Ann R Coll Surg Engl 2008; 90: 62-64 62Day-case surgery has become more popular in recent times. It benefits the patient as no stay in hospital is required enabling recovery at home with family and friends and, most importantly, decreases the risk of nosocomial infection.1 Day-case surgery also carries benefits to the health service as it reduces pressure on in-patient beds and eliminates the cost of an overnight admission. One risk of day-case surgery is in-patient admission following the operation. One factor necessitating an overnight admission is severe postoperative pain. Such a change in plan can be disruptive to both the patient, who was psychologically prepared to return home, and the hospital that will be required to allocate a bed to that patient at short notice. [4][5][6][7] Significant co-morbid factors such as high body mass index, hypertension and ischaemic heart disease adversely affect overall suitability for day-case surgery. The purpose of this study was to identify any factors predictive of in-patient admission following arthroscopic sub-acromial decompression (ASAD) of the shoulder planned as a day-case procedure.
Patients and MethodsA retrospective review was performed at the Day Surgical Unit (DSU) of the Royal Hampshire County Hospital, Winchester, UK. Over a 2-year period (June 2002 to June 2004), 27 day-case ASAD procedures were performed in 27 patients in the DSU. These would have previously been performed as an in-patient.All operations were performed under general anaesthesia without regional block anaesthesia but with local anaesthetic infiltration at the end of the procedure (20 ml 0.5% chirocaine). The postoperative analgesia was standardised with patients being given co-dydramol and diclofenac upon discharge from the DSU. Three patients did not receive diclofenac due to drug sensitivity. Admission following day-case surgery can be problematic for both the patient and the health service. The purpose of this study was to identify any factors predictive of admission following arthroscopic sub-acromial decompression (ASAD) of the shoulder planned as day-case procedures.
Summary: The beneficial effect of haemarthrosis aspiration in 13 women and one man aged over 60 years following anterior dislocation of the shoulder was compared with non-aspiration in a similar group of patients matched for age and sex. The results showed a consistent reduction in pain, early increased range of movement and earlier return of functional activity in the aspirated group. It is proposed that this simple therapeutic procedure be used to aid rehabilitation in the over-60 age group following anterior dislocation of the shoulder.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.