Clinical Evaluation of Ambulatory Surgical Patients

Kim, Soo Yeoun; Lee, Youn Woo; Lee, Young Seok; Kim, Yoon Ae; Kim, Jong Rae

Abstract

Ambulstory surgery in a hospital-based setting has been practiced at Yongdong Severance Hospital since August 1983. Several factors favor ambulatory surgery over the inpatient approach, first, hospital costs are decreased, second, it is less disruptive to the patient's personal life and the risk of hospital-acquired infection can be significantly decreased. The charts of 1913 patients who were anesthetized for ambulatory surgery were analyzed retrospectively to obtain better guidance for anesthetic management in ambulatory surgical patients. The results are as follows: 1) The number of patients has been increasing since 1983. 2) A total of 1913 patients were evaluated, including 660 males and 1253 females, ranging in age from 5 months to 80 years and averaging 26 years. 3) The operations performed were grouped into: gynecologic(33.9% of the cases), otolaryngologic(33.7%), orthopaedic(10.4%), etc. The most frequent procedures were diagnostic dilation and curettage(23.7%) and excision(17.6%). 4) General anesthesia was performed for 852 patients(44.5%) and the anesthetic agents administered were intravenous narcotics in 360 cases, halothane-N2O-O2 in 289 cases, enflurane-N2O-O2 in 67 cases, etc. Nongeneral anesthesia was included regional nerve block in 76 cases(4.0%) and local infiltration in 985 cases(51.5%). 5) Anesthesia lasted less than one hour in 79.2% of the cases. Recovery time lasted less than one hour in 88.0% of the cases. 6) Only one patient was admitted for an anesthetic reason which was aspiration pneumonia. Seventeen patients were admitted for surgical reasons such as fever, bleeding, etc. From the above results, we believe that anesthetic care for ambulatory surgical patients can be provided safely and cost saving. Safety is an attitude, and when good practice is followed in selection of patients with careful preanesthetic evaluation and careful anesthetic technique, there is no reason to expect more complication than under the circumstance of hospitalization.