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Office-based anesthesia

Fred E Shapiro, DO
Brian M Osman, MD
Section Editor
Joyce A Wahr, MD, FAHA
Deputy Editor
Nancy A Nussmeier, MD, FAHA


The number of elective surgical procedures performed in an office-based setting has expanded rapidly. In the United States, the proportion of all outpatient surgeries performed outside a hospital setting has increased from 10 to 55 percent since the 1980s, and at least 17 percent of these are performed in physician offices [1]. In part, this shift is due to newer surgical and anesthetic techniques that have allowed more invasive procedures to be safely performed in non-hospital settings.

This topic will review advantages and disadvantages, patient and procedure selection, and anesthetic and postoperative management for office-based surgery.


Advantages – The major advantages of office-based anesthesia for surgical procedures are patient and surgeon convenience and cost containment compared with hospital settings [2]. Patients perceive greater personal attention and privacy. Surgeons perceive greater ease of scheduling, consistency in nursing personnel, efficiency, and reduced costs. Also, some data suggest that nosocomial infection rates are lower in office-based settings compared with hospital settings [2].

Disadvantages – The major disadvantages of office-based anesthesia are safety concerns regarding the facility’s resources and anesthetic techniques used in this setting, as well as less regulation of office settings compared with hospitals and other ambulatory surgery facilities.

Safety: Office facility resources – More invasive and time-consuming surgical procedures are now offered to patients in an office-based setting [2]. However, private physician offices may be less safe than other surgical care settings due to fewer resources (eg, personnel, equipment, and access to specialists in other disciplines), which may be critically important when procedural or anesthetic complications occur [3]. In some instances, the demand for office-based procedures by patients with challenging comorbidities (eg, obesity) may exceed the qualifications of the office-based surgical team. Ideally, these procedures should be performed in an accredited facility (eg, the Association for Accreditation of Ambulatory Surgical Facilities) by board-certified surgeons who are credentialed for the same procedures at a local hospital [4-9].

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Literature review current through: Oct 2017. | This topic last updated: Oct 13, 2017.
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