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Outcomes, Measures and Recovery After Ambulatory Surgery and Anaesthesia: A review

Ambulatory surgery is becoming increasingly adopted and today more complex procedures and not only ASA 1–2 patients are scheduled to undergo surgery according to a fast track concept. Rapid recovery and resumption of capacity to stand, walk, void, eat and drink is essential for safe discharge. There is, however, an increasing need for better way to assess and measure recovery and outcome after surgery and anaesthesia. Morbidity and unplanned admission are no longer deemed adequate for assessing quality of performance or to use as tool to measure efforts to improve the medical care and or logistics. There are several aspects that should be considered when analysing the recovery process and measuring outcome after ambulatory surgery and anaesthesia. The Postoperative Quality of Recovery scale is a multi-dimensional tool that has been shown to be able to quantify and discriminate the recovery process. This review will provide an overview of recovery and outcome following ambulatory surgery/anaesthesia.

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Systemic Lidocaine Decreased the Perioperative Opioid Analgesic Requirements but Failed to Reduce Discharge Time After Ambulatory Surgery

Perioperative systemic lidocaine significantly reduces opioid requirements in the ambulatory setting without affecting time to discharge. Postoperative pain is the most common reason for delay in discharge and unplanned hospital admission after ambulatory surgery. 1–3 Because postoperative pain is to a large extent an inflammatory phenomenon, administration of systemic local anesthetics, which have inflammatory modulatory properties, 4 could significantly reduce pain and therefore allow more rapid discharge. 5 Lidocaine has an excellent safety record when administered by low-dose infusion. 5–7 However, whereas decreased hospital stay after inpatient surgery has been demonstrated, the effect of intraoperative and early postoperative lidocaine infusion on duration of stay after ambulatory surgery is not known. Although it see...