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Outpatient Surgery

  • Kelly R. Mercer
Chapter

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.

Keywords

Outpatient surgery Ambulatory surgery Continuous perineural catheter Single-shot technique Infusion pump Outpatient regional service 

References

  1. 1.
    Hall MJ, Lawrence L. Ambulatory surgery in the United States, 1996. Adv Data. 1998;359:1–16.Google Scholar
  2. 2.
    Chung F, Ritchie E, Su J. Postoperative pain in ambulatory surgery. Anesth Analg. 1997;85:808–16.CrossRefPubMedGoogle Scholar
  3. 3.
    Rawal N, Hylander J, Nydahl PA. Survey of postoperative analgesia following ambulatory surgery. Acta Anaesthesiol Scand. 1997;41:1017–22.CrossRefPubMedGoogle Scholar
  4. 4.
    Brown AR, Weiss R, Greenberg C, et al. Interscalene block for shoulder arthroscopy: comparison with general anesthesia. Arthroscopy. 1993;9:295–300.CrossRefPubMedGoogle Scholar
  5. 5.
    White P, Issioui T, Skrivanek G, Early J, Wakefield C. The use of a continuous popliteal sciatic nerve block after surgery involving the foot and ankle: does it improve the quality of recovery? Anesth Analg. 2003;97:1303–9.CrossRefPubMedGoogle Scholar
  6. 6.
    Liu SS, Strodtbeck WM, Richman JM, Wu CL. A comparison of regional versus general anesthesia for ambulatory anesthesia: a meta-analysis of randomized controlled trials. Anesth Analg. 2005;101:1634–42.CrossRefPubMedGoogle Scholar
  7. 7.
    Ilfeld B, Morey T, Wright T, Chidgey L, Enneking FK. Continuous interscalene brachial plexus block for postoperative pain control at home: a randomized, double-blinded, placebo-controlled study. Anesth Analg. 2003;96:1089–95.CrossRefPubMedGoogle Scholar
  8. 8.
    Williams B, Kentor M, Vogt M, Williams J, Chelly J, Valalik S, et al. Femoral-sciatic nerve blocks for complex outpatient knee surgery are associated with less postoperative pain before same-day discharge. Anesthesiology. 2003;98:1206–13.CrossRefPubMedGoogle Scholar
  9. 9.
    Macaire P, Gaertner E, Capdevila X. Continuous post-operative regional analgesia at home. Minerva Anestesiol. 2001;67:109–16.PubMedGoogle Scholar
  10. 10.
    Fredrickson M, Ball C, Dalgleish A. Successful continuous interscalene analgesia for ambulatory shoulder surgery in a private practice setting. Reg Anesth Pain Med. 2008;33:122–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Ilfeld B, Morey T, Enneking FK. Continuous infraclavicular brachial plexus block for postoperative pain control at home. Anesthesiology. 2002;96:1297–304.CrossRefPubMedGoogle Scholar
  12. 12.
    Ilfeld B, Morey T, Wang RD, Enneking FK. Continuous popliteal sciatic nerve block for postoperative pain control at home. Anesthesiology. 2002;97:959–65.CrossRefPubMedGoogle Scholar
  13. 13.
    Rawal N. Postoperative pain treatment for ambulatory surgery. Best Pract Res Clin Anesthesiol. 2007;21:129–48.CrossRefGoogle Scholar
  14. 14.
    Klein SM, Buckenmaier CC. Ambulatory surgery with long acting regional anesthesia. Minerva Anestesiol. 2002;68:833–47.PubMedGoogle Scholar
  15. 15.
    Cucchiaro G, Ganesh A. The effects of clonidine on postoperative analgesia after peripheral nerve blockade in children. Anesth Analg. 2007;104:532–7.CrossRefPubMedGoogle Scholar
  16. 16.
    Casati A, Magistris L, Fanelli G, Beccaria P, Cappelleri G, Aldegheri G, et al. Small-dose clonidine prolongs postoperative analgesia after sciatic-femoral nerve block with 0.75% Ropivicaine for foot surgery. Anesth Analg. 2000;91:388–92.PubMedGoogle Scholar
  17. 17.
    Capdevila X, Bringuier S, Borgeat A. Infectious risk of continuous peripheral nerve blocks. Anesthesiology. 2009;110:182–8.CrossRefPubMedGoogle Scholar
  18. 18.
    Liu S, Salinas FV. Continuous plexus and peripheral nerve blocks for postoperative analgesia. Anesth Analg. 2003;96:263–72.PubMedGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.UAB Department of Anesthesiology and Perioperative MedicineUniversity of Alabama HospitalBirminghamUSA

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