While the surgical procedures are similar whether they are performed in the inpatient or outpatient setting, the anesthetic technique and nursing care are quite different. The majority of ambulatory surgery procedures are associated with a relatively minor surgical trauma. Thus the discharge of these patients to their homes is frequently limited by the time required to recover from anesthesia. The peripheral location of the surgical site in lower extremity surgery and the possibility to block the pain pathways at multiple levels, present a clear advantage for peripheral nerve blocks over either neuraxial or general anesthesia in ambulatory surgery setting.
Postoperative pain is one of the major challenges in ambulatory anesthesia practice.
This may lead to inadequate pain relief in the immediate postoperative period, which in turn may result in more pain and discomfort after discharge than in those patients whose pain was adequately controlled after surgery. Many regional block techniques will in addition to surgical anesthesia provide an extended and superb postoperative analgesia. Another excellent example of how regional block techniques can be useful in the same-day surgery is anterior cruciate ligament reconstruction. This procedure is associated with severe postoperative pain frequently requiring hospital admissions. However longer duration of analgesia can be achieved by using long acting local anesthetics or placing catheters in the vicinity of the nerves of interest.