Canadian Journal of Anesthesia, Vol 24, 401-407, Copyright © 1977 by Canadian Anesthesiologists' Society

An Evaluation of the Anaesthetic Techniques Used in an Outpatient Unit

¹ Department of Anaesthesia, University of Toronto

Our follow-up of 250 gynaecology patients and 100 dental patients who had received anaesthesia for elective outpatient surgical procedures indicates:

(1) The practice of outpatient anaesthesia in proper facilities with proper selection of patients appears to be safe.

(2) There is widespread patient acceptance of surgery and anaesthesia on an outpatient basis.

(3) Complications are frequent but minor.

(4) Many of the complications may be minimized:

(i) Adequate depth of anaesthesia preferably with a volatile agent will do away with awareness during operation.

(ii) Methoxyflurane should be avoided to minimize late arousal. Volatile agents such as enflurane or halothane would seem to be preferable to intravenous agents.

(iii) Post-fasciculation pain could be minimized by avoiding succinylcholine for short procedures like D & C and using adequate depth instead. For dental procedures requiring tracheal intubation, one could perhaps use non-depolarizing muscle relaxants, like pancuronium, with reversal at the end of the procedure.

(5) Nausea, vomiting, dizziness and headache are complications that occur very frequently in all series reported and this is an area where more research is indicated.

Note:

Staff Anaesthetist, Mount Sinai Hospital, Toronto.

Anaesthetist-in-Chief, Mount Sinai Hospital, Toronto.