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The Outpatient Surgery Centre (OSC) is designed, functionally and structurally, to perform outpatient surgical procedures. Its goal is to perform procedures of average complexity in which the patient, following a recovery and monitoring period, and regardless of the anaesthetic technique used, is discharged, albeit maintaining the same effectiveness and standards of care as for patients operated in-hospital.
The anaesthesiologists working in this Unit are entrusted with the following functions:
- Perform the preoperative examination if the patient has not been seen in the Anaesthesiology Office, and have them sign the specific IC for the OSC
- Perform scheduled and/or emergency surgery in the OSC
- Monitor the patient until discharge
- Have the patient admitted in the event of a serious complication, be it surgical or anaesthetic
Patients are screened initially by the surgeon, although definitive acceptance depends on the anaesthesiologist's decision following the preoperative examination.
Criteria for the inclusion or rejection of a patient in the OSC:
A. Surgery-related inclusion criteria
- Not require intravenous antibiotics in the postoperative period.
- The surgery should not be performed on a septic focus.
- The surgical procedure should not be subsidiary to prophylactic heparinisation and present a minor risk of blood loss.
- Scant probability of serious post-operative complications (particularly haemorrhageal).
- The approximate duration of surgery under general anesthesia is 60 minutes. If other anaesthetic techniques are used, this time is advisable, although not indispensable.
B. Inclusion criteria according to patient pathology
- ASA I and II patients.
- ASA III, and exceptionally ASA IV patients with compensated disease who have not presented the compensation episodes in the three months prior to surgery, operated preferably under regional or local anaesthesia with mild sedation.
- Patients with COPD, type 2 diabetes (treated with OAD) in surgical procedures that do not require general anaesthesia. Insulin-dependent type 1 diabetes only in ophthalmological procedures.
- Obesity: the type of surgical procedure and anaesthetic technique will be assessed on a by-case and by-condition basis.
C. Exclusion criteria according to the patient's pathology.
- Type 1 diabetes.
- COPD and type 2 diabetes (treated with OAD) in surgical procedures requiring general anaesthesia.
- Psychiatric patients.
- Drug addiction.
- Treatment with anticoagulants and/or coagulation alterations.
- A record of serious anaesthetic complications in previous surgical procedures.
- Risk of malignant hyperthermia.
- Pediatric patients under the age of 18 months (except for patients with lacrimal sac obstruction, lingual frenulum or delayed umbilical cord separation).
- Patients with heart disease presenting clinical symptoms in the past two years, except cataract surgery (absence of symptoms in the 3 months prior to surgery).
- High blood pressure poorly controlled with medication.