Ambulatory surgery is common and develops alongside surgery and anesthetic methods. Time admitted is short and aftercare takes place in the home environment. Objective: The aim of the study was to investigate which symptoms patients experience after ambulatory surgery related to anesthesia. Furthermore how strongly symptoms affect the patient. Symptoms appear as a result of anesthesia and surgery and can therefore be interpreted as nursing induced suffering. Method: Participants were recruited at ambulatory clinics at a Swedish university hospital spring, 2015.  Prior to the study permission was granted from the clinic managers. The study is a quantitative descriptive longitudinal study.  Data collection forms were administered and data collection was performed by phone. Incisional pain, headache, neck pain, hoarseness, postoperative sore throat, nausea, drowsiness, post-discharge urine retention and numbness were requested parameters. Answers were evaluated as; none-existing, mild, moderate and severe. Data was measured at 48 hours and postoperative day seven. Result: The study included 67 participants. The various symptoms were all apparent to some extent by some of the participants at 48 hours. Concerning headache, neck pain, hoarseness, sore throat, nausea, urine retention and numbness most were symptom free. Incisional pain and drowsiness however affected the participants noticeably. Seven days after surgery there was an overall improvement throughout the parameters. Although incisional pain and drowsiness also lessened some participants still evaluated their experience moderate to severe. Conclusion: The majority of the day surgery patients were content with their care, in our study 97% were satisfied. There was an improvement within the experienced symptoms after seven days compared to after 48 hours. There is room for improvement concerning pain management and time for recovery in the home environment as drowsiness was still an evident issue. / Dagkirurgi är vanligt och drivs framåt av utvecklingen inom kirurgi och anestesi. Vårdtiden är kort och mycket av eftervården sker i hemmet. Syfte: Syftet var att undersöka vilka symptom patienter upplever efter genomgången dagkirurgi relaterat till anestesi. Vidare undersöks hur starkt olika symptom påverkar patienten. Symptom efter anestesi och kirurgi uppkommer till följd av omvårdnaden och kan därför tolkas som ett vårdlidande. Metod: Deltagare har rekryterats från dagkirurgiska avdelningar vid ett mellansvenskt universitetssjukhus våren 2015. Tillstånd inhämtades före studien från verksamhetschefer. Studien är en beskrivande kvantitativ longitudinell studie och data har samlats in med frågeformulär där svaren delgivits via telefon. Parametrarna smärta i operationsområde, huvudvärk, smärta i nacke, heshet, smärta i svalg, illamående, trötthet, urinretention samt känselbortfall har efterfrågats. Svaren har delgivits på en skala som graderats i nivåer från; inte alls, mild, måttlig och svår.  Mättillfällen var efter 48 timmar samt sju dagar postoperativt. Resultat: Studien har 67 deltagare. Efter 48 timmar upplevdes de olika symptomen alltid av någon deltagare, men vid huvudvärk, smärta i nacke, heshet, smärta i svalg, illamående, urinretention samt känselbortfall var de flesta symptomfria. Smärta i operationsområdet och trötthet påverkade dock patienterna påtagligt. Efter sju dagar upplevdes förbättring i alla parametrar. Smärta i operationsområdet samt trötthet minskade, men upplevdes fortfarande av vissa som måttlig och svår. Slutsats: De flesta dagkirurgiska patienterna är nöjda med sin vård, 97% i vår studie. En förbättring i upplevda symptom finns efter sju dagar jämfört med efter 48 timmar. Förbättringspotential finns inom smärtlindring och vidare bör utrymme för återhämtning finnas då trötthet visat sig vara förekommande

Introduction: Hysterectomy is the most common major gynecological operation in the Western World and approximately 5000 benign hysterectomies are performed in Sweden every year. Consequently it is a surgical procedure that affects many women. The procedure comprises challenges concerning perioperative health care, perceived postoperative symptoms, quality of life aspects and health economics. The concept of fast track is a multimodal strategy to reduce hormonal surgical stress response and achieve an enhanced postoperative recovery and is today considered to be evidence based in relation to colorectal surgery. Spinal anesthesia, as an important part of fast track, provides benefits of extended effect on analgesia and reduced postoperative morbidity. It is reasonable to believe that employing the strategies of fast track including spinal anesthesia could also provide substantial benefits for women requiring surgical removal of the uterus. Aims: To determine whether duration of hospital stay, presence and intensity of postoperative symptoms, duration of sick leave and cost-effectiveness differ between women undergoing benign fast track abdominal hysterectomy in spinal anesthesia with intrathecal morphine (SA) and in standard general anesthesia (GA). Material & Methods: 180 women participated in this open randomized multicenter study with five participating hospitals in the southeast region of Sweden. One hundred and sixty two completed the study; 82 women were randomized to SA and 80 to GA. A fast track model comprising premedication without sedatives, intravenous fluid regulation, analgesics based on non-opioids, pre-emptive antiemetic therapy, early enteral nutrition and mobilization and standard criteria for discharge were used. End points were duration of hospital stay, use of analgesics, perceived postoperative symptoms, occurrence of postoperative complications, duration of sick leave and health economic evaluations. Results: Duration of hospital stay did not differ between the two modes of anesthesia. Vomiting and pruritus occurred significantly more often after SA. Complication rates did not differ between groups. Women with SA experienced less overall discomfort and had a reduced need for opioids postoperatively. Abdominal pain, drowsiness and fatigue occurred less often and with lower intensity among the women in the SA group. Health related quality of life improved faster and the duration of sick leave was shorter in women after SA. Total costs (hospital costs plus costs for productivity loss) were lower for the SA group. Within the first 29 days after hysterectomy the women in the SA group gained more QALYs than women in the GA group. Conclusions: The duration of hospitalisation after fast track abdominal hysterectomy was less than 50 hours and mode of anesthesia did not influence this. SA displayed considerable advantages regarding postoperative symptoms and recovery. SA was considered cost-effective in comparison with GA due to lower total costs and more QALYs gained. Our study indicates that SA should be recommended as the first choice of anesthesia in benign abdominal hysterectomy.