Authors: Talluto J et al
Anesthesia & Analgesia 141(2): 231-235. doi:10.1213/ANE.0000000000007457
This review highlights the growth and evolving safety considerations of office-based anesthesia (OBA), driven by increased outpatient procedure volume, patient convenience, cost savings, and efficiency. The COVID-19 pandemic accelerated this shift, with more complex patients and procedures now performed outside hospitals. While OBA can offer comparable complication rates to hospital-based care for select procedures—such as cataract surgery and pediatric tympanostomy—safety data remain limited due to variable state regulations and lack of mandated reporting in many states.
The American College of Surgeons and the American Society of Anesthesiologists have issued recommendations for accreditation, patient selection, emergency preparedness, and outcome tracking. Effective OBA requires careful screening for comorbidities, adherence to ASA guidelines, proper equipment, and trained personnel. Safety tools like simulation training, audiovisual emergency support, and standardized checklists have shown promise in improving preparedness and reducing complications.
Advantages include lower costs, greater privacy, and streamlined workflow; risks stem from inconsistent standards and resource limitations. With an aging, more comorbid patient population, robust quality assurance and strict adherence to safety protocols will be essential to maintaining positive outcomes as OBA continues to expand.
References
1. Dyrda L. 10 key trends for ASCs and outpatient surgery in the next 10 years. Becker’s ASC Review. Accessed August 14, 2024.
2. Young S, Osman B, Shapiro FE. Korean J Anesthesiol. 2023;76:400–412.
3. Marshall SE. Nurs Manage. 2023;54:30–35.
4. Osman BM, Shapiro FE. Anesthesiol Clin. 2019;37:317–331.
5. Osman BM, Tieu TG, Caceres YG, Hernandez VH. J Am Acad Orthop Surg Glob Res Rev. 2023;7:e22.00259.
6. Berglas NF, et al. PLoS One. 2018;13:e0190975.
7. Kugler LJ, Kapeles MJ, Durrie DS. J Cataract Refract Surg. 2023;49:907–911.
8. Voigt A, et al. Int J Pediatr Otorhinolaryngol. 2023;175:111772.
9. ACS. Accessed August 14, 2024.
10. ASA. Accessed August 14, 2024.
11. Shapiro FE, et al. J Healthc Risk Manag. 2022;41:27–35.
12. Rajan N, Rosero EB, Joshi GP. Anesth Analg. 2021;133:1415–1430.
13. Knoedler S, et al. Int J Surg. 2023;109:2631–2640.
14. Schramm KM, et al. J Vasc Interv Radiol. 2020;31:614–621.e2.
15. ASA. Accessed August 14, 2024.
16. Rothkrug A, Mahboobi SK. StatPearls. 2023.
17. Greenberg SB, et al. Simul Healthc. 2024;19:281–286.
18. ISOBS. Accessed August 14, 2024.
19. Rosenberg NM, et al. Eplasty. 2012;12:e59.
20. Anesthesia Patient Safety Foundation. Accessed August 14, 2024.
Thank you to Anesthesia & Analgesia for providing this valuable update on office-based anesthesia trends and practices.