Featured Articles: The Open Mind
Rosero, Eric B. MD, MSc* ; Rajan, Niraja MD† ; Joshi, Girish P. MBBS, MD, FFARCSI*
From the * Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas
† Department of Anesthesiology and Perioperative Medicine, Penn State Health, Hershey, Pennsylvania.
Accepted for publication September 8, 2021.
Funding: None.
Conflicts of Interest: See Disclosures at the end of the article.
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Reprints will not be available from the authors.
Address correspondence to Girish P. Joshi, MBBS, MD, FFARCSI, Department of Anesthesiology and Pain Management, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd, Dallas, TX 75390. Address e-mail to [email protected]
doi: 10.1213/ANE.0000000000005776
Abstract Associated Multimedia
Migration of surgical and other procedures that require anesthesia care from a hospital to a free-standing ambulatory surgery center (ASC) continues to grow. Patients with cardiac implantable electronic devices (CIED) might benefit from receiving their care in a free-standing ASC setting. However, these patients have cardiovascular comorbidities that can elevate the risk of major adverse cardiovascular events. CIEDs are also complex devices and perioperative management varies between devices marketed by various manufacturers and require consultation and ancillary services, which may not be available in a free-standing ASC. Thus, perioperative care of these patients can be challenging. Therefore, the suitability of this patient population in a free-standing ASC remains highly controversial. Although applicable advisories exist, considerable discussion continues with surgeons and other proceduralists about the concerns of anesthesiologists. In this Pro-Con commentary article, we discuss the arguments for and against scheduling a patient with a CIED in a free-standing ASC.
