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Ambulatory surgery has developed extensively over the past few years in most Western countries. The absence of specific legislation in Italy creates a lack of trust in patients and interferes with the development of this discipline. The authors describe their experience in the organisation of an outpatient foot surgery centre over the past thirteen years, which is in constant expansion and currently performs about 300 operations every year. They report the criteria used to select patients, the organisation of the operating theatre, pre- and postoperative treatment and the anesthetic techniques used. Among the latter, they describe a new approach used to block the popliteal sciatic nerve. The results obtained show a high approval rate from the majority of patients treated. The authors attribute this success to a series of factors, including patient selection and surgical procedures, the maintenance of constant standards of quality similar to those in hospitals and the experience of outpatient anesthesia.

The authors have compared two different techniques of anaesthesia: the classical anaesthesia with benzodiazepine-analgesic (diazepam and fentanyl) and one of its variant obtained by using flunitrazepam and buprenorphine. The 45 patients submitted to gynaecological surgery were causally divided in two groups in connection with the two different anaesthesiological techniques. The clinical and statistical analysis of the collected data demonstrated the real validity of this anaesthesiological variant: either for premedication by perfect anxiolysis and sedation, or for the maintenance by low incidence on cardiocirculation system and perfect analgesia that extended its effects for many hours after surgical operation.