LAUSR

Study Objective To investigate the impact of a consistent anesthesiologist for laparoscopic hysterectomy on time to discharge and same-day discharge. Design A retrospective cohort study. Setting An academic medical center. Patients or Participants Two hundred and twenty patients who underwent laparoscopic hysterectomy for benign indications. Interventions Outpatient laparoscopic or robotic-assisted hysterectomy between 2018 and 2019. Measurements and Main Results A total of 220 patients were included in the study with 99 patients who had a single consistent anesthesiologist and 121 patients who had inconsistent anesthesiologists from a large anesthesia provider group. Demographic and preoperative characteristics between groups were similar, except patients with an inconsistent anesthesiologist were more likely to be tobacco users (p = .005). Surgery variables not controlled by the anesthesiologist were similar between groups including operative time, uterine weight, urine output, and estimated blood loss. Variables which are controlled by the anesthesiologist at our institution included intraoperative and recovery room opioids, NSAIDS, and intravenous (IV) fluids. The consistent anesthesiologist gave intraoperative and recovery room fentanyl more frequently than morphine and hydromorphone, gave more IV ketorolac, and gave less IV fluids (500mL versus 1000mL, p Conclusion The presence of a single consistent anesthesiologist significantly shortened the time to discharge and improved the success of same-day discharge after outpatient laparoscopic hysterectomy.