Intravenous anesthesia


Anesthesia and Pain Medicine. 2004 Mar. 8(1): 25-32
ⓒ Korean Society for Intravenous Anesthesia
Analysis of Ambulatory Anesthesia for Gynecologic and Obstetric Patients
Sang Ho Shin, M.D., Yoon Kyung Lee, M.D., Sung Gang Cho, M.D., and Hong Seuk Yang, M.D.
Department of Anesthesiology and Pain Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul, Korea

Background: Ambulatory surgery saves the medical cost, makes patients return to their daily activities earlier than inpatients, reduces the incidence of nosocomial infection and postoperative delirium in the elderly. But aiming at the discharge on the day of surgery, the anesthesiologist should make the careful selection of proper patients for ambulatory anesthesia and manage with specialized skill. We reviewed the anesthetic records of gynecologic and obstetric ambulatory surgery during six and half years.
Methods: We reviewed the anesthetic records and postanesthetic care records of gynecologic and obstetric ambulatory surgery from January 1997 to May 2003. Data were classified and analyzed according to the patients\' demographic profiles, physical status of American Society of Anesthesiology, anesthetic techniques and agents, type and duration of operation. The incidence and causes of unexpected postoperative admissions, complications and cancellations of operation were reviewed.
Results: Three hundred and fifty four patients were operated as ambulatory surgery out of all elective surgery from January 1997 to May 2003. All patients were classified as physical status 1 or 2 by ASA classification. The most common type of operation was hysterosalphyngoscopic surgery (49.7%). The most common anesthetic technique was general anesthesia (96.3%) with endotracheal intubation and continuous propofol infusion. The incidence of unexpected postoperative admission was 2.8% and those were requested by surgeon.
Conclusions: The incidence of postoperative complication, cancellation of operation and unexpected admission was low. Many gynecologic procedures can be performed efficiently and safely in the outpatient setting with proper ambulatory anesthetic technique and prudent patient selection.
Key words : Ambulatory anesthesia, gynecology, obstetrics
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