# Anaesthesia and surgery Anaesthesia and surgery It is not expected that there should be any di ff erence in surgical technique. Surgeons should perform their usual operation, which should be appropriate for rapid recovery and should be performed well. Drains should generally be avoided or, if used, clear plans of when they should be removed and by whom made clear. Any specific postoperative care or discharge information should be documented in theatre to avoid delay to discharge. Appropriate day surgery anaesthesia requires meticulous attention to ensuring good pain relief and avoidance of postoperative nausea and vomiting. This should include premedica tion and a multimodal approach. Short-acting general anaesthesia agents, day case spinals or regional anaesthesia techniques should be used to enable rapid recovery . Use of long-acting opioids such as intravenous morphine is discouraged because they can delay recovery owing to increased sleepiness or nausea. - Do you live alone? Yes Is it laparoscopic or a airway surgery? Yes Carer at home or inpatient Yes Can you get someone? No Yes Inpatient Home TABLE 22.4 List planning. Operation with potentially Types of patients who might longer recovery times need longer recovery time Tonsillectomy Very elderly Knee replacement High BMI Hip replacement Complex laparoscopic cholecystectomy BMI, body mass index. Anaesthesia and surgery It is not expected that there should be any di ff erence in surgical technique. Surgeons should perform their usual operation, which should be appropriate for rapid recovery and should be performed well. Drains should generally be avoided or, if used, clear plans of when they should be removed and by whom made clear. Any specific postoperative care or discharge information should be documented in theatre to avoid delay to discharge. Appropriate day surgery anaesthesia requires meticulous attention to ensuring good pain relief and avoidance of postoperative nausea and vomiting. This should include premedica tion and a multimodal approach. Short-acting general anaesthesia agents, day case spinals or regional anaesthesia techniques should be used to enable rapid recovery . Use of long-acting opioids such as intravenous morphine is discouraged because they can delay recovery owing to increased sleepiness or nausea. - Do you live alone? Yes Is it laparoscopic or a airway surgery? Yes Carer at home or inpatient Yes Can you get someone? No Yes Inpatient Home TABLE 22.4 List planning. Operation with potentially Types of patients who might longer recovery times need longer recovery time Tonsillectomy Very elderly Knee replacement High BMI Hip replacement Complex laparoscopic cholecystectomy BMI, body mass index. Anaesthesia and surgery It is not expected that there should be any di ff erence in surgical technique. Surgeons should perform their usual operation, which should be appropriate for rapid recovery and should be performed well. Drains should generally be avoided or, if used, clear plans of when they should be removed and by whom made clear. Any specific postoperative care or discharge information should be documented in theatre to avoid delay to discharge. Appropriate day surgery anaesthesia requires meticulous attention to ensuring good pain relief and avoidance of postoperative nausea and vomiting. This should include premedica tion and a multimodal approach. Short-acting general anaesthesia agents, day case spinals or regional anaesthesia techniques should be used to enable rapid recovery . Use of long-acting opioids such as intravenous morphine is discouraged because they can delay recovery owing to increased sleepiness or nausea. - Do you live alone? Yes Is it laparoscopic or a airway surgery? Yes Carer at home or inpatient Yes Can you get someone? No Yes Inpatient Home TABLE 22.4 List planning. Operation with potentially Types of patients who might longer recovery times need longer recovery time Tonsillectomy Very elderly Knee replacement High BMI Hip replacement Complex laparoscopic cholecystectomy BMI, body mass index.