Day surgery procedures, Selection of patients

February 23, 2013 | By | Reply More

Day surgery procedures, Selection of patients

Day surgery procedures
An increasing number of procedures in all aspects of surgery are being performed as day surgery. The key features that make a procedure suitable include:
  • low risk of major complications;
  • predictable recovery period not requiring specialist postoperative therapy or treatment;
  • postoperative analgesia that does not need routine opiates;
  • anaesthetic technique not requiring invasive monitoring, prolonged muscle relaxation, or epidural/spinal anaesthesia;
  • low risk of difficult or unpredictable anaesthetic technique.
Many areas of surgery are now performed routinely as day surgery, including minor and intermediate anorectal surgery, hernia surgery, minor laparoscopic surgery, arthroscopy, and minor endoscopic bladder surgery.
Selection of patients for day case surgery
Most hospitals have well defined protocols to select patients for suitability for day surgery and most day surgery units conduct their own preadmission assessment either by telephone or questionnaire. Typical criteria might include:
  • maximum age of 75y (this upper limit has gradually increased as familiarity with the procedures has grown);
  • appropriate social support for the patient at home, including transport and a responsible adult to monitor progress;
  • no history of more than mild to moderate cardiac or respiratory disease (e.g. uncomplicated asthma or controlled angina);
  • non-insulin dependent diabetes only (unless for LA procedures);
  • BMI below 35 (typically)—higher than this is associated with increased risk of anaesthetic and surgical complications.

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Category: Surgery

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