scholarly journals Surgical Outpatient Care: Triage, Time and Test

2021 ◽  
Author(s):  
Satyendra K. Tiwary
Keyword(s):  
Surgical Procedures ◽  
Day Care ◽  
Surgical Techniques ◽  
Length Of Hospital Stay ◽  
Developed Countries ◽  
Day Care Surgery ◽  
Minimally Invasive Surgical ◽  
Early Return ◽  
Treat All ◽  
Care Surgery

Day care surgery is the standard of care for minor surgical procedures in developed countries and rapidly increasing in practice in developing countries. The main advantages of day care surgery are cost containment, early mobilization of the patient, less pain because of minimally invasive surgical techniques, early return of patient to their home and work. The downsides of day care surgery include the inability to treat all patients and perform all surgical procedures since surgical fitness for day care procedures is demanding, unforeseen readmission, the need for more operating rooms, and increasing expertise among health care workers. Considering day care surgery as systematic, scheduled and short duration stay in hospital, it is very important to select or sort out the cases which fit in the criteria according to all conventional definitions of triage. It is well organized within stipulated time frame and performed in fixed unit with proper assessment by anesthesia and nursing team in addition to core assessment of surgical team. Surgical option exercised and close follow up with ability to manage complications are integral components in working team. Delivery of more surgery in primary care has potential for enhancing patient-centred management by promoting the development of multi-specialty community providers and reducing length of hospital stay. The outpatient surgical centers provide many benefits and advantages for surgical patients with proper organizations, dedicated services, and meticulous procedures.

scholarly journals Early Experience of Day Care Surgery in Nepal

2010 ◽  
Vol 49 (179) ◽  
Author(s):  
DR Singh ◽  
M R Joshi ◽  
U Koirala ◽  
BR Shrestha ◽  
S Shrestha ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Day Care ◽  
Developed Countries ◽  
Early Morning ◽  
Day Care Surgery ◽  
American Society ◽  
Set Up ◽  
Care Surgery ◽  
Age Range

INTRODUCTION: The day care laparoscopic cholecystectomy (DCLC) is found to be safe and effective in developed countries. However, it has not been well accepted in our part of the world probably because of lack of infrastructures,established norms and published reports. We have analyzed the safety and feasibility of the procedure in the recently established first dedicated day care surgery centre of the country. METHODS: All the patients with American society of anaesthesiologist (ASA) score I and II admitted for laparoscopic cholecystectomy are included. Operation are performed in the morning and closely observed till evening. Patients found to be medically fit to discharge; having a responsible person at home and who can make their own arrangements in case of problems were advised for discharge. Follow up was done by telephone call from next morning. RESULTS: Total 35 patients underwent laparoscopic cholecystectomy. Age range was between 16-65 years and most of them were females (88%). Only 30 patients were operated in early morning and were eligible for day care surgery. 25 (83%) Patients were advised for discharge but only 10 (33%) could make arrangement. Other 15 patients could not go home mainly due to different psychosocial reasons. Only one patient needed readmission and Complications observed were minor and relatively few. CONCLUSIONS: Day care laparoscopic cholecystectomy is safe and feasible in our set up. Acceptance of the procedure is expected to increase once it is regularly practiced and awareness in improved. Keywords: day care, laparoscopic cholecystectomy, surgery, Nepal.

scholarly journals Day-Care Surgery for Pilonidal Sinus

2006 ◽  
Vol 88 (7) ◽  
pp. 656-658 ◽  
Author(s):  
AKM Abdul-Ghani ◽  
AN Abdul-Ghani ◽  
CL Ingham Clark
Keyword(s):  
Pilonidal Sinus ◽  
Day Care ◽  
Day Surgery ◽  
Complete Healing ◽  
Sinus Surgery ◽  
Potential Cost ◽  
Day Care Surgery ◽  
Ambulatory Treatment ◽  
Wound Breakdown ◽  
Care Surgery

INTRODUCTION The surgical approach to symptomatic pilonidal sinus is open to debate. Many techniques have been described and no single technique fulfils all the requirements of an ideal treatment. Ambulatory treatment with minimal morbidity and rapid return to activity is desirable. The aim of this work was to study the feasibility of day-care surgery for excision and primary asymmetric closure of symptomatic pilonidal sinus. PATIENTS AND METHODS All patients referred electively over 2 years were assessed in a single-consultant, colorectal clinic and booked for day-care surgery. All patients had excision and primary asymmetric closure under general anaesthesia in the left lateral position. Whenever possible, they were discharged on the same day according to the day-surgery protocol. Patients were subsequently seen in the out-patient clinic for removal of stitches and were followed up further if there was any wound breakdown. RESULTS Fifty-one patients were operated on electively for pilonidal sinus over the 2 years. Two patients were excluded as the final diagnosis was not pilonidal sinus. At 4 weeks following operation, 43 (88%) had complete healing and 6 (12%) had dehiscence of the wound. Recurrence rate was 8% (4 patients) for follow-up of 12–38 months. There was no admission from the day-surgery unit and no unplanned re-admissions. The cost for day-care pilonidal sinus surgery was estimated to be £672.00 per patient compared with in-patient cost of £2405.00. CONCLUSIONS Excision and primary asymmetric closure for pilonidal sinus is safe and feasible as day-care surgery and is associated with potential cost saving.

scholarly journals Adult tonsillectomy and day care surgery

2007 ◽  
Vol 59 (4) ◽  
pp. 341-345 ◽  
Author(s):  
Ashok Verma ◽  
Sharifa Al Nabhani ◽  
Mazin Al-Khabori
Keyword(s):  
Day Care ◽  
Day Care Surgery ◽  
Care Surgery ◽  
Adult Tonsillectomy

scholarly journals SPECTRAL ENTROPY FOR ASSESSING THE PATIENT RESPONSIVENESS DURING PROPOFOL/FENTANYL SEDATION IN DAY CARE SURGERIES

2019 ◽  
Vol 3 (9) ◽  
Author(s):  
Dr Shalendra Singh ◽  
Dr Priya Taank
Keyword(s):  
Day Care ◽  
Objective Assessment ◽  
Primary Objective ◽  
Sedation Scale ◽  
Depth Of Anaesthesia ◽  
Anesthetic Care ◽  
Mean Values ◽  
Day Care Surgery ◽  
Monitoring Of Sedation ◽  
Care Surgery

Background: For day care surgery under monitored anesthetic care, precise monitoring of sedation depth facilitates optimization of dosage and prevents adverse complications from over sedation. Conventionally subjective sedation scales, such as the Modified observer’s assessment of alertness/ sedation scale (MOAA/S) have been widely utilized for sedation monitoring. The newer monitoring called entropy is considered to be beneficial for objective assessment with combined use of opioids and hypnotics if applied. The primary objective is to determine measurement of entropy as a marker for measuring depth of anaesthesia. Methods: Two groups P and PF ( with 25 patients each) received either propofol 1mg/kg followed by maintenance infusion of 250 mic/ kg/hr whereas “PF”group received additional single dose of fentanyl 2 mic/kg respectively. The values of response entropy (RE) and state entropy (SE) corresponding to each MOAA/S (5 to 0) were determined. Results: The patient’s demographic profile and clinical characteristics were comparable in both the groups. No difference observed in duration of anaesthesia and surgery in both groups. No difference observed in MOAA/S in both groups.  The results shows a highly significant differences in the observed means of SE, RE, MAP and HR with considerably higher mean values in group P (p<0.0001). However other parameter such as SPO2, ETCO2 and RR were almost comparable in both groups. Conclusion: The mean value of SE and RE in group P and PF indicates that deeper plane of anaesthesia is observed in PF group. It is concluded that in assessing the level of hypnosis during intra-operative sedation in MAC, entropy corresponds to MOAA/S and increases or decreases proportionately depending upon increase or decrease level of sedation. Hence from these results it is proposed that entropy monitoring is a reliable monitoring index of anaesthesia depth in MAC. Keywords: Entropy, Propofol, Sedation, Day care surgery, Observer’s assessment of alertness/ sedation scale, Monitored anaesthesia Care

scholarly journals Effect of Pre-Anaesthetic Evaluation on Complication Free Outcome among Day-Care ENT Surgeries in a Tertiary Care Hospital

2020 ◽  
Vol 7 (50) ◽  
pp. 3016-3021
Author(s):  
Jayachandran C.G ◽  
Naiji S. James ◽  
Ushakumari P.R
Keyword(s):  
Health Care ◽  
Postoperative Pain ◽  
Day Care ◽  
Health Care Personnel ◽  
Pain Intensity Score ◽  
Care Hospital ◽  
Day Care Surgery ◽  
Duration Of Surgery ◽  
Associated Symptoms ◽  
Care Surgery

BACKGROUND Day-care surgery in all the surgical specialities has become an accepted and popular method among the health care personnel and patients. Lesser demand for in-patient beds and lower cost of hospital stay are making this therapeutic modality more acceptable. Current concepts in anaesthesia, availability of newer anaesthetic drugs and surgical methods have helped in achieving progress of daycare surgeries. Pre-anaesthetic evaluation of patients determine their fitness for day-care anaesthesia and surgery, and at times guide the anaesthesiologist in formulating appropriate plans and strategies. We wanted to observe the demography of patients undergoing day-care surgery and estimate the proportion of complication free outcome among day-care ENT procedures following preanaesthetic evaluation. METHODS 96 patients aged between 18 and 60 years undergoing day-care ENT surgeries for which pre-anaesthetic evaluation was done were included. Demographic data was obtained, thorough pre-anaesthetic evaluation and detailed clinical ENT examination were done. Nature of anaesthesia given, duration of the surgery and severity of the postoperative pain were recorded. Analgesic protocol undertaken during recovery period and associated symptoms were recorded. RESULTS Out of 96 patients 55 (57.29) were males and 41 (42.70 %) were females with a male to female ratio of 1.4:1. The mean age was 31.50 ± 4.15 years. 32 / 96 (33.33 %) ear surgeries, 26 / 96 (27.08 %) nose surgeries, 22 / 96 (22.91 %) throat surgeries and 16 / 96 (16.66 %) head and neck surgeries were performed. The smallest mean duration of surgery was 13.30 ± 02.5 minutes for removal of foreign body in the ear and the largest mean duration of surgery was for cortical mastoidectomy, 91.65 ± 6.20 minutes. Postoperative pain was present in 93 / 96 (96.87 %) of the patients varying from class I to class V of Verbal Pain Intensity Score (VPIS). CONCLUSIONS To manage patients undergoing day-care surgeries, efficient pre-anaesthetic evaluation is essential. It should include proper selection of patients, assessing the nature of surgery, analysis of comorbid conditions, counselling patients regarding type of anaesthesia and postoperative pain management. The postoperative pain and associated symptoms should be assessed and monitored periodically and should be managed by trained health care personnel to avoid unplanned overnight stays. KEYWORDS ENT, Anaesthesia, Day-Care Surgery, Complications, Pre-Anaesthetic Medication and Post-Operative Outcome

scholarly journals Effect of preoperative education on anxiety in children undergoing day-care surgery

2019 ◽  
Vol 63 (7) ◽  
pp. 565 ◽  
Author(s):  
Nandini Dave ◽  
Aarti Baghele ◽  
Raylene Dias ◽  
Harick Shah
Keyword(s):  
Day Care ◽  
Preoperative Education ◽  
Day Care Surgery ◽  
Care Surgery

scholarly journals Pediatric Laparoscopic Surgery: Four Years Experience in Dhaka Medical College Hospital

2015 ◽  
Vol 4 (1) ◽  
pp. 11-18
Author(s):  
Tahmina Hossain ◽  
Md Ashraf Ul Huq
Keyword(s):  
Inguinal Hernia ◽  
Surgical Procedures ◽  
Surgical Techniques ◽  
Oral Feeding ◽  
Medical College Hospital ◽  
College Hospital ◽  
Medical College ◽  
Laparoscopic Procedures ◽  
Surgical Conditions ◽  
Care Surgery

Purpose: Laparoscopy is gaining popularity over laparotomy in various surgical conditions. Now a day, an increasing number of diagnostic and therapeutic surgical procedures are being done laparoscopically. The aim of this study was to assess the safety and feasibility of laparoscopy in children.Materials and Methods: This retrospective study was carried out in the Department of Pediatric Surgery of Dhaka Medical College Hospital over a period of 52 (Fifty two) months from June 2009 to August 2013. A total of 123 patients were operated laparoscopically up to 12 years of age for different surgical conditions. Data was collected from the hospital records and analyzed retrospectively.Results: Out of these 123 laparoscopically performed cases, Appendectomy was performed in 39 cases, closure of internal inguinal ring for Inguinal Hernia was done in 36 patients, 20 patients underwent Cholecystctomy, 16 patients had laparoscopic procedures for impalpable Undescended Testis (UDT), 5 patients were operated for Adnexal Mass of which one case was converted into open procedure due to technical difficulties and 1 for Pancreatic Pseudo cyst. Diagnostic Laparoscopy was performed for 2 patients with Biliary Atresia and 4 patients for Ambiguous Genitalia. Median age of the patients was 6.08 years (ranging from 2 months to 12 years of age). The length of post operative hospital stay was 2-3 days. All the laparoscopic procedures for Inguinal Hernia and impalpable UDT were performed as day care surgery. Operative and post operative complications were minimal. Other advantages of the laparoscopic procedures were smaller incisions, incidental diagnosis of other associated pathology, lesser post operative pain, earlier oral feeding, quicker mobilization and a better cosmetic result.Conclusion: With the recent development of laparoscopic surgical techniques and equipments, laparoscopic surgical procedures are becoming popular day by day and can be performed safely for both diagnostic and therapeutic purposes in pediatric surgical patients.J. Paediatr. Surg. Bangladesh 4(1): 11-18, 2013 (January)

Chapter-32H Day Care Surgery

2013 ◽  
pp. 1274-1276
Author(s):  
Sriram M
Keyword(s):  
Day Care ◽  
Day Care Surgery ◽  
Care Surgery
Sign in / Sign up

Export Citation Format

Share Document