This chapter summarises the results of a systematic literature search published between the dates of 1990 and July 2005. Day-case surgery, known as ambulatory surgery in North America, has grown substantially in the last 20 years. Despite increasing demand for day-case surgery and advances in surgical technique, patient selection remains important to reduce postoperative complications. In 2003, the UK National Institute for Clinical Excellence (NICE) published guidelines for routine preoperative testing. The ideal anaesthetic for day-case surgery would provide rapid recovery, quick return to "street fitness" and be free of side-effects. Other considerations include turnover times and cost-effectiveness. Postoperative pain is one of the most frequently occurring adverse events after day-case surgery. Postoperative nausea and vomiting (PONV) is an important cause of morbidity following day surgery and along with pain is a major cause of unexpected admission.

Preoperative assessment encompasses surgical and anaesthesia evaluation, preoperative testing, patients' preparation for surgery and obtaining informed consent. This chapter presents a summary of published evidence-based literature on the subject, which have been revised using the same methodology of the AGREE instrument. The collection of anaesthesia history can be facilitated by a structured, ad hoc questionnaire: its use is strongly encouraged by the Italian and British Society Guidelines. Preoperative tests should be ordered only after the patient's assessment, and only those relevant to the particular case. Recently, a very exhaustive evaluation of the available evidence on the subject has been published by the National Institute for Clinical Excellence (NICE) in the UK. The abridged version of the NICE Guidance presents possible combinations of the four dimensions, patients' age, physical status, grade of surgery and coexisting disease.