Should Patients Age or ASA Physical Status Influence Case Selection?
Although the vast majority of individuals scheduled for outpatient surgery are relatively healthy (ASA physical status 1 and 2), practitioners are constantly being pressured to consider “simple outpatient surgery” for patients with significant baseline disease. In the past, many individuals had arbitrarily stated that freestanding ambulatory surgical facilities were severely limited in the type of patients they could anaesthetize, particularly with regard to age and physical status. Recent clinical experience suggests otherwise. In a retrospective study of over 1500 cases of patients anaesthetized for ambulatory surgery, Meridy was unable to demonstrate an age-related effect on the duration of recovery or on the incidence of postoperative complications. Natof concluded that ASA 3 patients whose systemic diseases were well controlled preoperatively were at no higher risk for postoperative complications than ASA 1 or 2 patients. Furthermore, in 1987 the Federated Ambulatory Surgery Assoc
