Recovery from outpatient anaesthesia

Evaluation of Spinal Anaesthesia Using Low Dose Hyperbaric Bupivacaine for Day-Care Surgery

“…An out-patient should be a carefully selected patient who is undergoing a non emergency procedure and all its constituent elements (admission, surgical procedure and discharge home) on the same day (Korttila 1995) 5 6 .The ambulatory surgery unit (ASU) or phase II unit is a less expensive unit than the regular PACU; thus fast-tracking means savings in costs 6 . In most studies, the modified Aldrete scoring system has been used to determine fasttrack eligibility 7,8. For patients undergoing UA, the new tast tracking criteria are more suitable, since they also take into consideration the common side effects, nausea and pain ) and, according to these guidelines, the routine requirement of voiding before discharge has also been recommended to be necessary only for selected patients (i.e, highrisk patients).…”

Ambulante und tageschirurgische Eingriffe

“…Während Hatfield u.Tronson die Miktionsfähigkeit noch im ambulanten Operationszentrum als Bedingung für die Entlassung nach Hause ansehen, halten einige Autoren dies mittlerweile nicht mehr für notwendig [48], auch nicht nach Spinalanästhesie [35].Diese Auffassung stützt sich auf eine Untersuchung, nach der "nur" 3 von 30 Patienten, die ohne vorheriges Wasserlassen nach Spinalanästhesie entlassen wurden,zu Hause katheterisiert werden mussten. Die Anlage des Katheters wurde dabei von einer Pflegekraft übernommen, die die Patienten zu Hause betreute [35].Dieses Beispiel zeigt,dass einzelne Entlassungskriterien tendenziell einer Relativierung unterliegen,die unter dem Aspekt der Ökonomisierung der personalintensiven postoperativen Betreuung vorgenommen werden.…”

Desflurano: propriedades físico-químicas, farmacologia e uso clínico

“…Pode ser usado com grande margem de segurança em anestesia para cirurgia cardiovascular, considerando-se que oferece boa estabilidade hemodinâmica e não é arritmogênico. Paciente idosos toleram melhor agentes menos solúveis porque permanecem menos em seus organismos e deste modo interferem menos em suas atividades metabólicas celulares, especialmente em órgãos nobres como os componentes do sistema nervoso central 25 . Por esta razão, o desflurano é bem indicado para uso em anestesias destes pacientes que devem recuperar suas funções mentais o mais cedo possível 26 .…”

“…For such situations, desflurane is a very good choice 24 . Elderly patients tolerate better less soluble agents because they remain in their bodies for a shorter period thus interfering less with their cell metabolic functions, especially in noble organs such as central nervous system components 25 . So, desflurane is a good indication for such patients who need to recover their mental functions as soon as possible 26 .…”