Postoperative morbidity after day surgery (Tab 69.4)

Day surgery has an excellent safety record. Major morbidity with the potential for serious harm is rare. In a large study from the Mayo Clinic in 1993, Warner reported that the mortality and major morbidity in the 30 days after day surgery was 0.0007 per cent — lower than in the general population who had not had surgery.

Minor morbidity, however, is common and apparently minor problems can have significant consequences. For the hospital, it results in longer stays in the DSU and increased rates of overnight admission, which may cause problems if no bed is available or the bed is earmarked for another patient. For the patient, it is not only unpleasant but delays their recovery and return to normal life and is a cause of dissatis­faction. For GP, it may increase workload.

Postoperative morbidity is related to the type of anaesthesia used and the surgery itself. The procedure is generally the most important predictor of complications. The requirement to discharge patients within a relatively short time of their surgery demands meticulous and safe anaesthetic and surgical techniques to ensure good recovery with minimal postoperative morbidity.