• M Segerdahl, M Warrén-Stomberg, N Rawal, M Brattwall, and J Jakobsson.
• Department of Clinical Science, Intervention and Technology, Unit for Anesthesia, Karolinska Institute, Stockholm, Sweden. marta.segerdahl@ki.se
• Acta Anaesthesiol Scand. 2008 Jan 1; 52 (1): 117-24.

BackgroundDay surgery has expanded considerably during the last decades. Routines and standards have developed but differ between and within countries.MethodsWe studied the practice of day surgery in Sweden by an extensive questionnaire survey sent to all 92 hospitals.ResultsThe proportion of day surgery vs. in-hospital procedures was overall 43%, with 43% in adults and 46% in children. Orthopaedic (33%), general (29%) and gynaecological (17%) surgery were the most common ambulatory procedures. Most patients (>90%) underwent pre-operative assessment by an anaesthesiologist. Patient self-assessment questionnaires were common (86%). Risk stratification for post-operative nausea and vomiting was used by 70% of the departments. Anxiolytic pre-medication was uncommon. Most anaesthesiologists (95%) used pre-operative oral analgesics to initiate post-operative analgesia, the most common being paracetamol (95%), NSAIDs (73%) and coxibs (15%). A balanced general anaesthesia technique was preferred. Post-operatively, 93% of the units routinely assessed patients' pain. Analgesic combinations of paracetamol, NSAIDs and weak opioids were used by 94% of the units. Most hospitals (80%) had standardised discharge criteria based on clinical assessment, and many required a patient escort at home for 24 h post-operatively. Assessments of unplanned admission, re-admission and post-operative complications were not performed routinely. Follow-up telephone calls within 1-2 days were performed regularly in about 40% of the units, or in selected patients only (37%). Pain was the most frequent complaint on follow-up.ConclusionsIn Sweden, a high degree of standardised regime for day surgical practice was found. Post-operative pain is the most common complaint after discharge.

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