Chapter 37 - Outpatient Anesthesia

Abstract

Since the first ambulatory surgical center (ASC) was opened in Iowa more than 100 years ago, outpatient anesthesia has evolved into the field of ambulatory anesthesia. Ambulatory anesthesia services are now offered at various settings, including hospital operating rooms, ASCs, non–operating room anesthesia (NORA) areas, and office-based anesthesia (OBA) practices. As surgical and anesthetic techniques improve and new anesthetics are developed, ambulatory anesthesia indications expand, and more complex procedures are offered to high-risk patients at these different facilities. Although fundamental principles of perioperative management are shared with anesthesia services provided at hospital main operating rooms for inpatients, ambulatory anesthesia providers pay extra attention to techniques and interventions that allow safe and efficient same-day discharge. The key to a successful and safe outpatient anesthesia practice is appropriate patient selection depending on a thorough preoperative assessment. This chapter reviews different types of ambulatory anesthesia settings and presents topics of particular interest to ambulatory anesthesia providers, including patient comorbidities, different anesthetic techniques, and common complications.