Evidence-based medicine in day surgery.
OBJECTIVE
To present the evidence available for the management of pain, for the prevention of nausea and vomiting, and for the best anaesthetic technique during ambulatory surgery.


RESULTS
Paracetamol and nonsteroidal anti-inflammatory drugs are effective analgesics with a low number needed to treat, and are recommended when not contraindicated. Droperidol, dexamethasone and ondansetron are equally effective in the prevention of postoperative nausea and vomiting during ambulatory surgery. The choice of the anaesthetic technique appears to play a minor role in recovery from anaesthesia or in the occurrence of minor postoperative complications or home discharge, except for the use of total intravenous anaesthesia for the prevention of postoperative nausea and vomiting.


CONCLUSIONS
Pain should be prevented adequately and treated vigorously. Postoperative nausea and vomiting is common and should be prevented in the at-risk patient. The choice of inhalation agents during ambulatory surgery is of minor importance in recovery from anaesthesia.
Gupta
Anil
A
Department of Anesthesiology and Intensive Care, University Hospital, Orebro, Sweden. anil.gupta@orebroll.se
D000556:Ambulatory Surgical Procedures / Q000592:standards*; D000700:Analgesics / Q000627:therapeutic use; D000768:Anesthesia, General; D000777:Anesthetics / Q000627:therapeutic use; D019317:Evidence-Based Medicine; D006801:Humans; D010149:Postoperative Pain / Q000517:prevention & control*; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*
D000700:Analgesics; D000777:Anesthetics