Inpatient vs. Outpatient Procedure Determination

? Sleep apnea severity status ? Anatomic/physiologic abnormalities ? Coexisting diseases ? Nature of surgery ? Type of anesthetic ? Need for post-operative opioids ? Patient age ? Adequacy of post-op observation ? Outpatient facility capabilities

The pre-op phone call reveals that the large patient (BMI 32) scheduled for laparoscopic cholecystectomy has a history of snoring and daytime somnolence. Would you flag this patient as a poor candidate for outpatient surgery? New clinical data and American Society of Anesthesiology guidelines suggest you should - just as you would a patient with hypertension, diabetes, coronary artery disease and active angina.