[Locoregional anesthesia in ambulatory patients].
The use of regional anaesthesia in ambulatory patients is discussed. Five criteria for discharge are described: the four 'A's (Awake, Ambulation, Alimentation, Analgesia) and micturition. Recommended agents for additional sedation with the regional block, if required, are midazolam and fentanyl. These should be titrated in order to administer the minimal efficient dosage. The main techniques for regional anaesthesia of upper limb are intravenous regional anaesthesia, axillary and interscalenic brachial plexus blocks and for the lower limbs epidural and spinal blocks. However, urinary retention and orthostatic hypotension can occur. The risk of headache is not a contraindication for day-case surgery if some guidelines are followed. Penile blocks and caudal blocks are widely used in pediatric surgery.
Département d'Anesthésiologie, Hôpital de Bicêtre, Université Paris-Sud, Le Kremlin-Bicêtre.
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Ecoffey
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Samii
D000556:Ambulatory Surgical Procedures; D000762:Anesthesia Recovery Period; D000765:Anesthesia, Conduction / Q000009:adverse effects / Q000379:methods*; D006261:Headache / Q000209:etiology; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology; D011184:Postoperative Period; D014555:Urination Disorders / Q000209:etiology
L'anesthésie locorégionale chez le patient ambulatoire.