2623

1. The continued growth in ambulatory surgery is related to expansion in minimally invasive surgical techniques and office-based procedures.
2. Preexisting medical conditions are rarely, if ever an exclusionary criterion for ambulatory surgery.
3. Routine laboratory testing is not recommended before ambulatory surgery.
4. The choice of anesthetic technique has a significant effect on postoperative side effects and discharge time. The use of local anesthesia with sedation, so-called monitored anesthesia care, is associated with the fewest side effects and the shortest time to discharge home.
5. The use of propofol for induction or maintenance of anesthesia (or both) is associated with a reduced incidence of postoperative nausea and vomiting.
6. The use of desflurane or nitrous oxide (or both) in conjunction with antiemetic prophylaxis will facilitate the "fast-track" recovery process.
7. The use of potent opioid analgesics (e.g., fentanyl, sufentanil) in combination with local anesthetics will decrease the time to discharge home after spinal anesthesia.
8. Multimodal ("balanced") analgesic and antiemetic regimens will allow most outpatients to be fast-tracked after ambulatory surgery under general anesthesia.
9. Fast-tracking after ambulatory surgery is accomplished by taking the patient directly from the operating room to the day-surgery step-down unit ("bypassing the PACU") or simply discharging the patient home from the PACU ("PACU bypassing").
10. Outcomes after ambulatory (and office-based) surgery are no different than after inpatient (hospital-based) surgery procedures. Recent data suggest that for elderly patients, the surgical outcome may be improved.