Outpatient Surgery

Abstract

The volume of outpatient surgical cases performed in the United States and worldwide continues to expand, paralleling advances in surgical and anesthetic techniques. Today, upward of 60–70% of all surgical procedures in the United States are performed on an outpatient basis (Hall and Lawrence. Adv Data 359:1–16, 1998). This increase in outpatient volume offers an opportunity for healthcare providers to not only increase patient satisfaction but also provide a vehicle for cost containment in an era of ever-increasing healthcare expenses. Both anesthesiologists and surgeons are tasked with the challenge of expediting patient discharge. This is accomplished by optimizing recovery and decreasing side effects of surgery and anesthesia such as postoperative pain, nausea, vomiting, and oversedation (Chung et al. Anesth Analg 85:808–16, 1997; Rawal et al. Acta Anaesthesiol Scand 41:1017–22, 1997). Regional anesthesia, within the constructs of a multimodal analgesic regimen, helps address this challenge and can help expedite the transition from the operating room to home.

Review Questions

• 1. Postoperative follow-up of block performance as well as surveillance for any potential complications is important in any practice. Questions regarding block performance should include which of the following topics?

• (a) Pain intensity

• (b) Motor function

• (c) Sensory function

• (d) All of the above

• 2. Characteristics of patients who are likely to successfully manage a perineural catheter from home include…

• (a) Adequate cognitive ability with a good support/caregiver network

• (b) Poor cognitive ability

• (c) Multiple comorbidities/medications

• (d) Absence of adequate social support

• 3. Which of the following blocks may precipitate respiratory distress via partial diaphragmatic paralysis in a susceptible patient?

• (a) Axillary block

• (b) Infraclavicular block

• (c) Interscalene block

• (d) Femoral block

Answers

• 1. d

• 2. a

• 3. c