الفهرس 
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Abstract
Over the last 3 decades, outpatient surgery has grown at an exponential rate, progressing from the practice of performing simple procedures on healthy outpatients to encompassing a broad spectrum of patient care in freestanding ambulatory surgery centers.
The perioperative period is stressful, with many pathophysiologic alterations rendering patients vulnerable to several potential adverse events. In the last few years, it increasingly has been recognized that postoperative pain can contribute not only to human suffering but to postoperative morbidity.
Surgical procedures suitable for ambulatory surgery should be accompanied by minimal postoperative physiologic impairment and uncompli-cated recovery.
With advances in surgical technologies and the rapid growth of minimally invasive (”keyhole”) surgery, a wide variety of operations may now be performed on an outpatient basis.
While only American Society of Anesthesiologist (ASA) class I or class II patients were formerly considered candidates for outpatient surgery, many centers currently allow medically stable ASA class III.
Quality, safety, efficiency, and the cost of drugs and equipment are important considerations in choosing an anesthetic technique for outpatient surgery. The ideal outpatient anesthetic should have a rapid and smooth onset of action and it should produce intraoperative amnesia and analgesia, good surgical conditions with a short recovery period, and no side effects.
Propofol is the drug of choice for induction and maintenance of day-case anesthesia and the most widely used intravenous agent for ambulatory anesthesia and sedation because of its favorable pharmacokinetic and pharmacodynamic properties in this specific setting.
Regional anesthesia can reduce or avoid the hazards and discomforts or general anesthesia, including sore throat, airway trauma and muscle pain.
These techniques provide analgesia without sedation, earlier discharge and prolonged postoper-ative analgesia.
Optimal postoperative pain control for day-case surgery should be effective and safe, produce minimal side-effects, facilitate recovery and be easily managed by patients at home. Analgesic techniques should permit ’normal’ activities and additional analgesic supplements should be provided to cover any painful activity.
The administration of analgesia before surgery (preemptively) may be effective in reducing the postoperative pain from surgery by preventing the peripheral and central sensitization caused initially by surgical incision and later by inflammatory injury.
The concept of multimodal or balanced analgesia is to provide optimal pain control through additive and synergistic effects using different analgesics, with a concomitant reduction in side effects owing to the lower doses of individual drugs and differences in side-effect profiles.