[Anesthetic and perioperative management of patient for breast reconstruction in an outpatient clinic].
BACKGROUND
Our clinic provides various reconstructive surgeries but does not have facilities for patient admission, but there is a hospital providing satisfactory post-operative treatments in our area.


METHODS
During the past 3 years, 276 patients received reconstructive mammoplasty under general anesthesia at our clinic. Their post-operative conditions immediately after the recovery were evaluated with the Modified Post-Anesthesia Discharge Scoring System (MPADSS). After observation for 4 to 5 hours in a recovery room, all the patients were transferred to another hospital by car.


RESULTS
The score was 9 or 10 points in 45% of the patients. This indicates that the patients can be transferred to another hospital without problems. Twenty percent of patients had 6-7 points. These patients had mild bleeding, pain and/or unsteadiness/nausea/vomiting while walking. Among the 256 patients who were transferred to another hospital by car, one patient vomited in the car and 5 patients had nausea after the transfer. The other 20 patients whose score was 7 or lower were transferred by special vehicle with a stretcher and their conditions did not aggravate at all.


CONCLUSIONS
At present, it is dangerous to perform all breast reconstructive surgeries as a day surgeries. A system is indispensable in which patients are transferred after surgery to another hospital with over-night stay facilities enabling observation.
Yanaga
Katsu
K
Yanaga Clinic, Kitakyusyu 802-0044.
Yanaga
Hiroko
H
Toda
Chiaya
C
D000328:Adult; D000554:Ambulatory Care Facilities / Q000706:statistics & numerical data; D000556:Ambulatory Surgical Procedures / Q000706:statistics & numerical data; D000762:Anesthesia Recovery Period; D000768:Anesthesia, General / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016462:Mammaplasty / Q000706:statistics & numerical data; D008875:Middle Aged; D010360:Patient Transfer / Q000706:statistics & numerical data; D019990:Perioperative Care / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000453:epidemiology