GENERAL VERSUS REGIONAL ANESTHESIA IN AMBULATORY SURGERY

Abstract

Ambulatory anesthesia is continuing to evolve and has now become a recognized anesthesia subspecialty. There is increasing evidence that arbitrary limits placed on the type of surgery, age of patients, duration of operation, preoperative fasting period and selection of perioperative medication may be unwarranted.

Anesthetic care will continue to improve into the next century with the availability of more rapid-acting and shorter­ acting anesthetic, analgesic and muscle relaxant drugs, highly specific intravenous adjunctive drugs, as well as, improved administration and monitoring techniques.

The rational use of combinations of anesthetic drugs will provide for rapid and smooth induction, excellent intraoperative conditions, and fast recovery with minimal adverse effects. The incidence of anesthetic-related side effects may be altered depending on the premedication, the anesthetic technique, and the skill of the anesthesiologist.

Anesthesia and surgical procedures are most cost effective in outpatient surgical facilities than when the same procedures are performed in the in-patient setting because patients are discharged home soon after their operations.

The aim of this study was to compare three different anesthetic techniques (general, central neuroaxial and peripheral nerve blocks) as regards perioperative hemodynamic stability, recovery and discharge criteria, postoperative pain and the need for analgesia, postoperative nausea and vomiting (PONV) and the need for antiemetic, patient satisfaction and cost effectiveness.