Contraindications

Contraindications to day surgery include:

• medical:
  • angina at rest } all ischaemic
  • myocardial infarct in last six months } heart disease is controversial
  • hypertensives - diastolic greater than 105 mmHg
  • cardiac failure
  • acute respiratory infection
  • asthma - moderate to severe require increased observation
  • chronic bronchitis
  • emphysema
  • gross obesity: body mass index > 35
  • insulin dependent diabetics
  • coagulation defects
  • anticoagulation therapy
  • deformity or anatomical problems in jaw or neck
  • extent of pathology, e.g. large scrotal hernia
  • operation longer than one hour
  • painful operations - need an increase in analgesia
    
    
• psychological:
  • psychologically unstable, e.g. psychosis
  • concept of day surgery unacceptable to patient
    
    
• social:
  • lives over one hour away from unit
  • no reliable person to drive patient home after surgery and look after them for the first 24-48 hours postoperatively
  • at home, no access to a lift, telephone or indoor toilet and bathroom

These recommendations will vary from centre to centre.