Anesthesiology Oral Board Flash Cards > Procedures

Ambulatory Surgery

"Anesthetics with adequate recovery profile

Major complications (MI, stroke, PE, respiratory failure) are rare

Minor complications (pain, PONV, sore throat, somnolence, hypotension, hypertension, and bleeding) are common

Ease of transfer in case of unplanned admission? Know your surroundings—office-based procedure, freestanding ambulatory surgery center, or hospital

Predictors of hospital admission after ambulatory surgery: >65 years, prior inpatient admission in last 6 months, invasiveness of surgery, surgery >2 hours, general anesthesia rather than regional anesthesia

Unanticipated admission causes: Medication—complications from preexisting diseaseSurgical—direct complication, pain, bleedingAnesthesia—aspiration, PONV, somnolenceSocial—no escort, long distance from home

Controversial patients for ambulatory surgery—elderly, morbid obesity, severe OSA, significant COPD or asthma, and infants (risk of apnea if postconceptual age <60 weeks)

ENT, urology, and generally surgery—higher rates of unanticipated admission

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