Pediatric Ambulatory Surgery: What’s New, What’s Controversial

This article aims to review recent innovations and trends in ambulatory anesthesia through the lens of the pediatric ambulatory population and strategizes the feasibility of implementation for individual ambulatory sites. Reducing greenhouse gasses via total intravenous anesthesia (TIVA) and/or low fresh gas flows (FGF), the expansion of 23-h stays, and increasing prescriptions for GLP-1 agonists are all contemporary issues with relevance to pediatric ambulatory surgery. Pediatric patients present unique challenges for environmental stewardship. It is likely eliminating nitrous oxide and using low flows for sevoflurane are most effective for ear tubes, while tonsillectomy and other procedures may utilize TIVA alone. In certain instances, providing 23-h stays to pediatric ambulatory patients can positively impact the healthcare system as a whole. Finally, GLP-1 agonists have been approved for pediatric patients and practitioners should know the implications for this patient population. Dependent upon individual ASCs, these changes can represent new opportunities to better serve the community.