A–E
ambulatory surgery Surgery, sometimes called
same-day or outpatient surgery, in which the per-
son comes to the hospital or AMBULATORY SURGERY
FACILITYthe day of the surgery, has the OPERATION,
and goes home without an overnight stay in the
hospital. Often the operation uses MINIMALLY INVA-
SIVE SURGERYprocedures such as endoscopic meth-
ods (laparoscopy, arthroscopy), which greatly
reduce the size of the incision and the amount of
trauma the body experiences during operation.
Minimally invasive surgery techniques allow a
rapid course of recovery in the immediate postop-
erative period as well as over the longer term.
Surgeons also can perform numerous OPEN SUR-
GERYprocedures on an ambulatory surgery basis.
People tend to feel more comfortable recovering
in their own homes and often require lower doses
of PAINmedications during their recovery. As well,
a shorter stay reduces the risk for NOSOCOMIAL
INFECTIONS(infections acquired from exposure to
BACTERIAin the hospital environment) and more
quickly returns a person to regular activities.
Because each person’s rate of recovery is
unique, some people more quickly return to CON-
SCIOUSNESSfrom sedation or general ANESTHESIAand
to function from regional anesthesia to engage in
basic activities such as drinking fluids and going to
the bathroom. Underlying health conditions also
influence how quickly a person is ready to leave
after ambulatory surgery. Hospitals and ambula-
tory (outpatient) surgery facilities are equipped
and staffed to handle medical emergencies that
may arise and are prepared for a person to stay
overnight in a hospital should circumstances war-
rant additional care or observation. The person
returns to his or her surgeon for follow-up care
such as wound check, suture removal, and dress-
ing changes.
See also ANALGESIC MEDICATIONS; ENDOSCOPY;
LASER SURGERY; POSTOPERATIVE PROCEDURES; PREOPERA-
TIVE PROCEDURES; SURGERY BENEFIT AND RISK ASSESS-
MENT; WOUND CARE.anesthesia The intentional establishment of loss
of PAINsensation or of consciousness to make a
surgical OPERATION possible. Anesthesia may be
local, regional, or general, depending on the oper-
ation and on the individual’s health circumstances
and preferences. Doctors sometimes use local and
regional forms of anesthesia to treat severe or
CHRONIC PAINnot related to surgery.
Anesthesia today is very effective as well as
safe. There are several types of anesthesia and
numerous anesthetic agents. The anesthesiologist
or anesthetist selects the types and agents accord-
ing to the operation and the person’s health con-
ditions and health status, and may combine types
and agents to achieve the desired anesthetic effect.
The risks of anesthesia vary with the type and
agent though are generally minimal.
Individual response to anesthetic agents varies,
so the anesthesiologist or anesthetist very closely
monitors the person’s vital signs and level of anes-
thesia throughout the operation. After the opera-
tion monitoring continues in the postanesthesia
care unit (PACU), also called the recovery room,
until the person has emerged from anesthesia
enough to go to a hospital room or for discharge
home (AMBULATORY SURGERY).Local Anesthesia
Local anesthesia numbs a small area of the body for
minor operations such as removal of a LIPOMA
(benign tumor of fatty tissue) or NEVUS(SKINlesion
such as a mole). The surgeon generally administers
local anesthesia by injection into and surrounding260