The majority of patients who undergo surgery or diagnostic tests at NewYork-Presbyterian/Weill Cornell Medical Center do not need to stay overnight in the hospital. Ambulatory (or outpatient) anesthesia and surgical care has proven to be safe, convenient, and cost-effective. Short-acting anesthetic drugs, and specialized anesthetic techniques and care specifically focused on the needs of the ambulatory patient are used to make your experience safe and pleasant. Because each patient is unique, your anesthesiologist and your surgeon will carefully evaluate you, your health status, and the extent of your surgical procedure to determine if you should undergo ambulatory anesthesia.
There are a variety of anesthetic techniques suitable for ambulatory surgery, including local anesthesia, local anesthesia with sedation (commonly referred to as monitored anesthesia care or MAC), regional anesthesia (such as spinal and epidural anesthesia, and peripheral nerve blocks), and general anesthesia. The choice of technique depends on the operative site, the needs of your surgeon, your medical history, and your preference. Your anesthesiologist will discuss the anesthetic options available to you, and the risks and benefits associated with each. Together you will select the most appropriate anesthetic choice.
Before Ambulatory Surgery
Ambulatory surgery patients will receive a telephone call from a hospital staff member on the day before surgery. During the call you will be told what time to come into the hospital and where to go. You will also be reminded to adhere to the fasting guidelines, and to have a responsible adult available to take you home after your surgery.
If you experience any change in your physical condition before your scheduled surgery date, such as a cold, fever, sore throat, rash, or flu, please notify your surgeon.
After Ambulatory Surgery
After your early recovery from anesthesia, you usually will return directly home. Most patients will be ready to leave the hospital a few hours after surgery. In some instances patients may require extended observation for several hours before they go home. Appropriate pain management will be included as part of your discharge planning. In most cases, family and friends can provide all the needed assistance. If you do not have family members or others to help at home, please let your surgeon know before scheduling an outpatient procedure; you may require additional help.
The amount of discomfort you experience will depend on a number of factors, especially the type of surgery. Your doctors and nurses can relieve pain after your surgery with medicines given by mouth, injection or by numbing the area around the incision. Your discomfort should be tolerable, but do not expect to be totally pain-free.
Nausea or vomiting may be related to anesthesia, the type of surgical procedure, or postoperative pain medications. Although less of a problem today because of improved anesthetic agents and techniques, these side effects continue to occur for some patients.
Rest assured that every effort will be made by your anesthesiologist, your surgeon, and the nurses taking care of you in recovery to minimize postoperative pain, nausea, and vomiting.
Most patients are ready to go home between one and four hours after surgery. Before you are discharged, you will be given written discharge instructions that the nurse will review with you and your family. Any other special instructions will also be discussed. You will be given prescriptions if needed. You are encouraged to ask questions! Be sure you understand how to take care of yourself at home before you leave the hospital.
You must make arrangements for a responsible adult to take you home after your anesthetic or sedation. Your surgery will be cancelled if you have not arranged an escort. In addition, it is strongly suggested that you have someone stay with you during the first 24 hours after your surgery. If you have local anesthesia only, with no sedation, it may be possible to go home without someone to accompany you. Check with your surgeon first.
Recovery at Home
Be prepared to finish your recovery at home. Patients often experience drowsiness and minor after-effects following ambulatory anesthesia, including muscle aches, a sore throat, and occasional dizziness or headaches. Nausea may also be present, but vomiting is less common. These side effects usually decline rapidly in the hours following surgery, but it may take several days before they are gone completely. In general, for 24 hours after your anesthesia:
- Do not drink alcohol
- Do not take any medications not authorized by your surgeon
- Do not drive a car or operate dangerous machinery
- Do not make important decisions
- Do not travel alone on public transportation
- Do not care for a dependent person
Most patients do not feel up to their typical activities the next day, usually due to general tiredness or surgical discomfort. Plan to take it easy for a few days until you feel back to normal. Know that a period of recovery at home is common and to be expected.
Remember to ask questions! Your experience will be easier if you know what usually happens and what you should expect. Remember, the focus of ambulatory anesthesia is on you, the patient.
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