Trends in day surgery rates

Aylin, Paul; Williams, Susan; Jarman, Brian; Bottle, Alex

doi:10.1136/bmj.331.7520.803

Cited by 37 publications

(28 citation statements)

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“…The incidence and popularity of ambulatory surgery (also known as day-case or outpatient surgery) have increased rapidly over the last two decades, from over 500 000 cases annually in the UK in the 1990s to over 700 000 in 2005, and are continuing to rise [1]. This is related primarily to cost savings and enhanced convenience for patients [2,3].…”

Section: Introductionmentioning

confidence: 99%

A comparison of total intravenous anaesthesia using propofol with sevoflurane or desflurane in ambulatory surgery: systematic review and meta‐analysis

et al. 2014

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SummaryWith the popularity of ambulatory surgery ever increasing, we carried out a systematic review and meta-analysis to determine whether the type of anaesthesia used had any bearing on patient outcomes. Total intravenous propofol anaesthesia was compared with two of the newer inhalational agents, sevoflurane and desflurane. In total, 18 trials were identified; only trials where nitrous oxide was administered to, or omitted from, both groups were included. A total of 1621 patients were randomly assigned to either propofol (685 patients) or inhalational anaesthesia (936 patients). If surgical causes of unplanned admissions were excluded, there was no difference in unplanned admission to hospital between propofol and inhalational anaesthesia (1.0% vs 2.9%, respectively; p = 0.13). The incidence of postoperative nausea and vomiting was lower with propofol than with inhalational agents (13.8% vs 29.2%, respectively; p < 0.001). However, no difference was noted in post-discharge nausea and vomiting (23.9% vs 20.8%, respectively; p = 0.26). Length of hospital stay was shorter with propofol, but the difference was only 14 min on average. The use of propofol was also more expensive, with a mean (95% CI) difference of £6.72 (£5.13-£8.31 (€8.16 (€6.23À€10.09); $11.29 ($8.62-$13.96))) per patient-anaesthetic episode (p < 0.001). Therefore, based on the published evidence to date, maintenance of anaesthesia using propofol appeared to have no bearing on the incidence of unplanned admission to hospital and was more expensive, but was associated with a decreased incidence of early postoperative nausea and vomiting compared with sevoflurane or desflurane in patients undergoing ambulatory surgery.

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Section: Introductionmentioning

confidence: 99%

A comparison of total intravenous anaesthesia using propofol with sevoflurane or desflurane in ambulatory surgery: systematic review and meta‐analysis

et al. 2014

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“…[5] Paul Aylin et al in their study showed that the British NHS plan has predicted 75% of all elective operations would be managed as a day care procedures. [17] The American Academy of Head and Neck surgery considers Tonsillectomy in Adults as a day care procedure preferred if the cases were selected carefully enough. [19] All the above mentioned trials like our study conclude that the rate of primary or reactionary hemorrhage was too low to dictate the length of stay is hospital.…”

Section: Resultsmentioning

confidence: 99%

Adult Tonsillectomy as a Day care Procedure - Our Experience

Anoop¹,

Kumar²,

Naseeruddin³

et al. 2017

Ann. Int. Med. Den.Res.

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Background: Adult Tonsillectomy as a day care procedure is challenging task for any ENT surgeon because of the sole reason of haemorrhage encountered during Tonsillectomy as the surgeon and anesthetist has to compromise at the airway for the surgery to be done under general anesthesia. With proper patient selection, adequate pre-operative care, meticulous surgical dissection, good post-operative care can bring out success in day care procedure. Thus we can reduce the burden to the patients as well as hospital staff in terms of time, man power, hospital resources, money and less period of hospital stay. Methods: In our present study we have performed adult tonsillectomy as a day care procedure for selected 70 patients between the ages of 16 years to 35 years. Patients were selected with the diagnosis of chronic Tonsillitis and obstructive sleep apnea. Tonsillectomy was performed by using Dissection and snare method. Results: In our study of 70 patients, we observed that 2 cases had reactionary hemorrhage due to the presence of clot in the tonsillar fossa, which were managed with the simple treatment. There were no cases of secondary haemorrhage. Conclusion: Thus we conclude the adult tonsillectomy can be performed as a day care procedure with a careful selection of the case, pre and post-operative management as this will be more economical by reducing the cost as well as hospital stay for the patient

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“…Increasing use of minimally invasive procedures, postoperative enhanced recovery pathways and day surgery facilities [8] have improved time to discharge and return to normal activities [9]. However, comparatively little focus has been made on the patient's pre-operative journey.…”

Section: Discussionmentioning

confidence: 99%