[Anesthesiology and day surgery]

The day surgery, known also as an office based practice, is a major change in the clinical medicine of the last two decades. In some countries (for instance in Austria) exists a clear difference between the ambulatory and the day surgery. While the ambulatory patient does not need a hospital bed at all, the day surgery patient occupies a bed for at least few hours, but never stays in the unit overnight. The shift from the hospital to extrahospital surgery is dictated by economical pressure on hospitals, are made possible by new non-invasive surgical techniques and new anaesthetic drugs and, finally, demanded by the society. Anaesthesiologists play a major role in this development, their main task in this new scenario is to secure a balance between the "fast track" approach ot the out-patient surgery and the patient's safety. The meticulous application of the standards in monitoring and perioperative care is the primary obligation of an anaesthesiologists. There is no clear definition of the magnitude of the operation, which can be performed in the settings of day surgery, it varies according to organisation of such units and from the proximity of the hospital in its background. Generally from the day surgery programs should be excluded patients with the risk class above ASA 2, operations lasting more then 90 minutes, all intracranial and intrathoracic operations and all procedures requiring blood transfusion. Day surgery is generally free from mortality and major complications like myocardial infarction, pulmonary embolism or neurological consequences, therefore the assessment of outcome should include minor morbidity, pain relief and satisfaction of the patient.