Anaesthesia for day case surgery: a survey of adult clinical practice in the UK.
OBJECTIVE
In October 2000, we conducted a national postal survey of consultant day case anaesthetists in the UK to explore the range and variation in the practice of anaesthetizing a patient for day case surgery (paediatrics, urology and orthopaedics). The survey was carried out as part of a larger study that comprised a major two-centre randomized controlled trial designed to investigate the costs and outcome of several anaesthetic techniques during day care surgery in paediatric and adult patients (cost-effectiveness study of anaesthesia in day case surgery). We report the findings of this national survey of adult urology and orthopaedic day case anaesthetic practice in the UK.


METHODS
The survey used a structured postal questionnaire and collected data on the duration of the surgical procedure; the use of premedication; the anaesthetic agents used for induction and maintenance; the fresh gas flows used for anaesthesia; the use of antiemetics; and the administration of local anaesthesia and analgesia.


RESULTS
The overall response rate for the survey was 74% (63% for urology, 67% for orthopaedics). The survey indicated the following practice in adult urology and adult orthopaedic day case surgery: 6 and 12% used premedication; propofol was the preferred induction agent (96 and 97%) and isoflurane the preferred maintenance agent (56 and 58%); 32 and 41% used prophylactic antiemetics; 86 and 93% used a laryngeal mask.


CONCLUSIONS
This survey identifies the variation in current clinical practice in adult day surgery anaesthesia in the UK and discusses this variation in the context of current published evidence.
Payne
K
K
University of Manchester, School of Pharmacy & Pharmaceutical Sciences, Manchester, UK. katherine.payne@man.ac.uk
Moore
E W
EW
Elliott
R A
RA
Pollard
B J
BJ
McHugh
G A
GA
D000328:Adult; D000556:Ambulatory Surgical Procedures; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000758:Anesthesia; D000768:Anesthesia, General; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D018686:Anesthetics, Intravenous / Q000008:administration & dosage; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000932:Antiemetics / Q000627:therapeutic use; D001182:Arthroscopy; D003558:Cystoscopy; D003625:Data Collection; D006801:Humans; D007432:Intraoperative Period; D007717:Knee / Q000601:surgery; D020250:Postoperative Nausea and Vomiting / Q000453:epidemiology / Q000517:prevention & control; D010818:Practice Patterns, Physicians'; D011292:Premedication; D011795:Surveys and Questionnaires; D006113:United Kingdom
D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000932:Antiemetics