Preoperative Optimization of Patients Undergoing Ambulatory Surgery

Abstract

As the percentage of surgical procedures performed in the outpatient setting continues to increase, development of standardized guidelines, recommendations for the preoperative assessment, and optimization of ambulatory surgery patients has become an increasing area of focus. While ambulatory surgery encompasses low-risk procedures and is generally well tolerated, the patients considered for these procedures manifest increasingly complex profiles of comorbidity. Minimizing perioperative adverse events among ambulatory surgery patients while maintaining responsible stewardship of health care resources and preventing unnecessary delays demands a thoughtful and evidence-based approach to preoperative assessment and medical optimization of comorbid conditions. This review summarizes current thought with regard to preoperative testing as well as assessment and management of important comorbid conditions in the ambulatory surgical population. General goals and specific recommendations based upon available evidence and expert consensus statements are provided to guide the preoperative management of patients considered for ambulatory surgery.