Rajan Niraja, Rosero Eric B, Joshi Girish P
From the Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, Pennsylvania.
Department of Anesthesiology and Pain Management, University of Texas Southwestern, Dallas, Texas.
Anesth Analg. 2021 Dec 1;133(6):1415-1430. doi: 10.1213/ANE.0000000000005605.
With migration of medically complex patients undergoing more extensive surgical procedures to the ambulatory setting, selecting the appropriate patient is vital. Patient selection can impact patient safety, efficiency, and reportable outcomes at ambulatory surgery centers (ASCs). Identifying suitability for ambulatory surgery is a dynamic process that depends on a complex interplay between the surgical procedure, patient characteristics, and the expected anesthetic technique (eg, sedation/analgesia, local/regional anesthesia, or general anesthesia). In addition, the type of ambulatory setting (ie, short-stay facilities, hospital-based ambulatory center, freestanding ambulatory center, and office-based surgery) and social factors, such as availability of a responsible individual to take care of the patient at home, can also influence patient selection. The purpose of this review is to present current best evidence that would provide guidance to the ambulatory anesthesiologist in making an informed decision regarding patient selection for surgical procedures in freestanding ambulatory facilities.
随着病情复杂的患者接受更广泛手术操作后转向门诊手术环境,选择合适的患者至关重要。患者选择会影响门诊手术中心(ASC)的患者安全、效率和可报告结局。确定门诊手术的适宜性是一个动态过程,它取决于手术操作、患者特征和预期麻醉技术(如镇静/镇痛、局部/区域麻醉或全身麻醉)之间的复杂相互作用。此外,门诊手术环境的类型(即短期住院设施、医院门诊中心、独立门诊中心和门诊手术)以及社会因素,如是否有负责的人员在家照顾患者,也会影响患者选择。本综述的目的是提供当前最佳证据,为门诊麻醉医生在独立门诊设施中为手术患者选择做出明智决策提供指导。