DISCHARGE FOLLOWING OUTPATIENT ANESTHESIA

Due to the recent development in operative medicine medical and organi zational demands on perioperative patient care have changed significan tly. Corresponding to the responsibility of the operative colleagues f or therapy of the primary disease, anesthesiologists have to account f or monitoring and treatment of vital functions throughout the perioper ative period, starting from preoperative evaluation until postoperativ e care. The postanesthesia recovery unit has a key role in perioperati ve management. Beyond post-operative monitoring and stabilization of v ital parameters it is increasingly used as a buffer and switch operati ng station,where patients are prepared and allocated to a normal ward, an observation or intensive care unit for subsequent postoperative car e. The recovery unit has developed to a ''multitasking'' care center, which should be operational 24 h a day with an anesthesiologist presen t during working hours. The terminology should be changed in the futur e in order to better characterize the new task spectrum, e.g. in perio perative anaesthestic care unit (PACU) for medical and medicolegal rea sons patient security must have absolute priority above economic aspec ts. Effective postoperative pain control using epidural or patient-con trolled intravenous analgesia may increase patient comfort and reduce postoperative complications caused by sympathoadrenergic activation. B oth method can be safely used on normal wards provided that close coop eration and training of ward personnel is guaranteed as well as contin uous supervision by a specialized acute pain service.