Assessing Discharge Readiness After Propofol-Mediated Deep Sedation in Pediatric Dental Procedures: Revisiting Discharge Practices with the Modified Aldrete Recovery Score

Background: Efficient and safe discharge is critical in pediatric dental procedures performed under deep sedation in non-operating room anesthesia (NORA) settings. Traditional institutional criteria may delay discharge due to subjectivity. Objective: This study compared the Modified Aldrete Recovery Score (MAS) and institutional discharge criteria to determine which provides faster and reliable discharge decisions. Methods: In this prospective observational study, 100 children (ages 2–10, ASA I–III) undergoing deep sedation for dental treatment were evaluated. Two nurse anesthetists independently assessed discharge readiness every five minutes using either MAS or institutional criteria. Demographic data, BMI percentile, ASA class, anesthesia duration, and propofol dose were recorded. Discharge times were compared using Wilcoxon signed-rank and subgroup analyses and correlation tests. Results: MAS allowed significantly earlier discharge than institutional criteria (24.75 ± 7.33 vs. 36.79 ± 8.59 min, p = 0.01). The agreement between methods was poor (ICC = 0.06). Discharge time varied significantly by BMI percentile (p = 0.01); obese children had shorter recovery times, while time differences were greater in overweight children. No adverse events or readmissions occurred. Conclusions: MAS provides a quicker and equally safe discharge assessment in pediatric dental sedation. Its use may enhance workflow efficiency and standardize recovery decisions in NORA settings lacking formal PACUs.