[Ambulatory anesthesia preoperative evaluation and its effects on anesthetic care].
BACKGROUND
Adequate preoperative evaluation with sufficient informed consent from patients will lead to safe perioperative anesthetic managements. We started outpatient preoperative evaluation from October, 2002.


METHODS
We investigated 1137 elective cases operated during one year after starting outpatient examination. They were compared with 1083 cases under the previous system. On requests from surgeons we examined the patients and obtained informed consents. Additional examinations and medications were ordered if necessary for adequate preoperative management.


RESULTS
Eight hundred and twenty-three cases (72.4%) of 1137 elective operative cases visited our outpatient booth and 86.8% of them visited before admission for the surgery. Patients classified into ASA-PS II-III, 550 cases (66.9%), and their major complications were cardiovascular and pulmonary diseases. Two hundred and ninety seven cases (36.1%) required additional examinations following adequate preoperative management by another consultants. After the introduction of this system, the number of postponing or cancellation of operation after hospitalization was only 1.3% of elective operations. Furthermore the number of patients admitted on the day and the day before the operation significantly increased compared with those under the previous system (27.9 - 45.2%).


CONCLUSIONS
Our preoperative consulting system will decrease average length of hospital stay and improve the quality control of patients before surgery.
Nomura
Yuko
Y
Division of Anesthesia, Tokyo Metropolitan Health and Medical Corporation Ohkubo Hospital, Tokyo.
Ashikari
Eri
E
Tanaka
Kumiko
K
Mitsunari
Hiroaki
H
Kuroyanagi
Aya
A
Nomura
Minoru
M
Ozaki
Makoto
M
D000553:Ambulatory Care; D000554:Ambulatory Care Facilities; D000758:Anesthesia; D006801:Humans; D007258:Informed Consent; D010353:Patient Education as Topic; D010808:Physical Examination; D011300:Preoperative Care / Q000706:statistics & numerical data*