Analysis of factors affecting successful discharge in patients undergoing lumbar discectomy for sciatica performed on a day-surgical basis: a prospective study of sequential cohorts.

This is a prospective study of sequential cohorts of patients undergoing elective lumbar discectomy scheduled on a day-surgical basis between April 1995 and October 1998, representing all such cases from the author's practice during the review period. Preliminary review of the first 38 cases was undertaken 18 months after this surgical program was initiated and revealed an 18% rate of failure in achieving same-day discharge. Subsequent review of the balance of 92 additional cases revealed this failure rate was decreased to only 2% through a combination of appropriate perioperative patient education and the institution of a low-dose perioperative narcotic routine.