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Organizational prerequisites for anesthesia outside the operating room

Evron, Shmuela,b,c; Ezri, Tiberiua,b,c

Current Opinion in Anesthesiology: August 2009 - Volume 22 - Issue 4 - p 514–518
doi: 10.1097/ACO.0b013e32832dbac0
Anesthesia outside the operating room: Edited by Alwin E. Goetz

Purpose of review The purpose of this review is to define the responsibility and designation of anesthesia personnel to nonoperating room location anesthesia and their education in this regard. The review will also define the safety standards, guidelines, physical environment, equipment, accreditation, the quality of care and patient and procedural selection.

Recent findings Anesthesia outside the operating room continues to be a challenging field. With the advances in surgical and anesthetic technology, there is an increasing need for research in the area of office-based anesthetic techniques and for improvement in terms of adherence to safety standards in aiming to decrease morbidity and mortality and increase patient satisfaction.

Summary Complications of anesthesia outside the operating room still persist even in American Society of Anesthesiologists (ASA) status I patients and in accredited facilities with board-certified physicians. The department of anesthesiology taking care of the in-hospital office-based facility has the responsibility to define safe practice standards according to the ASA guidelines regarding education, documentation, guidelines preparation, equipment, standards monitoring, collaboration with other facilities, backup for the personnel in case of emergencies and prolongation of observation of a complicated patient in the postanesthesia care unit. Office-based facilities outside the hospital should comply with all federal, state, local laws and regulations. Such precautions will enhance safety, efficiency and reliability of office-based anesthesia inside and outside the hospital.

aDepartment of Anesthesia, Israel

bObstetric Anesthesia Unit, Edith Wolfson Medical Center, Tel Aviv University, Holon, Israel

cThe Outcome Research Consortium, Cleveland Clinic, Cleveland, Ohio, USA

Correspondence to Tiberiu Ezri, Head, Department of Anesthesiology, Wolfson Medical Center Holon, Holon 58100, Israel Tel: +972 3 5028229; fax: +972 3 5028218; e-mail:

© 2009 Lippincott Williams & Wilkins, Inc.