Recovery after ambulatory anesthesia.
OBJECTIVE
The purview of ambulatory anesthesia continues to broaden in response to national interest in controlling healthcare costs and eliminating unnecessarily expensive hospital stays. Recent advances in anesthesia allow us to minimize side effects and complications of anesthesia and surgery that might otherwise delay recovery and discharge. The purpose of this review is to highlight some of these latest advances in clinical care that may soon change how we practice.


RESULTS
In many instances, hospitalization has been necessary to permit adequate control of pain and opioid-related side effects after surgery. A variety of multimodal analgesic techniques are described in this review (including alpha-2 agonists, beta-blockers,corticosteroids, cyclo-oxygenase 2 inhibitors, and regional anesthetic blocks) that reduce requirements for opioids, thereby eliminating some of the undesirable opioid related side effects. New antiemetic recommendations are included for management and prevention of postoperative nausea and vomiting. In addition, novel ways of reversing the effects of some anesthetic drugs (inhalational anesthetics and muscle relaxants) are described.


CONCLUSIONS
The research and advances in clinical care described will likely influence how we manage our patients in the future, eliminating the need for prolonged hospital stay after surgery.
Pavlin
Janet D
JD
Department of Anesthesiology, Universityof Washington, Box 356540, Seattle, WA 98105, USA. kentc02@u.washington.edu
Kent
Christopher D
CD
D000556:Ambulatory Surgical Procedures; D000700:Analgesics / Q000008:administration & dosage; D000758:Anesthesia; D000762:Anesthesia Recovery Period; D018681:Anesthetics, General / Q000008:administration & dosage; D018685:Anesthetics, Inhalation / Q000008:administration & dosage; D000779:Anesthetics, Local / Q000008:administration & dosage; D006801:Humans; D009466:Neuromuscular Blocking Agents / Q000008:administration & dosage / Q000037:antagonists & inhibitors; D020250:Postoperative Nausea and Vomiting / Q000517:prevention & control*; D016032:Randomized Controlled Trials as Topic
D000700:Analgesics; D018681:Anesthetics, General; D018685:Anesthetics, Inhalation; D000779:Anesthetics, Local; D009466:Neuromuscular Blocking Agents