Chapter

Regional anaesthesia for day-care surgery

Stuart Grant

in Principles and Practice of Regional Anaesthesia

Fourth edition

Published on behalf of Oxford University Press

Published in print November 2012 | ISBN: 9780199586691
Published online November 2012 | e-ISBN: 9780191755507 | DOI: http://dx.doi.org/10.1093/med/9780199586691.003.0024

Series: Oxford Textbooks in Anaesthesia

Regional anaesthesia for day-care surgery

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The continued growth of day surgery has led to more invasive, more prolonged, and increasingly painful procedures being performed (McGrath et al. 2004). With such large numbers of patients undergoing routine surgery the working practices of day units must be geared to proper selection of suitable patients, efficient management of operating time, and the rapid restoration of the patients to ‘street fitness’ so that they can be discharged home with the minimum of postoperative morbidity. In well-run units, the unplanned admission of patients to an in-patient bed after surgery should be no more than 2–3% of total activity, and many units manage a lower incidence than this. A number of factors predict unanticipated admission after day-care surgery, but the common reasons include pain, excessive drowsiness, and postoperative nausea & vomiting (PONV) (Chung & Mezei 1999, Fortier et al. 1998). The ability to discharge patients home and avoid subsequent readmission relies greatly on the appropriate use of regional anaesthesia to minimize these sequelae, either directly or by reducing general anaesthetic and opioid requirements (Chan et al. 2001).

Chapter.  6429 words. 

Subjects: Anaesthetics ; Clinical Skills

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