Outpatient Surgery

Outpatient Surgery

Packing a bag for a night or two in the hospital might not be on your to-do list if you’re preparing for surgery. Today nearly two-thirds of all operations are performed in outpatient facilities, according to the Centers for Disease Control and Prevention. Your surgery might be performed in a facility connected to a hospital, a separate surgical center or your physician’s office. Outpatient surgery, also called same-day, ambulatory or office-based surgery, provides patients with the convenience and comfort of recovering at home, and can cost less. It might also help lower your risk of infection.

Wherever your surgery is performed, you will be given some form of anesthesia or medication to keep you from feeling pain during the procedure.

Outpatient surgeries can take a few minutes or a few hours, and most are not for medical emergencies. A typical outpatient surgery might be a simple mole removal, a hernia repair or a knee replacement.

What types of anesthesia are available?

Wherever your surgery is performed, you will be given some form of anesthesia or medication to keep you from feeling pain during the procedure. There are four main types of anesthesia used in outpatient surgery. You and your surgeon or physician anesthesiologist, a medical expert who specializes in anesthesia care, will discuss this with you before your surgery so you will know what to expect and can prepare for a safe and comfortable experience.

The four types of anesthesia:

  • General anesthesia. This type of anesthesia is given through a mask or IV and causes you to become unconscious during the procedure. General anesthesia is typically used for major procedures such as knee or hip replacements.
  • Regional anesthesia. Regional anesthesia is usually given through an injection or a thin tube called a catheter, often in the spine. It numbs a larger part of the body than local anesthetic does, such as your body from the waist down. It is often used for procedures such as childbirth, or surgeries of the abdomen, arm or leg. You will be awake but won’t feel pain in the area that is numbed.
  • Monitored anesthesia care or (IV) sedation. You may be given medication that relaxes you or makes you sleepy through an IV into a vein. There are several levels of sedation, and people react differently to them. Some people are awake and can talk but feel no pain. Others fall into a deep sleep and remember nothing of the procedure. This type of anesthesia is often used for minimally invasive procedures such as colonoscopies. Sedation sometimes is combined with local anesthetic.
  • Local anesthetic. This is usually a one-time injection of medicine that numbs a small area for procedures such as a taking a skin biopsy, repairing a broken bone or stitching a deep cut. You will be awake and alert but won’t feel pain in the area being treated.

Your physician will give specific instructions on how to prepare the night before and the day of your surgery to help ensure a safe and successful experience.

How should you prepare for outpatient surgery?

Just like for inpatient surgery in a hospital, there are instructions to follow to prepare for your outpatient surgery. Your preparation will depend in part on the type of anesthesia you will be having. If you are having sedation or general anesthesia, you may be told not to eat or drink anything for several hours before your procedure. This is usually not necessary for minor procedures requiring only local anesthesia.

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Other preparations that will help ensure a safe and comfortable procedure include the following:

  • Bring a friend or family member. If you are having anesthesia that puts you to sleep or sedates you, you won’t be able to drive or get home on your own. Having someone with you will also help you relax before your procedure and will help you remember the instructions for your recovery.
  • Wear comfortable clothing. You may be sore from the surgery or have bandages that cover incisions, so wear loose and comfortable clothes.
  • Plan for recovery time. If you’ve had a minor surgery with local anesthetic, you may be able to go home very soon after your procedure. If you have regional anesthesia, sedation or general anesthesia, the physician anesthesiologist may monitor you for a few hours to make sure your heart and breathing are normal and you aren’t experiencing side effects. Once you’re home, it’s a good idea to have someone stay with you for at least the first 24 hours. You will probably have some soreness and may be sleepy. The anesthesia also may affect your reflexes and judgment for a while, so plan to stay home and rest.
  • Be prepared for side effects. Ask your physician anesthesiologist or surgeon what type of pain or soreness to expect and how best to treat it. Physician anesthesiologists are specialists in controlling pain and can advise you on prescription and over-the-counter medications, as well as ways to manage pain without drugs. The physician anesthesiologist can also help if you have nausea or vomiting, which some patients experience for a few hours or days after surgery and anesthesia.

What should you know about the facility and physicians?

Although outpatient surgeries may not be for medical emergencies and are often less complex than surgeries requiring an overnight hospital stay, it’s still important to do your homework to make sure you’re getting the best care.

Here are some questions to ask:

  • What are the qualifications of the surgeon and other medical staff? Ask about the qualifications and experience of the physician leading your care to make sure he or she is certified to perform the procedure. Those who are qualified have special training and have passed exams given by a national board of surgeons. Also ask your surgeon about his or her record with the specific procedure you’re having, and about successes and complications.
    Be sure the nurses and other clinical staff who support the surgeon are also experienced with the procedure and have the appropriate medical education and training.
  • Who is providing and monitoring the anesthesia? Be sure a physician anesthesiologist is leading your anesthesia care, especially if you are having general anesthesia or sedation. A physician anesthesiologist also can make sure you get the most effective pain management after your procedure.
  • Is the surgery center licensed and well-equipped to handle your procedure? Although rare, emergencies can occur during surgery. Unlike hospitals, an office-based or same-day surgery site may not have an emergency facility nearby, so it’s important to ask if the surgery center has emergency medications, equipment and procedures in place to safely care for you if there is an emergency. The outpatient surgery center should be licensed and accredited.

For more information on preparing for surgery, visit Preparing for Surgery.

 

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Physician anesthesiologists are the most highly skilled medical experts in anesthesia care, pain management, and critical care medicine with the education and training that can mean the difference between life and death.