Enhanced recovery after surgery in ambulatory procedures.

PURPOSE OF REVIEW: The expansion of ambulatory surgeries has increased the demand for efficient, safe, and patient-centered perioperative strategies. Enhanced recovery after surgery principles offer a structured framework to streamline ambulatory care. This review highlights recent evidence and advancements in the management of patients undergoing ambulatory procedures.

RECENT FINDINGS: Recent evidence has broadened the anesthetic armamentarium for ambulatory enhanced recovery pathways. Hypnotics such as remimazolam and ciprofol show promising safety profiles in select patient populations. Adjunct anesthetics, including low-dose ketamine, low-dose dexmedetomidine, and methadone, are increasingly being studied for opioid sparing analgesia. Other advances include Bispectral index-guided closed-loop systems, refined antiemetic strategies, and patient-centered recovery metrics to guide discharge readiness.

SUMMARY: Current evidence endorses the utilization of enhanced recovery protocols for ambulatory anesthesia, with anesthesiologists assuming a pivotal role. Additional research is required to assess newer agents within these enhanced recovery frameworks, establish standardized patient-centered outcome measures, and incorporate real-time audit tools.