Ambulatory General Anaesthesia, Day-Case Surgery, and Non-Operating Room Anaesthesia (NORA) — WACS Viva & Clinical Scenarios (General Anaesthesia)

Exam-style ambulatory general anaesthesia, day-case surgery, and non-operating room anaesthesia (nora) viva scenarios with examiner probes and model answers…

Scenarios covered

• SCENARIO 1: A 42-year-old executive is booked for elective ambulatory laparoscopic cholecystectomy. He demands to be discharged home 4 hours after surgery so he can attend an evening business meeting. Detail your patient selection criteria, intraoperative anaesthetic technique to facilitate fast-tracking, multimodal antiemetic and analgesic strategy, and objective criteria for home discharge.
• SCENARIO 2: You are requested to provide anaesthesia for a 58-year-old male with jaundice, obstructive sleep apnoea, and BMI of 34 kg/m² undergoing an urgent Endoscopic Retrograde Cholangiopancreatography (ERCP) in the gastroenterology endoscopy suite. How do you assess the remote environment, secure the airway in the prone/semi-prone position, manage sedation/general anaesthesia, and prepare for airway emergencies off-site?
• SCENARIO 3: A 29-year-old female undergoes day-case open umbilical hernia repair and superficial lipoma excision under general anaesthesia. Three hours postoperatively in the step-down day unit, she experiences severe dizziness, persistent nausea, and severe pain (VRS 8/10) upon standing, failing her discharge assessment. Formulate your systematic management protocol to resolve her symptoms and determine whether hospital admission is required.
• SCENARIO 4: A 65-year-old patient with well-controlled type 2 diabetes mellitus and hypertension is scheduled for outpatient wide local excision of a soft tissue lesion under Monitored Anaesthesia Care (MAC). Detail your pharmacological protocol, monitoring standards, depth of sedation titration, and rescue algorithms for sudden airway obstruction or hypoventilation.