[Anesthesia in ambulatory general practice]

Over the last years, ambulatory anaesthesia has gained more significance within the realm of anaesthesiology in Germany. The German health care system aspires to improve the link between ambulatory and clinical health care. Also, the increasing percentage of older people has changed the demographics of society considerably. As potential patients, older people tend to suffer from more pre-existing diseases than younger people, without necessarily being willing to forego ambulatory treatments. According to the guidelines of the "Bundesärztekammer", procedures in an ambulatory setting--and thus ambulatory anaesthesia--may not pose greater risks to patients than the same procedures performed in a clinical setting. The guidelines specifically include the pre-, intra- and post-operative care. This article reviews the guidelines of the "German Society of Anaesthesiology and Intensive Care Medicine" (DGAI) and other professional organizations with respect to ambulatory anaesthesia. It also reviews important structural and procedural requirements and recommendations for the implementation of ambulatory anaesthesia. Topics included are technical requirements, equipment, selection of patients, informed consent, fasting regulations, choice of anaesthetics and postoperative care. In order to accomplish a favourable outcome quality in ambulatory anaesthesia, professional judgement and implementation of the respective guidelines appear to be important rules of conduct.