It is estimated that close to 20% of all surgeries now occur in the surgeon's office. If you are contemplating surgery in the office that requires an anesthetic, here are some questions to ask:

Who will give the anesthetic?

If the physician, oral surgeon, dentist, or podiatrist is administering the anesthetic, he or she should not be actively involved in the surgical procedure at the same time when unconscious or deep sedation or general anesthesia is administered because both tasks demand full attention to the patient by the provider.

If a nurse gives the anesthetic, who will be supervising?

We believe that the practitioner providing supervision should be qualified by education and medical or professional training to prescribe the anesthetic and to recognize and direct treatment of medical emergencies should they occur during the administration of the anesthetic.

What type of anesthetic will be used and what are the risks associated with it?

Is the anesthesia provider qualified and trained in advanced cardiac life support (ACLS)?

Who will help me during the recovery from the anesthetic? Are they qualified to recognize medical emergencies?

What are the qualifications of the staff members in the facility where I am to undergo the office-based surgery?

What type of monitoring will be used? Is the anesthesia provider trained to use the monitoring equipment? Does the anesthesia equipment have the latest safety features? Is the equipment tested regularly to make sure that it works?

Clearly, pulse oximetry and capnography should be readily available; capnography primarily for general anesthesia, but it is very valuable for sedation and monitored anesthesia care.

What emergency preparations and procedures are in place in the facility where I am to have my office based surgery?

If the patient is a child and is having an anesthetic, is the office equipped with resuscitation equipment suitable for a child and is the anesthesia provider qualified and trained in pediatric advanced cardiac life support (PALS)?

No matter what type of anesthetic care is being used, is the office equipped with: 1) a defibrillator, 2) supplemental oxygen, 3) a fully stocked crash cart, 4) an intravenous that will be in place in case of an emergency, 5) an EKG, pulse oximeter, and carbon dioxide monitor?

Regarding postoperative pain, who provides the prescription and who is to be called with postoperative pain problems?

More information on office based surgery and anesthesia may be obtained from the Anesthesia Patient Safety Foundation's newsletter, Spring 2000 issue at: http://www.gasnet.org/