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Out of the operating room anesthesia requires the anesthesia provider to work in remote locations in a hospital, where ease of access to the patient and anesthesia equipment is compromised; furthermore, the staff at these locations may be unfamiliar with the requirements for safe anesthetic delivery.- In their guidelines and statements, the American Society of Anesthesiologists reminds anesthesia staff that it is important that both the physical and operational infrastructure is in place at any location to ensure the safe conduct of anesthesia.
- The underlying reason for ambulatory anesthesia and surgery is that it is less expensive and more convenient for the patient than inpatient admission.
- Regional and local anesthetic techniques are becoming increasingly popular in managing ambulatory orthopedic surgery.
- In general, ambulatory surgeries should be of a complexity and duration such that one could reasonably assume that the patient will make an expeditious recovery.
- Factors considered in selecting patients for ambulatory procedures include: systemic illnesses and their current management, airway management problems, sleep apnea, morbid obesity, previous adverse anesthesia outcomes (eg, malignant hyperthermia), allergies, and the patient’s social network (eg, availability of someone to be responsive to the patient for 24 h).
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Outpatient/ambulatory anesthesia is the subspecialty of anesthesiology that deals with the preoperative, intraoperative, and postoperative anesthetic care of patients undergoing elective, same-day surgical procedures. Patients undergoing ambulatory surgery rarely require admission to a hospital and are fit enough to be discharged from the surgical facility after the procedure.
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Nonoperating room anesthesia (or out of the operating room anesthesia) refers to both inpatients and ambulatory surgery patients who undergo anesthesia in settings outside of a traditional operating room. These patients can vary greatly, ranging from claustrophobic individuals in need of anesthesia for magnetic resonance imaging (MRI) procedures to critically ill septic patients undergoing endoscopic retrograde cholangiopancreatography in the gastrointestinal suite. Out of the operating room anesthesia requires the anesthesia provider to work in remote locations in a hospital, where ease of access to the patient and anesthesia equipment is compromised; furthermore, the staff at these locations may be unfamiliar with the requirements for safe anesthetic delivery.
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Office-based anesthesia refers to the delivery of anesthesia in a practitioner’s office that has a procedural suite incorporated into its design. Office-based anesthesia is frequently administered to patients undergoing cosmetic surgery, and anesthesia for dental procedures is also routinely performed in an office-based setting.
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Although treatment may be similar for inpatients, ambulatory surgery center patients, out of the operating room patients, and office-based anesthesia patients, there are nonetheless various guidelines and statements from the American Society of Anesthesiologists (ASA) that pertain to these different locations. All of these recommendations should be reviewed at the ASA website (www.asahq.org/For-Healthcare-Professionals/Standards-Guidelines-and-Statements.aspx), as they are subject to change and modification. In their guidelines and statements, the ASA reminds anesthesia staff that it is important that both the physical and operational infrastructure is in place at any location to ensure the ...