Intraoperative Considerations for Rapid Recovery After Ambulatory Surgery: What's New and What's Controversial

PurposeEnhanced recovery protocols can lead to faster patient recovery after ambulatory surgery. This review article will discuss novel therapies and controversies regarding intraoperative considerations for rapid recovery after ambulatory procedures.Recent FindingsPostoperative nausea and vomiting are frequent in ambulatory surgical patients. New antiemetic drugs (i.e., amisulpride or aprepitant) have been introduced that may have a role in the ambulatory setting. The administration of sugammadex or neostigmine is recommended to prevent residual muscle relaxation. Frail patients may require a different approach and electroencephalographic monitoring to prevent surgery-related cognitive decline or delirium. Patients who are obese or suffer from obstructive sleep apnea may prove to be challenging. Using a nasal mask with continuous positive airway pressure (CPAP) may prevent hypoxemia and reduce airway manipulation in obese and OSA patient populations. Novel technologies such as virtual or augmented reality have been shown to reduce pain and anxiety in ambulatory procedures.SummaryThe demand for ambulatory surgical procedures will increase in the coming years. Applying the "enhanced or fast-track recovery" concept after ambulatory surgery may result in improved postoperative outcomes.