Patient selection in ambulatory surgery

被引:26
作者
Lermitte, Jeremy [1 ]
Chung, Frances [1 ]
机构
[1] Univ Toronto, Toronto Western Hosp, Univ Hlth Network, Dept Anesthesia, Toronto, ON M5T 2S8, Canada
关键词
ambulatory anesthesia; ambulatory surgery; outpatient; patient selection;
D O I
10.1097/01.aco.0000188416.46061.37
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Purpose of review To evaluate the evidence regarding decisions made in the perioperative management of patients undergoing ambulatory surgery for the following: the elderly, hyper-reactive airways disease, coronary artery disease, diabetes, obesity, obstructive sleep apnea, the ex-premature infant and the child with an upper respiratory infection. Recent findings Major morbidity and mortality following ambulatory surgery is exceedingly low. Minor adverse cardiac events during the intraoperative period are associated with hypertension and the elderly. Minor adverse respiratory events during the intraoperative period are associated with obesity. Respiratory events during the postoperative period are associated with obesity, smoking and asthma. Prolonged stays following ambulatory surgery are predominantly caused by surgical factors or minor symptoms such as pain or nausea. Surgical factors are also the main causes of unplanned admissions. Age greater than 85, significant co-morbidity and multiple admissions to hospital in the 6 months preceding ambulatory surgery, however, are associated with higher readmission rates. Summary Evidence indicates that ambulatory anesthesia is currently very safe. Ambulatory surgery, however, is being offered to a population with increasing co-morbidity. As the population undergoing ambulatory surgery changes over time, the evidence regarding patient outcomes will need re-examination.
引用
收藏
页码:598 / 602
页数:5
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