THE DAY-CASE ANESTHESIA - Anesthesiology and Reanimation
The day-case surgery is a type of surgery which is applied to patients who are planned to be discharged on the operation day. The type of anesthesia employed in this kind of surgery is referred as day-case anesthesia
• It refers to the employment of anesthesia in outpatients who are admitted to the hospital for an elective surgery in order not to occupy a patient bed. These are not emergency interventions.
• Patients have an outpatient operation (or diagnostic process) and they go home on the same day without being hospitalized.
• Laboratory examination requirements of the patient are not dependent on whether the operation is a day case or not. In both cases, same examinations are required.
• An elaborative preoperative assessment must be performed by the anesthesia specialist in the outpatient clinic or examining the patient via phone call one day prior to the operation.
Why Is the Day-Case Anesthesia Preferred?
• Cost - effectiveness
• Early mobilization of the patient
• Less complications resulting from the surgery and the anesthesia
• Short of duration loss of consciousness and physical disorder
• Faster recovery of organ functions (recovery and regaining consciousness) and early rehabilitation
• Faster return of the patient to normal daily activities
• Comfort of the patient
• Perfect surgical conditions
• Fast recovery of cognitive functions
• Minimum side effects after the surgery
• Higher level of patient satisfaction
• Less psychological trauma in children
In which operations can day case anesthesia be used?
In all surgical and internal departments and for any and all types of examination, biopsy, intervention and minor operations (tonsillectomy, circumcision, incisions, etc.) performed under anesthesia
How are patients identified in the day-case procedures?
• Duration of the operation must be short (30-60 minutes).
• Patient must reside in a location which is I -hour distant from the hospital.
• Patient must accept employment of the day-case anesthesia to him/her.
• Patient must go home in company with a companion.
• At home, there should be a subject at legal age who can follow up the patient for at least 24 hours and can take responsibility.
Which method should I choose in the Day-Case Anesthesia?
• General anesthesia
• Regional techniques (nerve blocks)
• Monitored anesthesia care (MAC) (conscious sedation),
• Local anesthesia
How long will I stay in the hospital?
Average length of an outpatient case is three and a half hours or half of a working day.
How can I return to the active work?
You can return to your daily activities in one-day period, unless otherwise is suggested by your physician.
What are the criteria of recovery and discharge?
Before the day-case patient is discharged;
I. The day-case patients must be completely awake and conscious.
2. The babies and the patients with compromised baseline consciousness must be allowed to return to their initial states.
3. Vital functions must be stable and within acceptable limits.
4. The day-case patient must be accompanied by a responsible adult when they are discharged.
5. Written information regarding the post-operative diet, medication and activity (if any) must be given to patient.
6. Patient must be enabled to have oral intake following a reasonable time from the operation.
7. Pain, nausea and vomiting must be at a tolerable level by the time the patient is discharged to home.
8. There must not be a condition which hinders his/her mobilization or the necessary support device(s) (such as wheelchair) must be available, when the patient is discharged to home.
9. Patient must wait for 24 hours to perform tasks which require responsibility and attention (such as driving cooking working in jobs which require attention) due to the temporary disruption in consciousness and memory functions that may develop as a result of anesthetic substances.
Clear verbal and written instructions must be given to the patients before the discharge. These instructions must include appropriate postoperative pain management, postoperative nausea and vomiting and other minor complications.