[Orthopaedic one day surgery: anaesthesiologic techniques used and intra- and postoperative complications].
OBJECTIVE
Optimize patient management in one day surgery (ODS) by an observative study regarding one day orthopaedic surgery, assessing kind and quantity of intra- and postoperative complications, need for prolonged postoperative assistance postponing discharge, recovery in other hospitals, patients satisfaction index.


METHODS
From september 1999 until december 2000 we distributed a questionnaire 1286 consecutive patients. The patients were ASA I (80,7%), ASA II (17%) and ASA III (2,3%). We evaluated intra- and postoperative complications considering type of surgery and anaesthesiologic technique; need and reason for medical consulting; if consulting took place in other institutes. Patients judgement regarding medical and nursing assistance during in hospital stay was assessed.


RESULTS
Main surgical procedures: arthroscopy (44,6%), internal fixation removal (21,3%), neurolysis (9,5%), cysts/tumours/nodules removal (7,5%), foot surgery (8,0%). Used anaesthesiologic techniques: neural block (65,6%), plexus block (15,1%), general (12,5%), spinal (4,8%) and local anaesthesia (1,9%). An intraoperative complication (convulsion) was reported twice. Postoperative complications: pain (3,6%) most frequent in foot surgery (5,2%), nausea (0,2%), fever (0,7%), haematoma (0,5%). 5 delayed discharges (beyond 24h) were reported, for surgical reasons. In 5 cases another institute was visited. There were no deads.


CONCLUSIONS
The percentage of not planned recoveries (0,1%) is an indication of frequency of major complications. Satisfaction index of patients was high (96%). Kind of surgical procedure and anaesthesiologic technique, considering the minimal intra- and postoperative complications, are adjusted to the ODS regime. Reinforcing analgesic protocols in foot surgery though are necessary. According to our opinion the peripheral block is preferable in orthopaedic ODS.
Montebugnoli
M
M
Modulo Dipartimentale Anestesia One Day Surgery, IRCCS, Istituti Ortopedici Rizzoli, Bologna, Italy.
Calo
P
P
Rodler
M
M
Rolli
M
M
Broccoli
E
E
van Oven
H
H
Pignotti
E
E
D000556:Ambulatory Surgical Procedures / Q000009:adverse effects*; D000758:Anesthesia; D006801:Humans; D007431:Intraoperative Complications / Q000453:epidemiology / Q000209:etiology; D019637:Orthopedic Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology
One day surgery otropedico: tecniche anestesiologiche utilizzate e complicanze intra- e postoperatorie.