[Process optimization in pediatric anesthesia-- fast-track: what is possible: what makes sense?].

Process optimization offers the opportunity to improve the quality and efficiency of medical care. Various approaches are possible in a pre-, peri- and postoperative care setting: It is almost always possible to prepare the children for surgery on an outpatient basis. This allows for hospital admission the same day or the evening before the procedure. But a schedule needs to be established that includes a certain leeway for admission and preoperative fasting in order to cater for a flexible response to delays or cancelations on the surgical list. An efficient use of theatre time can only be assured if several anesthetists can work in parallel. This applies in particular to complex anesthetic inductions. Sufficient staff and facilities are a prerequisite for this. The use of ultrasound for vascular access and regional anesthesia raises the success rate and saves time. In the postoperative period good analgesia with a fixed therapeutic regime, immediate postoperative feeding and mobilization improve the care.