Contraindications to Outpatient Surgery

As a result of improving anesthetic techniques and minimally invasive surgical procedures, the number of patients undergoing ambulatory surgery continues to grow. Patients with more complex medical conditions are undergoing longer and more complicated surgical procedures performed on an ambulatory basis. However, patients with the following conditions may be at increased risk for postoperative complications and should be offered the option of overnight hospitalization^[29] :

1. Serious, potentially life-threatening diseases that are not optimally managed (e.g., brittle diabetes, unstable angina, symptomatic asthma)
2. Morbid obesity complicated by symptomatic cardiovascular (e.g., angina) or respiratory (e.g., asthma) problems
3. Multiple chronic centrally active drug therapies (e.g., use of monoamine oxidase inhibitors such as pargyline and tranylcypromine) and active cocaine abuse because of the increased risk of intraoperative cardiovascular complications, including death
4. Ex-premature infants less than 60 weeks' postconceptual age requiring general endotracheal anesthesia
5. Lack of a responsible adult at home to care for the patient on the evening after surgery