Postdischarge complications and rehabilitation after ambulatory surgery

Abstract

Purpose of review: To present the literature on recent developments in anesthetic and analgesic techniques in ambulatory surgery.

Recent findings: Studies published during the past 12 months have provided results for several 'take home messages', which include use of perioperative celecoxib improves short-term and long-term postoperative outcome; perineural catheter analgesia is feasible and safe at home; small incision cholecystectomy is quicker to perform and has no disadvantages when compared with laparoscopic technique; 2-chloroprocaine appears to be the drug of choice for spinal anesthesia; simple regional anesthesia techniques such as wound infiltration and intraarticular local anesthetics are safe and effective; Society of Ambulatory Anesthesia guidelines for managing postoperative nausea and vomiting recommend use of regional anesthesia techniques and use of certain drugs (and avoidance of others) if general anesthesia is chosen.

Summary: During the last year, several studies have demonstrated the benefits of regional anesthesia techniques in reducing postdischarge complications and improving rehabilitation. Perioperative use of the COX-2 selective inhibitor celecoxib seems to provide short-term and long-term postoperative advantages.