الفهرس 
Physiological , anatomical and pharmacologicalOnly 14 pages are availabe for public view
Abstract
Summary Children are good candidates for day surgery because they are typically healthy,and the surgical procedures they require are generally predictable and often of short duration. Ambulatory surgery over the past decade has become extremely popular, not only because costs are decreased but also, from the patient’s point of view, because it avoids hospitalization and allows the patient to recuperate in a home environment, The latter is especially true for children. It has been well recognized that the psychologic trauma of separation during hospitalization is minimized by having the child’s postoperative care managed in the home environment. In recent years, financial pressures have popularized adult ambulatory programs in many countries. Recent advances in surgical and anaesthetic techniques, as well as the publication of successful outcomes in patients with multiple comorbidities,have changed the emphasis in day surgery patient selection. It is now accepted that the majority of patients are appropriate for day surgery unless there is a valid reason why an overnight stay would be to their benefit as a major surgery or chronic disease. It is recommended that a multidisciplinary approach, with agreed protocols for patient assessment including inclusion and exclusion criteria for day surgery.
For example, preoperative evaluation and selection of patients were based on clinical and laboratory parameters,and the patients who were clinically fit and had packed cell volume (PCV) of ≥28% and hemoglobin genotype AA, AC and AS were included. Those with low
PCV (≤27%), genotype SS and compromising congenital anomalies; and preterm neonates were excluded. If inpatient surgery is being considered it is important to question whether any strategies could be employed to enable the patient to be treated as a day case. Full-term infants over one month are usually appropriate to undergo day surgery. A higher age limit is advisable for premature infants (60 weekspost-conceptional age).. General and local anesthesia, including intraoperative analgesia, were used in the patients as necessary. Local anaesthesia has been shown to improve specific outcome (as respiratory and cardiovascular systems)as well as a great role in postoperative analgesia. Post operative analgesia can be done using drugs as pentazocine 1 mg/kg intramuscular administered in the recovering room and intravenous paracetamol 15-20mg/kg every 4-6hours. After surgery significant risk posed by postoperative apnoea must be considered and infants with recent apnoea episodes, cardiac or respiratory disease, family history of sudden infant death syndrome and adverse social circumstances should be considered for overnight admission and close monitoring. Patients were also observed in the recovery room and reviewed in the ward prior to discharge by the unit doctors who instructed and reminded them about postoperative care and what to expect at home. Post-operative interviews on the second day for consultation regarding postoperative complications and events at home were done at the outpatient clinic