Are there any patients who should never have surgery on an ambulatory basis?
An exception to the list of acceptable candidates is ex-preterm infants who are less than 55–60 weeks post-conceptual age. These patients may have life-threatening episodes of postoperative apnea and bradycardia as many as 12 hours and up to 48 hours after receiving a general anesthetic. Therefore, in-hospital monitoring of these patients is recommended. For similar reasons, term infants less than 44 weeks postconceptual age should also have surgery performed only on an inpatient basis. Postoperative respiratory monitoring is mandatory for at least 12–18 hours. If at all possible, any required surgery or diagnostic proce-dures requiring the administration of either a sedative or a general anesthetic should be postponed until the child passes this period.