Ambulatory Anaesthesia/ Anestēzija Ambulatorajā Ķirurģija

Ambulatory (outpatient) surgery refers to the admittance into hospital on the day of surgery of carefully selected and prepared patients for a planned surgical procedure and their discharge within hours. About 65% of all surgical procedures are performed on an outpatient basis. There are many benefits of ambulatory surgery: cost reduction up to 25-75%, efficiency, shorter waiting lists, lower cancellation rate, patient convenience, low morbidity/mortality, less infections and respiratory complications and less medication. All patients should follow a sequential pathway and be pre-assessed according to a set of ambulatory case criteria (health status, age, complexity of surgery, transport, and social support). An anaesthesia plan is developed by an anaesthesiologist, then accepted by the patient after discussion and documented. Anaesthetic management includes the usage of local anaesthetic or short-acting general anaesthetic drugs with fewer residual psychomotor effects and low incidence of postoperative malaise. Medical discharge criteria as well as the discharge organisation are also important. The readmission rate after outpatient surgery is about 1%. Nausea/vomiting, pain and operative site bleeding are the most common causes. Extended stay or inpatient facilities should be available for patients who cannot be discharged after a reasonable stay in the post-anaesthesia care unit areas