Office Based Anesthesia

​What Every Patient Should Know

To Prepare for Surgery in a Physician’s Office
 
Office Surgery and Anesthesia: A Growing Demand
Surgery and anesthesia provided in an office setting is a safe alternative to hospitals and ambulatory surgical centers (ASCs).
 
There are many reasons why more and more patients are choosing the office setting: access to care, lower costs, efficiency, confidentiality, and comfort with the surroundings.
 
Today, plastic surgeons, podiatrists, dentists, ophthalmologists, and other specialists provide surgical and other services in office settings—services that used to be available only in hospitals and ASCs. Working closely with a qualified anesthesia professional such as a Certified Registered Nurse Anesthetist (CRNA), these practitioners enable their patients to safely and comfortably undergo procedures as complex as liposuction, face lifts, breast augmentation, lithotripsy, and arthroscopic knee surgery.
 
Is Office Anesthesia Safe?
Due to improvements in drugs, technology, anesthesia techniques, and provider education, anesthesia care is safer than it has ever been. In fact, the Institute of Medicine reported in 1999 that anesthesia is nearly 50 times safer today than it was in the early 1980s.
 
The same standard of anesthesia care for hospitals and ASCs also applies to office settings, regardless of whether the anesthesia professional is a CRNA or an anesthesiologist.
 
The first and most comprehensive “Standards for Office Based Anesthesia Practice” were developed by the American Association of Nurse Anesthetists (AANA) and adopted in 1999. They can be viewed at www.aana.com.
 
In addition, many states have adopted laws, regulations, or guidelines concerning office surgery and anesthesia practices as the demand for these services grows.
 
The Anesthetic Experience
Anesthesia allows you to be comfortable during your surgical procedure. There are several kinds of anesthesia:
  • Sedation and analgesia
  • Local anesthesia
  • Regional anesthesia
  • General anesthesia
The anesthesia option chosen for you will be based on your physical condition, reactions to medications, type of surgery, and other factors.
 
Partners in Safety—You and Your Anesthesia Professional
How can you find out if an office truly is safe for surgery and anesthesia? By becoming a partner in safety with your anesthesia professional. Patients who know what to look for in the office setting and what questions to ask their anesthesia professional can better determine how safe a facility is.

Below is an office based anesthesia checklist of questions that you should ask your anesthesia professional prior to deciding whether to undergo a procedure in an office.
 
Safe-Office Necessities*
  • Patient selection criteria
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  • Monitoring equipment with a back-up electrical source
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  • Adequate numbers of well-trained personnel to support the planned surgery and anesthesia
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  • The treatment of foreseeable complications
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  • Patient transfer to other healthcare facilities
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  • Infection control practices, including OSHA requirements
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  • Minimal preoperative testing, including required consultations
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  • Ancillary services (e.g., laboratory, pharmacy, consultation with outside specialists)
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  • Equipment maintenance
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  • Response to fire and other catastrophic events
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  • Recovery and discharge of patients
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  • Procedures for follow-up care
* Adapted from Standards for Office Based Anesthesia Practice, American Association of Nurse Anesthetists, 2009.
 

 Before Anesthesia

 
​Prior to your surgery, you will talk with your anesthesia professional. In many office settings, this will be a CRNA.
 
This confidential interview provides your anesthesia professional with information vital to your care. Being open and honest with your anesthesia professional is key to the selection of the best anesthetic for you. Be sure to follow instructions closely regarding your intake of medications (including herbal), food, or liquids before anesthesia. Such substances can react negatively with anesthetic drugs. You also need to tell your anesthesia professional about previous surgeries you have had, and whether you are or have been a smoker.
 

 After Anesthesia

 
​Following surgery, you will rest in the recovery room. Office procedures are usually same-day surgeries, which means you will be able to go home the day of your surgery. When you leave, you might still feel some effects from your anesthesia. So you will need to have someone drive you home. Closely follow the directions for your home care. Some routine activities you may not be able to do for a period of time include driving, using complex equipment, and making important decisions or signing legal documents.
A free copy of the Before Anesthesia and After Anesthesia brochures can be obtained by calling 847-692-7050.
 

 CRNAs

 
​A Tradition of Quality Care
 
Certified Registered Nurse Anesthetists (CRNAs) are anesthesia specialists who administer more than 34 million anesthetics to patients in the United States each year. The nurse anesthesia specialty has a history of more than 150 years.
 
CRNAs represent a commitment to high standards in a demanding field. The educational requirements to become a CRNA are extensive. Prior to applying for admission to a graduate program in nurse anesthesia, a candidate must have a four-year bachelor of science degree in nursing or other appropriate baccalaureate degree, a current license as a registered nurse, and a minimum of one year of acute care nursing experience. The master’s degree nurse anesthesia program itself is 24-36 months, depending on university requirements. CRNAs are board certified, and mandatory continuing education is required for recertification every two years.
 
Nurse anesthetists provide high-quality anesthesia services combined with personal concern for the health and welfare of patients. They are happy to assist you and offer information about what to expect with your anesthesia.