Abstract:The rapid expansion of day surgery has shifted anesthetic practice toward greater emphasis on rapid and smooth emergence, respiratory stability, and predictable postoperative discharge. To achieve these goals, contemporary ambulatory anesthesia has increasingly adopted total intravenous anesthesia, opioid-sparing strategies, and multimodal analgesia. This review summarizes current evidence on key intravenous anesthetics, including propofol, ciprofol, and remimazolam, as well as adjuncts such as dexmedetomidine, esketamine, and oliceridine in day surgery settings. It also outlines anesthetic management considerations for special populations, including older adults, patients with obesity or obstructive sleep apnea syndrome, and those with hepatic or renal dysfunction.