Clinical practice and routines for day surgery in Sweden: results from a nation-wide survey.
Acta Anaesthesiol Scand
; 52(1): 117-24, 2008 Jan.
Article
en En
| MEDLINE
| ID: mdl-17996005
ABSTRACT
BACKGROUND:
Day surgery has expanded considerably during the last decades. Routines and standards have developed but differ between and within countries.METHODS:
We studied the practice of day surgery in Sweden by an extensive questionnaire survey sent to all 92 hospitals.RESULTS:
The proportion of day surgery vs. in-hospital procedures was overall 43%, with 43% in adults and 46% in children. Orthopaedic (33%), general (29%) and gynaecological (17%) surgery were the most common ambulatory procedures. Most patients (>90%) underwent pre-operative assessment by an anaesthesiologist. Patient self-assessment questionnaires were common (86%). Risk stratification for post-operative nausea and vomiting was used by 70% of the departments. Anxiolytic pre-medication was uncommon. Most anaesthesiologists (95%) used pre-operative oral analgesics to initiate post-operative analgesia, the most common being paracetamol (95%), NSAIDs (73%) and coxibs (15%). A balanced general anaesthesia technique was preferred. Post-operatively, 93% of the units routinely assessed patients' pain. Analgesic combinations of paracetamol, NSAIDs and weak opioids were used by 94% of the units. Most hospitals (80%) had standardised discharge criteria based on clinical assessment, and many required a patient escort at home for 24 h post-operatively. Assessments of unplanned admission, re-admission and post-operative complications were not performed routinely. Follow-up telephone calls within 1-2 days were performed regularly in about 40% of the units, or in selected patients only (37%). Pain was the most frequent complaint on follow-up.CONCLUSIONS:
In Sweden, a high degree of standardised regime for day surgical practice was found. Post-operative pain is the most common complaint after discharge.
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Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Procedimientos Quirúrgicos Ambulatorios
Tipo de estudio:
Clinical_trials
/
Guideline
/
Prognostic_studies
Límite:
Adult
/
Child
/
Humans
País/Región como asunto:
Europa
Idioma:
En
Revista:
Acta Anaesthesiol Scand
Año:
2008
Tipo del documento:
Article
País de afiliación:
Suecia