Anesthesia and Post-operative Management in Day Case Surgery

在西方国家，60%的手术患者是在日间（门诊）麻醉下进行的，原因是为了减少住院费用，希望在家护理多于住院。相比之下，大多数日本患者正在住院治疗。由于医疗服务和财政方面的原因，日本必须重新考虑该制度。派遣一名首席研究员前往英国，在曼彻斯特大学和伦敦大学收集日间手术和左旋布比卡因的数据。邀请伦敦大学的Rood教授和曼彻斯特大学的Cluthard博士两位熟练的外科医生在日本推广左布比卡因的临床应用，分别加入0.75%和1.00%左布比卡因与1/80000和1/200000血管收缩剂肾上腺素进行试验。我们与Rood教授和Cluthard博士讨论了评估必要恢复水平的方法以及临床研究的基础研究，以确定适合日间病例麻醉的麻醉方法，使其符合本研究组织，术后尖锐疼痛的控制以及患者安全回家。

In the Western countries, 60 % of surgical patients are carried out under the day (ambulant) anesthesia by the reason such as a reduction of the hospitalization cost, hoping for the home care more than hospitalization. In contrast, most Japanese patients are under hospitalization. Japan must reconsider the system because of the medical service and financial aspect.1. Send a chief researcher to UK gathering data on day case surgery and levobupivacain at University of Manchester and London University.2. Invite two skilled surgeons in the field Professor Rood at London University and Dr. Cluthard at University of Manchester to promote clinical application of the levobupivacain in Japan. 0.75 % and 1.00 % levobupivacain with 1/80000 and 1/200000 vasoconstrictor epinephrine were added were tested.3. Discussion was done on the foundation research about the way of evaluating a necessary level of recovery and the clinical research with Professor Rood and Dr. Cluthard, to make the anesthetization which is suitable for day case anesthesia to go with this research organization, postoperative control of the sharp pain and a patient come home safely.