OUTPATIENT SURGERY - A SURVEY OF ANESTHESIA CARE IN A UNIVERSITY HOSPITAL

This study was done at the Linkoping University Hospital, Sweden, to a ssess the quality of care given to patients undergoing outpatient anae sthesia. A questionnaire was given to all adult patients ( > 15 years old) immediately on admission to the outpatients' surgical ward and th e patients were asked to answer all the questions, if necessary with t he help of an attending nurse. Another questionnaire was given to the patients in the post-operative ward immediately prior to their being d ischarged home. Analyses of results indicate that although most patien ts were satisfied with the care offered at the outpatient surgical uni t, 50% requested, but were not given, anxiolytic premedication before the operation. A majority of these were women undergoing gynaecologica l operations. Twenty per cent of the patients complained of post-opera tive pain that was poorly managed. Drowsiness (12%), headache (10%), a nd sore throat (8%) were common complications following general anaest hesia. In contrast, patients who had regional or local anaesthesia had an extremely low incidence of complications. Almost one-third of the patients were discharged without a responsible person accompanying the m home and 25% were alone at home during the first 24 hours. Of the pa tients who went home alone, most either walked, cycled or took the bus , but 4% actually drove home after the operation. In our opinion more stress should be laid on patient information before the operation and better methods to relieve preoperative anxiety should be used whenever indicated. If possible, local or regional anaesthesia should be used to reduce the incidence of post-operative complications and, finally, patients should not be encouraged to go home alone without a responsib le adult.