Standards of care for ambulatory surgery. Are we up to speed.

Ambulatory surgeries are becoming increasingly more common in daily anesthesia practice, placing greater demands on anesthesia providers to offer timely and thorough preoperative evaluation and preparation, optimal patient and surgical selection, and efficient, safe, and timely postanesthesia care, all of which necessitate an active participation of an anesthesiologist in all aspects of the organization and coordination of perioperative management. Numerous studies over the last couple of decades have introduced various organizational models for pre-anesthesia screening, with a goal of improving patient satisfaction, controlling the cost, and decreasing surgical delays. Having recognized the importance of anesthesia selection regarding patient comfort and the duration of post-anesthesia recovery in the ambulatory setting, many anesthesiologists have focused their attention on studying various anesthesia modalities and techniques with new emphasis on preemptive interventions (e.g. preoperative antiemetics, continuous peripheral nerve blocks). Finally, a concept of bypassing traditional recovery period in the post-anesthesia recovery rooms (''fast tracking'') that had been scrutinized over the last decade has been accepted as cost effective and safe, providing adequate patient selection.