Background and objective: The aim of this arm of the ANESCAT study was to describe the characteristics of ambulatory anesthesia in Catalonia, Spain.
Patients and method: Relevant data was extracted from a survey of anesthetic procedures in 131 public, publicly contracted, and private hospitals on 14 representative days in 2003.
Results: Of the estimated 603,189 anesthesias performed, 206,992 (34.32%; 95% confidence interval, 33.3%-35.4%) were on outpatients. The median (10th to 90th percentile) age of patients was 59 (22-80) years and 56.6% were women. The physical status of patients according to the American Society of Anesthesiologists (ASA) classification was ASA I or II for 75.1% of the patient sample. The most common approach to anesthesia was sedation/monitoring (47.7%), followed by regional anesthesia (28.9%). The types of regional anesthesia reported most often were peri- or retrobulbar blocks (50.8% of the regional blocks), followed by spinal anesthesia (22.2%). Anesthesia was required for surgery in 76.5% of the cases and for diagnostic or other nonsurgical procedures in 22%. The individual surgical specialties creating the greatest demand for anesthetic procedures were ophthalmology (39%) and orthopedic and trauma surgery (10.9%). The specific interventions accounting for the largest percentages of anesthetic procedures were cataract extraction (32.3%) and digestive tract endoscopy (16.7%). In 8.2% of the cases, patients did not require a stay in the postanesthetic recovery unit. Private hospitals, facilities with fewer than 250 beds, and those not accredited to provide medical resident training had higher rates of ambulatory anesthesia.
Conclusions: Ambulatory procedures account for approximately a third of the anesthesia workload in Catalonia. Sedation/monitoring and regional anesthesia are the approaches that predominate in this category. Ambulatory anesthesia is applied mainly in ophthalmology and the rate of endoscopic procedures requiring outpatient anesthesia is also high.