Um eine sichere ambulante Anästhesie zu gewährleisten, ist eine präoperative Evaluation
von elementarer Bedeutung. Dabei wird nicht nur die Anamnese des Patienten erhoben,
sondern auch der Umgang mit einer Dauermedikation bestimmt. Es ist wichtig, klare
Kontraindikationen und Begleiterkrankungen zu erfassen. Kontextfaktoren können dazu
führen, dass ein ambulant durchzuführender Eingriff stationär betreut und von den
Krankenkassen finanziert wird.
Abstract
Preoperative evaluation and indication are of paramount importance in the field of
outpatient anesthesia. Timing, implementation, and recognition of anesthetic contraindications
are important points for a good and comprehensive assessment. Not only is the patient’s
medical history taken, but the assessment also determines the management of any long-term
medication. This is more important as uncoordinated discontinuation of long-term medication
can lead to a problematic anesthetic outcome. Failure to observe fasting times, serious
comorbidities and lack of home care are clear contraindications to outpatient anesthesia.
Many comorbidities are not contraindications to outpatient anesthesia if the preoperative
setting is good and the anesthetic management and monitoring is adapted to the patient.
Knowledge of the management of comorbidities and their importance in outpatient anesthesia
broadens the spectrum of anesthesia that can be performed in the outpatient setting.
Knowledge
of contraindications that may arise from the surgical procedure helps to make a wise
decision for or against outpatient anesthesia. As Germany is only at the very beginning
of the “outpatientisation” of medicine, we will discuss contextual factors that may
lead to an operation/anesthesia that should actually be performed on an outpatient
basis also being performed on an inpatient basis.
Schlüsselwörter
präoperative Evaluation - Indikationen ambulante Anästhesie - Kontextfaktoren ambulante
Anästhesie
Keywords
preoperative evaluation ambulant anaesthesia - indications ambulant anaesthesia -
contextual factors ambulant anaesthesia
