Overview of anaesthesia and patient selection for day surgery

This article looks at the selection and preoperative assessment of patients for day surgery and includes a discussion of the ‘ideal’ anaesthetic for day surgery. The NHS has a target of 75% of all elective procedures being performed in the day case setting (defined as stays of under 24 hours) and day case surgery in the UK has grown as a result of economic pressure, limited resources, and modern medical techniques so that the British Association of Day Case Surgery now recommends more than 200 operations as day case procedures. A successful service revolves around selection criteria for patients and procedures, with the correct procedure being coupled to the correct patient. Suitable surgical and anaesthetic techniques must be employed aiming to minimize postoperative morbidity especially postoperative nausea and vomiting (PONV). The use of analgesic premedication, supplemental local anaesthesia, delicate tissue handling, and positive psychological reinforcement will help this, as will using techniques that minimize postoperative pain (including that from airway devices) and have a minimal ‘hangover’ effect.