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Chapter 27 - Anesthesia for Ambulatory Surgical Procedures

Published online by Cambridge University Press:  24 May 2023

Alan David Kaye
Louisiana State University School of Medicine
Richard D. Urman
Brigham and Women’s Hospital, Boston
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Ambulatory surgery centers (ASCs) have become the place of choice for an increasing number of diagnostic and surgical procedures. Improvements in anesthesia and pain control, minimally invasive surgical techniques, patient expectations, and economic factors have driven this increase in number and complexity of procedures performed at ASCs. Patients with significant comorbidities are also making up an increasing proportion of the population undergoing ambulatory procedures. There are multiple advantages with performing same-day surgical procedures in this setting – the cost of care is lower, in comparison with same-day procedures performed in hospital; waiting times and ease of access are also more convenient for patients and caretakers; and physicians can maximize the use of their operating room time by having efficient scheduling practices. At the same time, and in order to maintain the viability of ASCs, it is fundamental to understand the factors that make for a successful ambulatory surgical practice, such as optimal patient and procedure selection, preoperative preparation, anesthesia management and pain control strategies, management of postanesthesia care unit (PACU) complications, appropriate staffing and management of human resources, and contingency plans in the event of changes in patient condition that require hospital admission for further diagnosis or treatment.

Publisher: Cambridge University Press
Print publication year: 2023

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Further Reading

Boezaart, AP. Primer for Regional Anesthesia Anatomy: Macroanatomy, Microanatomy, and Sonoamatomy, 3rd ed. LLC; 2018.Google Scholar
Brennan, M, Rajan, N. HR issues: sexual harassment, workplace diversity, cultural sensitivity, privileging, credentialing, denying privileges, difficult conversations. Manual of Practice Management for Ambulatory Surgery Centers. 2020;16:239–52.CrossRefGoogle Scholar
Kopp, SL, Horlocker, TT. Regional anaesthesia in day-stay and short-stay surgery. Anaesthesia. 2010;65 Suppl 1:8496.Google Scholar


Mathis, M, Naughton, N. Patient selection for day case-eligible surgery. Anesthesiology. 2013;119:1310–21.Google Scholar
Lermitte, J, Chung, F. Patient selection in ambulatory surgery. Curr Opin Anaesthesiol. 2005;18:598602.Google Scholar
Bryson, G, Chung, F. Patient selection in ambulatory anesthesia – an evidence based review (parts I and II). Can J Anesth. 2004:51(8):768–94.Google Scholar
Visnjevac, O, Davari-Farid, S. The effect of adding functional classification to ASA status for predicting 30-day mortality. Anesth Analg. 2015;121(1):110–16.CrossRefGoogle ScholarPubMed
Lee, JH. Anesthesia for ambulatory surgery. Korean J Anesthesiol. 2017;70(4):398406.Google Scholar
White, P, Eng, M. Fast-track techniques for ambulatory surgery. Curr Opin Anaesthesiol. 2007;20:545–57.Google Scholar
Park, S, Warren, L. Ambulatory anesthesia. In: Dunn, PF, Alston, T, Baker, K, et al. eds. Clinical Anesthesia Procedures of the Massachusetts General Hospital, 7th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2007, pp. 563–69.Google Scholar
Okocha, O, Gerlach, R, Sweitzer, B. Preoperative evaluation for ambulatory anesthesia: what, when, and how? Anesthesiology Clin. 2019;37:195213.Google Scholar
Ardon, AE, et al. Regional anesthesia for ambulatory anesthesiologists. Anesthesiol Clin. 2019;37(2):265–87.Google Scholar
Mulroy, MF, McDonald, SB. Regional anesthesia for outpatient surgery. Anesthesiol Clin North Am. 2003;21(2):289303.Google Scholar
Klein, SM, et al. Peripheral nerve block technique for ambulatory surgery. Anesth Analg. 2005;101(6):1663–76.Google ScholarPubMed

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