The anesthetic work of day surgery should be guided by the standardized perioperative evaluation system. The evaluation methods and standards with strong operability and repeatability are the prerequisites to ensure the safety and efficiency of day surgery. For the assessment of patients’ preoperative physiological status, preoperative preparation and postoperative rehabilitation, standardized work procedures should be established to ensure patients’ medical safety to the greatest extent. Through summarizing the advanced management experience of day surgery anesthesia at home and abroad, and combining with the principled suggestions in The Consensus of Chinese Experts on Anaesthesia for Day Surgery, the First Affiliated Hospital of Dalian Medical University has repeatedly revised the perioperative anesthesia evaluation methods in practice, and gradually explored a comprehensive, rigorous and standardized perioperative anesthesia evaluation system. This paper will focus on the evaluation of perioperative anesthesia and postoperative follow-up procedures in day surgery.
Day surgery dates back to 1909, when it was first performed by British paediatricians. Anesthesia management for day surgery requires quick onset, early recovery, rapid recovery, and few perioperative adverse reactions. Ensuring the medical safety of patients is the primary condition for the gradual implementation of day surgery. With the continuous development of medical level, the applicable field of day surgery has gradually expanded, and new concepts and progress have also emerged in anesthesia management. This article summarizes the relevant research at home and abroad, and reviews the new progress of anesthesia for day surgery from three aspects: preparation before anesthesia, selection of anesthesia methods, and recovery after anesthesia, in order to provide a reference for anesthesia management of day surgery.
Under the same-day surgery mode, anesthesiologists play an important role in ensuring patient safety, eliminating medical risks, practicing the concept of enhanced recovery after surgery, and realizing comfortable diagnosis and treatment, and a standardized anesthesia management process is the key to protect patients. Based on the principled suggestions in The Consensus of Chinese Experts on Anaesthesia for Day Surgery, combined with the advanced management experience of day surgery anesthesia at home and abroad, and repeatedly revised through practice, a comprehensive, rigorous, and standardized anesthesia management process for same-day surgery was gradually explored by the First Affiliated Hospital of Dalian Medical University. This paper introduces the process from the aspects of procedure of anesthesia evaluation in same-day surgery, preoperative preparation, standardized intraoperative anesthesia management, postoperative pain management, and prevention and treatment of postoperative complications.
Enhanced recovery after surgery (ERAS) is a protocol designed to improve perioperative outcomes by multidisciplinary team with evidence-based interventions. The implementation of ERAS concept has been proved to reduce postoperative complications and hospital stay. The anesthesia management under the concept of ERAS is the basis of safe and smooth ambulatory surgical protocol. This article summarizes the latest clinical evidence at home and abroad, and reviews the preoperative optimization, anesthesia mode selection, ventilation strategies, fluid management, temperature support, pain management, postoperative nausea and vomiting prevention, postoperative nutritional support, and postoperative sleep improvement in the management of anesthesia under ERAS concept, in order to provide a reference for anesthesia management in ambulatory surgery.