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day surgery

Alternative Names 
outpatient surgery

Definition
Outpatient surgery allows a person having an operation to go home later the same day.

What is the information for this topic? 
Medical advances have now made it possible to go home the same day of an operation. For this to happen, everything must go smoothly and the person must feel comfortable. Any outpatient surgery may get turned into an overnight stay if needed.

For outpatient surgery, people are asked to come in early. Usually, a person must "check-in" at least 1 to 2 hours before surgery. Basic information is taken at the registration desk and the person is brought into the surgery area.

Several questions and forms may need to be taken care of before surgery. Basic personal information as well as who to call in an emergency, insurance, and other issues will need to be recorded. Once this is done, the person is asked to change into a hospital gown. They are then taken to the surgery prep area.

The surgery prep room is where a person spends the final minutes before going to the operating room. A person generally lies on a portable bed with wheels as they wait. Most people will have an intravenous or IV started in the surgery prep room if they don't already have one. An IV is almost always necessary before going into the operating room. Inserting an IV involves putting a needle through the skin and into a vein, usually on the hand or forearm. A bag of fluid may be hung so that it drips into the IV.

Blood tests may be required, depending on the surgery and any medical problems. More than one person may ask about the person's medical history. Questions may include medical conditions, medications, and allergies. People will be asked when their last meal was. A recent meal may cause the surgery to be cancelled due to risks. It is important to answer all questions completely and honestly. The heart rate, blood pressure, and temperature may be recorded, sometimes more than once.

If consent forms and other legal documents were not previously completed, they will need to be signed before surgery. The anaesthetist usually comes to talk to people about the anaesthesia. Anaesthesia is the medication used to control pain and put people to sleep. A mild sedative may be given to relax the person.

Many different healthcare team members may come to the person's bedside, some of whom the person has not met before. In some cases, family members will be allowed to wait in the surgery prep room with the person. At other times, this may not be allowed. If a person is not sure who someone is, or what role they play in their healthcare team, they should feel free to ask. Any last-minute questions should be asked at this time.

If the person has not met the surgeon yet, the surgeon will introduce himself or herself. Alternatively, the surgeon may come by and say hello if the person already knows him or her.

At this point, people are usually wheeled to the operating room on a portable bed or a wheelchair. Many people are drowsy or even asleep from a sedative given earlier. The actual trip to the operating room and the operation are often not remembered at all. The next thing most people remember is waking up after the surgery. People usually wake up in an area called the surgery recovery room. The recovery room is usually located right next door to the operating room area.

The initial few minutes in the surgery recovery room are usually confusing. It is not unusual for people to wake up in the recovery room and have no idea where they are. People go from a deep sleep or heavy sedation to a room they have never seen before. For most people, the only thing they will remember when they wake up is the last few minutes before surgery. An oxygen mask may be in place when the person wakes up. The IV that was put in before surgery will still be in place. The blood pressure, pulse, breathing rate, and temperature are monitored closely. Nausea is very common when people first wake up. Vomiting sometimes occurs. Analgesia is given as needed to control discomfort.

The recovery room is often busy with activity. New people come into the room after surgery as others are leaving. There may be loud beeping noises made by the different monitoring machines.

When the person meets the criteria for discharge from the surgery recovery room, they will be transferred to the outpatient surgery area. Once the anaesthesia has worn off, the IV is removed and the person can go home. Someone else must drive the person home in almost all cases. This is because the medication used for pain usually impairs the ability to function normally for several hours. The doctor or nurse should give home care instructions before a person leaves. A follow-up appointment and phone number for the doctor are usually given at this time. Any questions should be asked before a person goes home.

Author: Adam Brochert, MD
Reviewer: eknowhow Medical Review Panel
Editor: Dr John Hearne
Last Updated: 6/09/2005
Contributors
Potential conflict of interest information for reviewers available on request
 


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