Peri-operative management of patients having day surgery: a consensus statement from the Association of Anaesthetists, British Association for Day Surgery and the Association of Paediatric Anaesthetists, Great Britain and Ireland.

Abstract

Day surgery is now recognised widely as being a vital component of modern healthcare delivery with overall day surgery rates in the UK now > 85%. Day surgery offers an enhanced experience for patients with reduced risk of postoperative complications (e.g. infections, cognitive impairment and venous thromboembolism); reduced utilisation of inpatient beds; decreased hospital expenditure; and reduced environmental impact. Day surgery shortens elective surgery waiting times and has a major role to play in overcoming the elective surgery backlog. Despite this, there is still wide variation in day surgery rates across the UK. There is a huge opportunity for continued improvement in the delivery of services though optimising the efficiency and effectiveness of day surgery. This consensus guideline included stakeholders with expertise in the peri-operative management of day surgery including representation from the Association of Anaesthetists, British Association of Day Surgery and Association of Paediatric Anaesthetists of Great Britain and Ireland. Following targeted literature review, a two-round modified Delphi process was conducted to produce and ratify recommendations. Recommendations were made regarding the selection, pre-assessment and optimisation of patients having surgery; the impact of comorbidities (including frailty, obesity and obstructive sleep apnoea); surgical procedures (including urgent and emergency surgeries); logistical considerations; anaesthetic techniques; and discharge processes. This pragmatic consensus statement aims to support healthcare providers and institutions with the organisational and clinical peri-operative management of anaesthesia for day surgery in both adults and children.