Patients may be discharged home with residual sensory or motor effects after peripheral nerve or plexus blocks (not after neuraxial anaesthesia). Duration of the effects should be explained, and the patient should receive written instructions as to how to care for their numb limb until normal sensation.
Postoperative short-term memory loss may prevent verbal information being assimilated by the patient.26 If postoperative analgesia has been provided, clear written instructions on how and when to take medication should be provided. Other important information should also be provided in writing.5,9,25
A 24-hour telephone number should be supplied so that every patient knows whom to contact in case of postoperative complications. This should ideally be connected to an inpatient surgical area of the appropriate specialty and should not be an answerphone.
Following procedures performed under general or regional anaesthesia, a responsible adult should escort the patient home and should provide support for the first 24 hours after surgery.5 A carer at home may not be essential if there has been good recovery after brief or non-invasive procedures and where any postoperative haemorrhage is likely to be obvious and controllable with simple pressure.
Transport home should be by private car or taxi; public transport is not normally acceptable following general or regional anaesthesia.
Where the patient’s general practitioner (GP) practice may need to provide postoperative care within a short time of discharge, arrangements for this should have been made with the GP in advance of the patient’s admission.
The patient’s GP should be informed of the patient’s procedure as soon as practical, and provided with a written discharge summary, which will usually be completed by the surgeon.
All patients should receive a copy of their discharge summary in case emergency treatment is needed overnight.
A number of urgent surgical operations (e.g. abscess drainage, superficial lacerations or hand trauma) can be managed on a daycase basis, with semi-elective admission to day surgery facilities on the day of operation and discharge later the same day.10,17,27 Effective preoperative assessment will add to success for these patients. In contrast, the accommodation of...
