Outpatient surgery in paediatric patients

Abstract

As with spinal anaesthesia, outpatient surgery in paediatric patients has been practiced since the start of this century. It constituted a substantial part of paediatric anaesthesia even before the days of health care budget cuts, due both to the fact that most paediatric surgical procedures can be regarded as minor surgery and thus are well suited to be performed on an outpatient basis and also because of the psychological advantages for the child and parents when hospitalization can be avoided. Currently, outpatient surgery is very much “en vogue” mainly for financial reasons and more and sicker patients are now being treated as day cases. Although oupatient vs inpatient surgery represents true savings for the health care system and is also frequently viewed as an improvement by the patient, anaesthesiologists have to be very professional and careful not to be pressured into performing anaesthesia in patients that are not suitable as outpatients. The occasional complication that might occur due to the lack of postoperative supervision can dramatically affect the economic aspects of day care and, thus, quality control is essential. In the presently changing medicolegal climate one should also be very careful with the selection of patients that are to undergo outpatient surgery.