title: New approaches to anesthesia for day case surgery.
abstract: Anesthesia for day case or ambulatory surgery must be specifically tailored to meet its specialized goals, and the use of sevoflurane helps to meet these goals. Maintenance of sevoflurane anesthesia is associated with good titratability and short early recovery times. The rapidity and quality of recovery after sevoflurane anesthesia are as good or better than other available agents. Clinically more important are the new inhalation induction options possible with sevoflurane. These include vital capacity induction of general anesthesia in adult patients, intubation without neuromuscular blocking drugs, and management of selected patients with difficult airways. Anesthesia by facemask or LMA is easily performed without agent-related irritative side effects. The cost of induction with sevoflurane is significantly less than the standard agent propofol, and is even less when sevoflurane is used for both induction and intubation. The costs of maintenance with sevoflurane are more than isoflurane but less than propofol, and can be reduced to low money amounts by the use of N2O and low fresh gas flows, as well as elimination of the anesthetic adjuvant drugs. These new, cost effective anesthetic techniques are useful additions to the spectrum of anesthetic choices for ambulatory surgery.
authors.affiliation: Harvard Medical School, Day Surgery Unit, Brigham and Women's Hospital, Boston, Massachusetts, USA.
authors.forename: B K
authors.initials: BK
authors.lastname: Philip
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000769:Anesthesia, Inhalation / Q000379:methods*; D003362:Cost-Benefit Analysis; D004987:Ethers / Q000008:administration & dosage; D006801:Humans; D008738:Methyl Ethers; D000077149:Sevoflurane
chemical_list: D004987:Ethers; D008738:Methyl Ethers; D000077149:Sevoflurane