Extended Emergence Strategy on Post-Anesthesia Care Unit Events After Outpatient Orthopedic Surgery

Inclusion Criteria: * Participants with American Society of Anesthesiologists (ASA) physical status I-III * Scheduled for Elective Foot/Ankle Orthopaedic surgery at Stanford Health under planned propofol-based intravenous anesthesia and regional nerve block for preoperative analgesia * Able and willing to complete all cognitive assessments and Brice Interview in PACU Exclusion Criteria: * ASA physical status IV or V * Chronic opioid therapy * Chronic benzodiazepine use or ongoing treatment with strongly anticholinergic medications within 30 days prior to surgery. * Known major neuro-cognitive disorder, active psychotic disorder, or other severe psychiatric condition that, in the opinion of the investigator, would interfere with valid cognitive testing. * Active cardiac or neurological stimulators or pumps in use * Severe uncorrected visual or hearing impairment that precludes valid cognitive battery or interview completion. * Inability to speak and understand the study language sufficiently to provide informed consent and complete study assessments. * Inability to provide informed consent or lack of a legally authorized representative when required. * Concurrent participation in another interventional study that could confound PACU cognitive or delirium outcomes.