The Association of Anaesthetists, the British Association of Day Surgery and the Association of Paediatric Anaesthetists of Great Britain and Ireland issued a consensus statement on perioperative management for day surgery, in adults and children. It was built from a targeted literature review and a two-round modified Delphi process.
Its recommendations cover patient selection, pre-assessment and optimisation; the handling of comorbidities including frailty, obesity and obstructive sleep apnoea; which procedures suit day surgery, including urgent and emergency cases; logistics; anaesthetic technique; and discharge. The authors note that UK day surgery rates now exceed 85% overall but vary widely between hospitals.
The direction of travel is that comorbidity alone should rarely exclude a patient; the question is whether it is optimised and whether the pathway can manage it. Day surgery is expanding in Indian private and public hospitals, often without formal selection criteria, and this document is a ready framework for writing local ones. Its recommendations are consensus rather than trial evidence.
- Base day-surgery eligibility on functional status and optimisation, not on age, BMI or diagnosis labels alone
- Screen for obstructive sleep apnoea at pre-assessment and plan opioid-sparing analgesia for those at risk
- Consider frailty explicitly and plan support at home before the day of surgery
- Use short-acting agents and multimodal, opioid-sparing analgesia as the default
- Set discharge criteria in writing, including analgesia supply and a named contact number
Why it matters
Day surgery is often limited by blanket exclusions rather than by patient risk, and this gives units a common standard to work from.
Don't overread it
Delphi consensus built on a targeted review — its recommendations are expert agreement, not tested pathways.
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