Ambulatory anesthesia practice in a University Hospital Center: what is done; what could be done. Ambulatory Anesthesia Study Group

OBJECTIVES: To estimate the number and type of patients, who could be managed on a day-care basis in a University Hospital. Cases of ambulatory anaesthesia (AA) which could be managed in optimal conditions and current AA practice. To assess patients' opinion on inpatient or outpatient practices. STUDY DESIGN: Prospective survey over 8 weeks in 21 medical units potentially concerned by ambulatory practice. PATIENTS: Series of 1,396 patients undergoing an operation included in a previously established list of outpatient procedures. METHOD: A questionnaire was completed for each patient, from preoperative anaesthesia consultation until discharge. Thereafter patients were contacted after home discharge by telephone or mail. RESULTS: In the group of the 1,396 selected patients, 301 (22%) were contra-indicated for AA. In optimal conditions AA was indicated in 20% of all patients treated in these units. At the time of the survey there were 285 outpatients (26% of potential AA, 5% of all patients). Complications were uncommon. Ninety-eight percent of them would choose day surgery again. Among the 810 inpatients, 279 responded: 53% would prefer to be an ambulatory patient. CONCLUSION: At the time of this survey only one fourth of the possible oupatients for AA had in fact been treated on a day-case basis. Its development requires an improvement of the structures, team organisation and patients' information.