Abstract
Ambulatory surgery has increased in popularity in response to rising costs of inpatient hospital care. The technological developments in medicine, surgery, pharmacology and anaesthesia management also advanced ambulatory surgery. At present, 60– 70% of surgery in North America is performed on an ambulatory basis. The increasing number and complexity of operations being performed on an outpatient basis presents many unique challenges to the anaesthetists. The symposium on “Practical Issues in Outpatient Anaesthesia” was presented at the 1995 Annual Meeting of Canadian Anaesthetists’ Society in Ottawa, Ontario. The symposium was divided into three parts. The first part dealt with the management of postoperative pain and emesis in outpatients, the second part dealt with the practical infection control issues and the third part dealt with the practical discharge issues.
Ambulatory anaesthesia will play an ever-important role in the decade of the nineties. As more extensive and painful surgical procedures are being performed on an outpatient basis, anaesthetic techniques to improve analgesia with decreased emesis is needed to improve our ability to provide cost-effective care. The safe and expeditious conduct of ambulatory surgical care can only succeed by careful selection of patients and surgical procedures, appropriate intraoperative and postoperative anaesthetic care, prudent and timely discharge of patients.
Résumé
L’augmentation des coûts hospitaliers a propagé la pratique de la chirurgie ambulatoire. Les progrès technologiques réalisés en médecine, en chirurgie, en pharmacologie et en anesthésie se sont aussi appliqués à la chirurgie ambulatoire. Présentement, en Amérique du nord, de 60 à 70% de la chirurgie est effectuée en mode ambulatoire. L’augmentation du nombre et de la complexité des interventions ainsi réalisées présente un défi réel pour l’anesthésiste. Un symposium portant sur les aspects pratiques de l’anesthésie ambulatoire a été présenté au congrès annuel de la Société canadienne des anesthésistes à Ottawa. Le symposium était divisé en trois sections. La première portait sur la gestion de la douleur postopératoire et des vomissements, la seconde sur le contrôle des infections et la troisième sur le congé de l’hôpital.
Au cours des années 90, l’anesthésie ambulatoire aura joué un rôle de premier plan. Comme des interventions plus compliquées et plus douloureuses sont effectuées chez des patients ambulatoires, des techniques anesthésiques visant à améliorer l’analgésie tout en diminuant l’incidence des vomissements sont essentielles si on veut procurer des soins de qualité tout en limitant les coûts. Dans le domaine des soins ambulatoires, on ne peut réunir la sécurité à la diligence que par une sélection pertinente des patients et des interventions, des soins peropératoires et postopératoires appropriés, et une autorisation de départ prudente et opportune.
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Berry, A.J. Practical infection control. Can J Anaesth 42, 1051–1053 (1995). https://doi.org/10.1007/BF03011081
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DOI: https://doi.org/10.1007/BF03011081