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Ambulatory surgery has gained tremendous popularity within the last 2–3 decades. More and more surgeries are performed on outpatient basis at ambulatory surgery centers. The understanding of how the postanesthesia care unit (PACU) functions is important in the appropriate care and discharge of the patients. Multiple phases of recovery exist and patients can be triaged based on their emergence from anesthesia. PACU discharge scoring systems have been implemented to progress a patient through the stages of recovery until discharge. The scoring systems initially developed by Aldrete, later modified by Chung and White, are still being used today. Discharge from ambulatory surgery centers has unique concerns when compared with discharge from PACU to hospital wards. This chapter will discuss the special considerations when discharging patients from PACU in ambulatory surgery centers.

Goltz syndrome, also known as focal dermal hypoplasia, is a rare X-linked dominant multisystem syndrome presenting with cutaneous, skeletal, dental ocular, central nervous system and soft tissue abnormalities. This case report discusses an adult male patient with Goltz syndrome that was noted to have large, papillomatous, hypopharyngeal lesions upon induction of general anesthesia. We highlight challenges with airway management intraoperatively and postoperatively in patients with Goltz syndrome. Our aim is to increase awareness of the potential airway complications associated with this genetic disorder and to provide suggestions for optimal perioperative management for patients afflicted with Goltz syndrome.

Chronic pelvic pain (CPP) is a recurring and/or constant pain of at least six months duration that has resulted in either functional or psychological disability that can require interventional treatments. Chronic pelvic pain can be visceral, somatic, neuropathic, or a combination. Patients with CPP often suffer from concurrent bowel or bladder dysfunction, sexual dysfunction, depression, and anxiety. The complexity of chronic pelvic pain can be challenging to treat, which can lead to frustration for both patients and their physicians. Treatment should involve a comprehensive and multi-modal approach involving psychosocial support, counseling, physical therapy, medication management, and interventional procedures. This manuscript will focus both on the etiologies and the interventional treatment options for chronic pelvic pain.

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