Question
A patient is posted for laparoscopic cholecystectomy under general anesthesia. Which of the following makes the patient unsuitable for a day care surgery?
| A. |
ASA physical status grade III
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| B. |
Surgical duration more than 1 hour
|
| C. |
Home is 45 minutes away
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| D. |
No attendant available at home to care for patient
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Show Answer
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Correct Answer » D
Explanation
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Day-care (ambulatory) surgery allows patients to be discharged on the same day of surgery. Proper patient selection is essential to ensure safety after discharge.
One of the mandatory requirements is the availability of a responsible adult attendant to accompany the patient home and provide supervision for the first 24 hours after general anesthesia.
D. No responsible adult available at home to accompany and care for the patient after discharge
- Patients undergoing day-care surgery should have:
- A responsible adult escort.
- Someone to remain with them for at least the first 24 hours after discharge.
- Absence of an attendant is considered a contraindication to ambulatory surgery, as postoperative complications may occur after discharge.
Why the Other Options are Incorrect
A. ASA Physical Status Grade III
- Patients with stable, well-controlled ASA III disease may be considered suitable for selected ambulatory procedures after appropriate evaluation.
- Therefore, ASA III alone is not an absolute contraindication.
B. Expected surgical duration of more than 1 hour
- Many laparoscopic procedures lasting longer than 1 hour are successfully performed as day-care surgeries.
- Duration alone is not an absolute exclusion criterion.
C. Residence located 45 minutes from the hospital
- Living within approximately 1 hour of the hospital is generally considered acceptable.
- A distance of 45 minutes does not preclude day-care surgery.
