[Preoperative Evaluation, Indications and Contextual Factors in Ambulant Anaesthesia].

Abstract

Preoperative evaluation and indication are of paramount importance in the field of outpatient anesthesia. Timing, implementation, and recognition of anesthetic contraindications are important points for a good and comprehensive assessment. Not only is the patient's medical history taken, but the assessment also determines the management of any long-term medication. This is more important as uncoordinated discontinuation of long-term medication can lead to a problematic anesthetic outcome. Failure to observe fasting times, serious comorbidities and lack of home care are clear contraindications to outpatient anesthesia. Many comorbidities are not contraindications to outpatient anesthesia if the preoperative setting is good and the anesthetic management and monitoring is adapted to the patient. Knowledge of the management of comorbidities and their importance in outpatient anesthesia broadens the spectrum of anesthesia that can be performed in the outpatient setting. Knowledge of contraindications that may arise from the surgical procedure helps to make a wise decision for or against outpatient anesthesia. As Germany is only at the very beginning of the "outpatientisation" of medicine, we will discuss contextual factors that may lead to an operation/anesthesia that should actually be performed on an outpatient basis also being performed on an inpatient basis.