia in patients undergoing laparoscopic surgery.

Methods: In this prospective observational study, 200 patients (ASA I–II) aged 18–65 years undergoing elective laparoscopic surgery under general anaesthesia were evaluated. Recovery was assessed using MAS and FTC at 5 minutes, 30 minutes, 2, 6, 12, and 24 hours post-extubation. Time to achieve discharge readiness (MAS ≥9, FTC ≥12), Visual Analogue Scale (VAS) scores, and agreement between the tools were analysed.

Results: At 5 minutes, 47.5% (MAS) and 46% (FTC) of patients were eligible for transfer, increasing to 94.5% and 90.5% at 30 minutes, and 100% in both groups by 2 hours. Mean time to discharge readiness was significantly shorter with MAS (23.1 ± 26.4 minutes) compared to FTC (27.1 ± 32.5 minutes; p = 0.002). Agreement between MAS and FTC was almost perfect at 5 minutes (kappa = 0.97) and substantial at 30 minutes (kappa = 0.71). MAS scores improved from 8.3 ± 0.6 at 5 minutes to 10 at 12 hours, while FTC scores increased from 11.3 ± 0.7 to 13.9 ± 0.1 over the same period. VAS scores decreased significantly from 6.2 ± 0.5 at 5 minutes to 1.2 ± 0.4 at 24 hours (p < 0.001). Antiemetics were required in 21.5% of patients, while all patients required rescue analgesia.

Conclusion: The Modified Aldrete Score enables earlier identification of discharge readiness, whereas Fast-Track Criteria provides a more comprehensive assessment by incorporating pain and postoperative nausea and vomiting. A combined or context-based approach may optimize postoperative recovery assessment and PACU discharge decisions.