European Society of Anaesthesiology.

None.

Summary Guidelines are presented for the organisational and clinical management of anaesthesia for day‐case surgery in adults and children. The advice presented is based on previously published recommendations, clinical studies and expert opinion.

Patients exposed to a surgical safety checklist experience better postoperative outcomes, but this could simply reflect wider quality of care in hospitals where checklist use is routine.

Paracetamol and diclofenac have different mechanisms of action, and the combination may be more effective than each drug used alone in treating postoperative pain. In a double-blind, controlled design, we studied 60 patients undergoing elective abdominal gynaecological surgery, who received suppositories of paracetamol 1.5 g, diclofenac 100 mg or a combination of the two before the start of surgery. Patients received morphine in the intraoperative period, and cumulative morphine use from a patient-controlled analgesia system was recorded to measure the analgesic effect of the suppositories. Morphine consumption was greatest in the group that received paracetamol alone and lowest in the group given the combination (P < 0.01). There was no difference in the incidence of morphine-related side effects between the groups. We conclude that a diclofenac-paracetamol combination reduced the amount of morphine used compared with paracetamol alone.

This article describes the use of a quality improvement clinical audit approach to identify insertion practices, duration of therapy, and complications related to peripheral intravenous catheters. These data provide evidence for adherence to practice standards and benchmarks for evaluation of new interventions to improve the safety and efficacy of intravenous access practices. Implications for quality improvement and clinical research related to intravenous-device practices within the neonatal intensive care unit are discussed.

With good pre-assessment and adequate preparation ASA III patients can be treated safely in the day surgery setting.

SummaryThe elderly are a group of patients who would seem ideally suited to day surgery. However, age was initially regarded as a potential barrier to this process. We conducted a retrospective review of 1647 elderly patients (> 70 years of age) over a two-year period. Our results show a favourable outcome for these patients with low rates of unplanned admission and postoperative complications. Elderly patients seem to be at no increased risk of complications after day surgery, and show excellent satisfaction scores.