Up to 80% of surgeries in the future will be performed on an outpatient basis, meaning that patients will arrive and leave the hospital on the same day. Many factors have contributed to this phenomenon, including technical innovations in surgery and breakthroughs in short-acting anesthesia medications. The following questions and answers are intended to help you understand how Outpatient Surgery will affect you.

What kind of anesthesia will I get?
There are three main types of anesthesia: Local, Regional and General. The type of anesthesia prescribed will depend on the planned surgery and your general health. During your interview with the anesthesiologist, she or he will take into account these factors together with any previous anesthetic experiences or problems and will then formulate a plan.
Local anesthesia is useful for minor procedures like removal of lumps and bumps. Sedative medicines will often be combined with local anesthetic injection at the site of surgery. Modern sedatives often prevent you from remembering any details of the procedure, but wear off rapidly following surgery to allow you to go home.
Regional Anesthesia is suitable for more major surgeries, typically on an arm or leg, and involves injections of local anesthetic drugs close to larger nerves in the body. For example, hand or wrist surgery can be performed by numbing the nerves to the arm with an injection in the shoulder or upper arm. Once again, sedatives are given to reduce anxiety and to prevent any memory of the trip to the operating room.
Finally, many patients receive General Anesthesia. These patients receive intravenous medication to go off to sleep, and then are kept unconscious with a combination of sedatives, painkillers and muscle relaxants given through the IV. Some patients will require a breathing tube while others may receive anesthesia by mask.
No matter which anesthetic is given, your anesthesiologist and CRNA are trained to provide whatever type of anesthesia is safest and most comfortable for you.

What happens on the day of surgery?
You should plan on arriving at the hospital 2 hours before your scheduled operation, and register at the admissions center. From there you will be escorted to the ambulatory surgery area and be given a room. A nurse will review your medical history and take a set of vital signs. At this time you will change into a hospital gown, and your clothes and valuables will be stored. As the time for your surgery approaches, you will be taken on a stretcher to the preoperative holding area. Here you will meet your team of anesthesiologist and CRNA who have been assigned to care for you. The anesthesiologist will complete the interview and assessment and then will inform you of the anesthetic plan, along with the risks and alternatives. You will have an opportunity to review the consent form for anesthesia, which lists potential risks and complications. Your anesthesiologist will ask you to sign this form when the interview is finished. You will also meet a nurse who will be part of the team in the operating room. Finally, you will have an IV started and the anesthesiologist or nurse anesthetist will administer sedative medication in preparation for surgery. Few patients remember anything further until their arrival in the recovery unit.

What happens in the operating room?
After receiving sedation in the holding area, you are transferred by stretcher to the operating room and placed on the operating table. The anesthesiologist or CRNA will use a variety of monitors to ensure your safety during the procedure. These will include a blood pressure cuff, EKG leads and a pulse oximetry finger probe. With these monitors in place, you will then receive additional medications to go off to sleep. When you are asleep, the operative site will be cleaned and the surgery will be performed. During the surgery, your anesthesia team will closely monitor your vital signs and your anesthesia medications will be constantly adjusted. In addition to providing anesthesia, your anesthesiologist is also the physician who will manage any medical problems arising during surgery and who will continue to treat any problems you may have had beforehand. When the surgery is complete, the anesthesia medications will be adjusted again and you will gradually wake up as you go to the recovery unit.

What happens in the recovery unit?
On arrival in the recovery unit, a specially trained nurse will be assigned to care for you as you recover from the effects of the anesthesia. Your vital signs will be continually monitored and extra oxygen will be given as you need it. Your stay in recovery room will last approximately 30 -60 minutes. You will be offered something to eat and drink before discharge. After the anesthesiologist sees you again and determines that it is safe for you to leave, you can get dressed. A staff member will take you in a wheelchair directly to your car. You will be given a list of instructions on discharge with information on wound care, pain relieving medications, and what to expect as you recover as well as a list of telephone numbers to contact in the event of problems at home.

Can I drive myself home after the same day surgery?
No. You MUST make arrangements to have a responsible adult to provide you with transportation. It is not advised to operate vehicles or machinery for 24 hours after surgery. It is strongly suggested that you have someone stay with you during the first 24 hours.

What happens when I get home?
You should follow the instructions that you received prior to your discharge from the hospital. If their surgeon allows, most patients can resume their normal daily activities within the next day or so. A member of the hospital’s Post Anesthesia Care Unit staff will contact you the day after your surgery to ask about your recovery. This will give you a chance to discuss and get advice on any problems you may be having. In addition, the information gained from talking to you will allow both the anesthesia and surgical teams to evaluate and improve the care we give our patients in the future.

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