Is office-based anesthesia new?

No. Crawford Long, DDS, was giving ether to his office patients in Louisiana in 1842 and Ralph Waters, MD, practiced anesthesia from his Downtown Clinic in Sioux City, Iowa in 1919. Privacy issues as well as the considerable economic advantages are had by patients choosing office based surgery. Efficiencies in time accrue to the surgeon as well.

Patients must always balance the advantages and take care that the facility has the ability to handle common emergencies which may occur during surgical procedures. Supplemental oxygen, positive pressure devices (i.e. Ambu bag) and a suction device to clear the airway are minimal standards insisted upon by medical liability carriers.

According to the American Society of Anesthesiologists' (ASA - www.asahq.org) publication on guidelines for a safe office anesthesia practice, an anesthesia machine is not necessary when non-triggering (i.e. no inhalational agents like isoflurane, desflurane or sevoflurane) anesthesia is used. States like Florida and California led the nation in requiring office certification by either AAAASF, AAAHC or HCFA (now CMS) agencies. Certification assures that a crash cart and defibrillator are present as well as policies and procedures to handle the day to day activities as well as emergencies. Certification per se does not assure sound medical judgment is being practiced.