BC 06. Outpatient Breast Surgery is Safe: Recent Experience with 10836 Pateints at M. D. Anderson Cancer Center

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F. Goravanchi, D. Rigby, E. Rebello, G. Lange, A Kowalski, S. Kee, A Lucci, A Caudle, D. Baumann, K. French, H. Kuerer

Chair(s): Mustafa Cikirikcioglu, Frank Dor, René Tolba, David J. Hackam, Cliff Shearman, Modise Koto

14:20 - 14:30h at Erszebet Room (A)

Categories: Anaesthesiology and Resuscitation, ESSR Best Clinical Research Paper

Session: ESSR Best Clinical Research Paper

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Invited discussant: Osman Yuksel, Attila Szijártó, Lázár György, Gokhan Yagci, Mihály Boros, Thomas Hubert

Background
Many centers in America have moved toward performing breast and reconstructive surgery as an outpatient (OP) or overnight. This practice is based on patient preference to recover at home, better anesthetic techniques, and increasingly less morbid breast surgery. We present our experience at MD Anderson Cancer Center.

Material and Methods
We retrospectively analyzed data for all breast surgeries from our Automated Anesthesia Information Systems from 5/2006 to 12/2013.Patients were either discharged home on the day of surgery (OP), or on the following morning after spending the night at the observation unit (OBU). Discharge criteria was based on assessment of vital signs, pain, nausea, ability to eat, ambulate, urine output, and surgical dressing. Patients who did not meet discharge criteria the morning after surgery were transferred to the hospital ward (SDA). Anesthetic and surgical complications during the first 3 days post operatively were collected. Patients either received general anesthesia, paravertebral block (PVB) as a regional anesthesia technique along with general anesthesia, or PVB along with sedation.

Results
The total number of the surgeries is 10836 (See Picture 1). PVB anesthesia was used on 2,560 patients. 33 patients were admitted to the main hospital for further care or social reasons, 33 patients required hematoma evacuations, and 30 patients required blood transfusions.

Conclusion
Outpatient breast surgery and use of Paravertebral block may be accomplished with minimal complication rates in an outpatient setting. The majority of the patients were discharged home the day of surgery or the following morning without compromise to patient safety.

 

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