Clinical practice and routines for day surgery in Sweden: results from a nation-wide survey

Acta Anaesthesiol Scand. 2008 Jan;52(1):117-24. doi: 10.1111/j.1399-6576.2007.01472.x. Epub 2007 Nov 8.


Background: Day surgery has expanded considerably during the last decades. Routines and standards have developed but differ between and within countries.

Methods: We studied the practice of day surgery in Sweden by an extensive questionnaire survey sent to all 92 hospitals.

Results: The proportion of day surgery vs. in-hospital procedures was overall 43%, with 43% in adults and 46% in children. Orthopaedic (33%), general (29%) and gynaecological (17%) surgery were the most common ambulatory procedures. Most patients (>90%) underwent pre-operative assessment by an anaesthesiologist. Patient self-assessment questionnaires were common (86%). Risk stratification for post-operative nausea and vomiting was used by 70% of the departments. Anxiolytic pre-medication was uncommon. Most anaesthesiologists (95%) used pre-operative oral analgesics to initiate post-operative analgesia, the most common being paracetamol (95%), NSAIDs (73%) and coxibs (15%). A balanced general anaesthesia technique was preferred. Post-operatively, 93% of the units routinely assessed patients' pain. Analgesic combinations of paracetamol, NSAIDs and weak opioids were used by 94% of the units. Most hospitals (80%) had standardised discharge criteria based on clinical assessment, and many required a patient escort at home for 24 h post-operatively. Assessments of unplanned admission, re-admission and post-operative complications were not performed routinely. Follow-up telephone calls within 1-2 days were performed regularly in about 40% of the units, or in selected patients only (37%). Pain was the most frequent complaint on follow-up.

Conclusions: In Sweden, a high degree of standardised regime for day surgical practice was found. Post-operative pain is the most common complaint after discharge.

Publication types

  • Multicenter Study

MeSH terms

  • Adult
  • Aftercare / statistics & numerical data
  • Ambulatory Surgical Procedures / statistics & numerical data*
  • Analgesics / therapeutic use
  • Anesthesia / methods
  • Anesthesia / statistics & numerical data
  • Child
  • Data Collection
  • Drug Utilization / statistics & numerical data
  • Humans
  • Pain, Postoperative / drug therapy
  • Pain, Postoperative / epidemiology
  • Pain, Postoperative / prevention & control
  • Patient Discharge / standards
  • Postoperative Care / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data
  • Premedication / statistics & numerical data
  • Surgical Procedures, Operative / classification
  • Surgical Procedures, Operative / statistics & numerical data
  • Surveys and Questionnaires
  • Sweden


  • Analgesics