Anesthetic Management of Ambulatory Surgery

Abstract

When surgery is performed outside the conventional hospital environment, it can offer a number of advantages for patients, health care providers, medical insurance companies, and even hospital. Patient benefit from day-surgery because it decreases separation from their home and family environment, decrease their likelihood of contracting hospital acquired infections and reduces postoperative complication. Compared to traditional hospital admission, there is less preoperative laboratory testing and also a reduced demand for postoperative medications following ambulatory surgery. Unlike inpatient surgery, ambulatory surgery does not depend on the availability of a hospital bed and may permit the patient greater flexibility in selecting the time of their operation. Furthermore, there is greater efficiency in the utilization of the operating and recovery rooms in the ambulatory setting, contributing to a decrease in the overall patient charges compared to similar in-hospital care. Surgical procedures suitable for ambulatory surgery should be accompanied by minimal postoperative physiologic impairment and uncomplicated recovery. A wide variety of operations may now be performed on an outpatient basis. Selection decisions must be based upon physical status of the patient , invasiveness of the surgical procedure. ,where the procedure will be performed, its equipment, staff and their capabilities and reliability of the given surgeon. Length of operation is no longer a problem, long surgical procedures are regularly performed on outpatients, and with careful preoperative selection and postoperative management The premature infant is not a suitable candidate for ambulatory surgery because of potential immaturity of respiratory center, temperature control, and gag reflexes.