Day Surgery Anaesthesia
Day surgery (ambulatory surgery) constitutes 70-80% of elective surgical procedures in Australia, requiring rapid recovery, minimal side effects, and safe discharge criteria. Patient selection: ASA 1-2 (selected ASA 3...
What matters first
Day surgery (ambulatory surgery) constitutes 70-80% of elective surgical procedures in Australia, requiring rapid recovery, minimal side effects, and safe discharge criteria. Patient selection: ASA 1-2 (selected ASA 3...
Inability to maintain airway patency postoperatively
2 Feb 2026
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82 cited sources
Clinical board
A visual summary of the highest-yield teaching signals on this page.
Urgent signals
Safety-critical features pulled from the topic metadata.
- Inability to maintain airway patency postoperatively
- Uncontrolled pain preventing discharge
- Prolonged nausea and vomiting
- Excessive bleeding requiring admission
Exam focus
Current exam surfaces linked to this topic.
- ANZCA Final Written
- ANZCA Final Clinical Viva
Content status and exam context
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Clinical explanation and evidence
Quick Answer
Day surgery (ambulatory surgery) constitutes 70-80% of elective surgical procedures in Australia, requiring rapid recovery, minimal side effects, and safe discharge criteria. Patient selection: ASA 1-2 (selected ASA 3 acceptable), BMI <40 kg/m², age appropriate (infants >60 weeks PCA, elderly fit), procedure <2 hours duration, controlled comorbidities, adequate social support at home. Preoperative preparation: Fasting 2 hours clear fluids, 6 hours solids; screening for OSA (STOP-BANG), difficult airway, medications (continue ACE inhibitors, withhold SGLT2 inhibitors, oral hypoglycaemics). Anaesthetic technique: Rapid onset/offset (propofol TIVA or sevoflurane, desflurane), short-acting opioids (fentanyl, alfentanil), multimodal analgesia (paracetamol, NSAIDs, local infiltration, regional blocks), aggressive PONV prophylaxis in high-risk (5-HT3 antagonist + dexamethasone + droperidol/ondansetron). Regional techniques: Spinal anaesthesia for lower limb (rapid offset with lidocaine/procaine), brachial plexus block with low-dose long-acting local (ropivacaine), TAP block for abdominal procedures. Discharge criteria: Modified Aldrete score ≥9, stable vital signs, adequate pain control (VAS <4), controlled nausea/emesis, minimal bleeding, able to ambulate, voided (if appropriate), adult escort available, written instructions provided. Unplanned admission: 2-5% rate due to surgical complications (bleeding), medical complications (respiratory issues, arrhythmias), inadequate pain control, PONV, social factors. Fast-track surgery: Enhanced Recovery After Surgery (ERAS) protocols incorporating prehabilitation, carbohydrate loading, multimodal analgesia, early mobilization, goal-directed fluid therapy achieving same-day discharge for major procedures (laparoscopic cholecystectomy, knee arthroscopy, hernia repair). Indigenous patients: Remote location creates transport challenges for day surgery; ensure return transport arranged, 24-hour contact number provided, coordination with local health service for follow-up. [1-10]