Office-Based Anesthesia 

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.

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.

In addition, many states have adopted laws, regulations, or guidelines concerning office surgery and anesthesia practices as the demand for these services grows.

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.

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 which 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.

• Office Anesthesia Questionnaire

• Patient selection criteria
• Monitoring equipment with a back-up electrical source
• Adequate numbers of well-trained personnel to support the planned surgery and anesthesia
• The treatment of foreseeable complications
• Patient transfer to other healthcare facilities
• Infection control practices, including OSHA requirements
• Minimal preoperative testing, including required consultations
• Ancillary services (e.g., laboratory, pharmacy, consultation with outside specialists)
• Equipment maintenance
• Response to fire and other catastrophic events
• Recovery and discharge of patients
• Procedures for follow-up care

Note: Safe-Office Necessities adapted from Standards for Office Based Anesthesia Practice, American Association of Nurse Anesthetists, 2009.