Walk-in, walk-out day case genito-scrotal surgery with sedation reversal. A survey of patient attitudes and morbidity.

OBJECTIVES

To survey patient attitudes and assess the extent of patient morbidity in the first 24 h following walk-in, walk-out day case genito-scrotal surgery with sedation reversal.

PATIENTS AND

METHODS

One hundred patients who were undergoing genito-scrotal surgery were eligible for inclusion in the study. All patients walked into theatre, positioned themselves on the operating table and were sedated with intravenous (i.v.) midazolam (Hypnovel, Roche Products Ltd, Welwyn, UK) following which the appropriate local anaesthetic block was performed. One minute before the end of surgery sedation was reversed with an i.v. injection of 0.5 mg flumazenil (Anexate, Roche Products Ltd). When conscious and alert (approx. 2 min), patients were allowed to get themselves up off the operating table and walk from theatre. All patients were given a questionnaire to complete and were reviewed 2 weeks after surgery.

RESULTS

Eighty-six of 100 patients returned questionnaires. Fifty-five patients were asymptomatic and no patient experienced nausea or vomiting in the first 24 h post-operatively. Other symptoms such as headache (2%), drowsiness (20%) and dizziness (11%) were uncommon and significantly less frequent than seen with general anaesthetic procedures. Seventeen patients described minor wound complications and one patient with a scrotal haematoma was readmitted for overnight observation. Nearly all patients (98%) expressed their satisfaction with the technique.

CONCLUSION

Walk-in, walk-out day case surgery as described is a well-tolerated technique with a low morbidity and towards which patients have a positive attitude.