Hostname: page-component-586b7cd67f-tf8b9 Total loading time: 0 Render date: 2024-11-23T02:22:46.561Z Has data issue: false hasContentIssue false

Anaesthesia for day case surgery: a survey of adult clinical practice in the UK

Published online by Cambridge University Press:  02 June 2005

K. Payne
Affiliation:
University of Manchester, School of Pharmacy & Pharmaceutical Sciences, Manchester, UK
E. W. Moore
Affiliation:
Wirral Hospital NHS Trust, Department of Anaesthesia, Wirral, UK
R. A. Elliott
Affiliation:
University of Manchester, School of Pharmacy & Pharmaceutical Sciences, Manchester, UK
B. J. Pollard
Affiliation:
Central Manchester & Manchester Children's University Hospitals NHS Trust, Department of Anaesthesia, Manchester, UK
G. A. McHugh
Affiliation:
University of Manchester, School of Nursing, Midwifery & Health Visiting, Manchester, UK
Get access

Extract

Summary

Background and objective: In October 2000, we conducted a national postal survey of consultant day case anaesthetists in the UK to explore the range and variation in the practice of anaesthetizing a patient for day case surgery (paediatrics, urology and orthopaedics). The survey was carried out as part of a larger study that comprised a major two-centre randomized controlled trial designed to investigate the costs and outcome of several anaesthetic techniques during day care surgery in paediatric and adult patients (cost-effectiveness study of anaesthesia in day case surgery). We report the findings of this national survey of adult urology and orthopaedic day case anaesthetic practice in the UK.

Methods: The survey used a structured postal questionnaire and collected data on the duration of the surgical procedure; the use of premedication; the anaesthetic agents used for induction and maintenance; the fresh gas flows used for anaesthesia; the use of antiemetics; and the administration of local anaesthesia and analgesia.

Results: The overall response rate for the survey was 74% (63% for urology, 67% for orthopaedics). The survey indicated the following practice in adult urology and adult orthopaedic day case surgery: 6 and 12% used premedication; propofol was the preferred induction agent (96 and 97%) and isoflurane the preferred maintenance agent (56 and 58%); 32 and 41% used prophylactic antiemetics; 86 and 93% used a laryngeal mask.

Conclusions: This survey identifies the variation in current clinical practice in adult day surgery anaesthesia in the UK and discusses this variation in the context of current published evidence.

Type
Original Article
Copyright
© 2003 European Society of Anaesthesiology

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Guidelines for Day Case Surgery. London, UK: Royal College of Surgeons of England, 1992.
Yuen P. Compendium of Health Statistics. London, UK: Office of Health Economics, 2001.
Myles PS, Bain DL, Johnson F, McMahon A. Is anaesthesia evidence-based? A survey of in anaesthetic practice. Br J Anaesth 1999; 82: 591595.Google Scholar
Simpson RB, Russell D. Anaesthesia for daycase gynaecological laparoscopy: a survey of clinical practice in the United Kingdom. Anaesthesia 1999; 54: 7275.Google Scholar
Thoms GMM, McHugh GA, Pollard BJ, Moore J. Anaesthesia clinical directors in the United Kingdom: organisation, objectives and support needs. Anaesthesia 1999; 54: 753760.Google Scholar
Cheng KI, Chu KS, Fang YR, et al. Total intravenous anesthesia using propofol and ketamine for ambulatory gynecologic laparoscopy. Kaohsiung J Med Sci 1999; 15: 536541.Google Scholar
Chittleborough MC, Osborne GA, Rudkin GE, Vickers D, Leppard PI. Double-blind comparison of patient recovery after induction with propofol thiopentone for day case relaxant general anaesthesia. Anaesth Intensive Care 1992; 20: 169173.Google Scholar
De Grood PMRM, Harbers JBM, Van Egmond J, Crul JF. Anaesthesia for laparoscopy. Anaesthesia 1987; 42: 815823.Google Scholar
Gupta A, Larsen LE, Sjoberg F, Lindh ML, Lennmarken C. Thiopentone or propofol for induction of isoflurane-based anaesthesia for ambulatory surgery? Acta Anaesthesiol Scand 1992; 36: 670674.Google Scholar
Kashtan H, Edelist G, Mallon J, Kapala D. Comparative evaluation of propofol and thiopentone for total intravenous anaesthesia. Can J Anaesth 1990; 37: 170176.Google Scholar
Korttila K, Ostman P, Faure E, et al. Randomized comparison of recovery after propofol–nitrous oxide versus thiopentone–isoflurane–nitrous oxide anaesthesia in patients undergoing ambulatory surgery. Acta Anaesthesiol Scand 1990; 34: 400403.Google Scholar
Korttila K, Nuotto EJ, Lichtor L, et al. Clinical recovery and psychomotor function after brief anesthesia with propofol or thiopental. Anesthesiology 1992; 76: 676681.Google Scholar
Lim BL, Low TC. Total intravenous anaesthesia versus inhalational anaesthesia for dental day surgery. Anaesth Intensive Care 1992; 20: 475478.Google Scholar
Nielsen J, Jenstrup M, Gerdes NU, Rasmussen LS, Fruergaard K, Wiberg-Jorgensen F. Awakening and recovery of simple cognitive and psychomotor functions 2 h after anaesthesia for day case surgery – total intravenous anaesthesia with propofol–alfentanil versus thiopentone–alfentanil. Eur J Anaesthesiol 1991; 8: 219225.Google Scholar
Price ML, Walmsley A, Swaine C, Ponte J. Comparison of a total intravenous anaesthetic technique using a propofol infusion, with an inhalational technique using enflurane for day case surgery. Anaesthesia 1988; 43: 8487.Google Scholar
Ryom C, Flarup M, Cuadicani P, et al. Recovery following thiopentone or propofol anaesthesia by computerised co-ordination measurements. Acta Anaesthesiol Scand 1992; 36: 540545.Google Scholar
Sampson IH, Plosker H, Cohen M, Kaplan JA. Comparison of propofol and thiamylal for induction and maintenance of anaesthesia for outpatient surgery. Br J Anaesth 1988; 61: 707711.Google Scholar
Sanders LD, Clyburn PA, Rosen M, Robinson JO. Propofol in short gynaecological procedures. Anaesthesia 1991; 46: 451455.Google Scholar
Segatto A, Vincenti E, Valenti S. TIVA with propofol versus thiopental–nitrous oxide anaesthesia for uterine cerclage. Acta Anaesthesiol Ital 1993; 44 (S1): 5965.Google Scholar
Fish WH, Hobbs AJ, Daniels MV. Comparison of sevoflurane and total intravenous anaesthesia for daycase urological surgery. Anaesthesia 1999; 54: 9991006.Google Scholar
Ong EL, Chiu JW, Chong JL, Kwan KM. Volatile induction and maintenance (VIMA) versus total intravenous anaesthesia (TIVA) for minor gynaecological procedures. Ambulatory Surgery 2000; 8: 3740.Google Scholar
Joo HS, Perks WJ. Sevoflurane versus propofol for anesthetic induction: a meta-analysis. Anesth Analg 2000; 91: 213219.Google Scholar
McQuay HJ, Moore RA. Postoperative analgesia and vomiting, with special reference to day surgery: a systematic review. Health Technol Assess 1998; 2: 1236.Google Scholar
Tramer M, Moore RA, Reynolds DJM, McQuay HJ. A quantitative systematic review of ondansetron in treatment of established postoperative nausea and vomiting. BMJ 1997; 314: 10881092.Google Scholar
Scanlon P, Carey M, Power M, Kirby F. Response to LMA insertion after induction of anaesthesia with propofol or thiopentone. Can J Anaesth 1993; 40: 816818.Google Scholar