Day Stay Surgery in Paediatrics

Abstract

Day stay surgery is well established in paediatric practice. Its success depends on careful attention to patient selection and preparation, with the provision of adequate information and advice to parents both pre- and postoperatively. Units in which it is performed must offer the same standards of medical staff, nursing care and equipment as for inpatients, with access to full hospital facilities readily available.

Anaesthetists should be involved in the establishment of guidelines for day stay programmes and their continuing critical review. Their chief responsibility, however, is in the selection of techniques which provide pleasant induction of anaesthesia with rapid recovery, minimize complications and allow early discharge. The best methods of achieving these aims are still controversial, especially in relation to premedication and analgesia. That this is so, points firstly to the deficiencies of currently available sedative and analgesic drugs and explains the increasingly wide use of local anaesthetic techniques in the last decade. Secondly, it illustrates the need to recognize the differences in the practical functioning of various institutions and the requirements of individual patients. Ultimately, it is only in responding to those individual requirements that a day stay programme will achieve its potential medical, social and economic advantages for society and the family.