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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 avoide...

DAY SURGERY In the UK the definition of day surgery is the admission of selected patients to hospital for a planned surgical procedure, returning home on the same day . ‘True day surgery’ patients are day case patients who require full operating theatre facili...

DELIVERY OF DA Y SURGERY Facilities National guidance from the Royal College of Anaesthetists, Royal College of Surgeons and BADS recommends that, ideally , day surgery should be performed in a dedicated unit with its own admission area, operating theatres a...

Discharge The expectation by the patient and healthcare team should be that the patient will be going home the same day . Therefore, unless there has been an unexpected anaesthetic or surgical issue the patient should routinely have a nurse-led discharge. Pati...

EMERGENCY DA Y SURGERY Many emergency surgical procedures are minor and non-life-threatening. Patients may be considered low priority for surgical intervention and can therefore end up waiting hours or days for a slot on the emergency theatre list, resulting i...

FURTHER READING Bailey CR, Ahuja M, Bartholomew K et al . Guidelines for day-case surgery 2019: guidelines from the Association of Anaesthetists and the British Association of Day Surgery . Anaesthesia 2019; 74 (6): 778–92. British Association of Day Surger...

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Learning objectives To understand: The key components of the day surgery pathway • Which surgical procedures can be done as day surgery • Patient selection and preparation for day surgery • Learning objectives To understand: The key components of the day surge...

Medical With the developments of anaesthesia and surgery , there should be very few restrictions to patients having day surgery ( Table 22.2 ). Every e ff ort should be made to optimise a patient’s health so that they can be treated as a day case. There should...

Preoperative assessment A key component to successful day surgery is a well-informed, well-prepared patient. It is essential that the day surgery message starts at the time of referral by the primary care doctor and continues throughout the pathway by all sta ...

SELECTION CRITERIA Surgical Surgical techniques have progressed significantly and now cause less physiological disruption and stress to patients; therefore, they have a lower postoperative complication profile and a faster recovery rate. The British Association ...

Social Social criteria for day surgery include: /uni25CF Adequate housing conditions such as heating, an inside toilet and access to a phone. /uni25CF The patient should live within a 1-hour drive of a hospital. /uni25CF A responsible adult should be able to ...

Chronic pain Chronic pain is defined as pain that persists or recurs for more than 3 months. In chronic pain syndromes, pain can be the sole or a leading complaint and requires special treatment and care. This could be ‘chronic primary pain’, which may be conce...

Common local anaesthesia techniques Topical anaesthesia /uni25CF EMLA (eutectic mixture of local anaesthetics) This is a mixture of lidocaine and prilocaine for applica tion to the skin for venepuncture in children. Johann Friedrich Horner , 1831–1886, Profe...

GENERAL ANAESTHESIA General anaesthesia is commonly described as the triad of unconsciousness, analgesia and muscle relaxation. Summary box 23.2 The general anaesthetic triad /uni25CF /uni25CF /uni25CF Induction of general anaesthesia is most frequently done ...

HISTORY Anaesthesia, as we know it today , was first successfully demon strated by William Morton, a local dentist, at the Massachu setts General Hospital, Boston, MA, USA on 16 October 1846 when he administered ether to Gilbert Abbot for an operation on a vasc...

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KEY PRINCIPLES OF ANAESTHESIA Optimum patient care is dependent on a collaborative approach by the anaesthetic and surgical teams. The importance of multidisciplinary collaboration has been clearly demonstrated by national audits such as the National Confidenti...