Office-based anesthesia.
OBJECTIVE
Ambulatory office-based anesthesia (OBA) is a relatively new but rapidly growing field. OBA requires a different approach than that used in the hospital, because there are unique considerations that must be recognized when administering anesthesia in a free-standing office facility. This review provides a summary of the important issues and aspects of safe patient care.


METHODS
The Medline, Embase, Biological Abstract, Science Citation Index, and Healthstar databases were searched under the key words "office-based anesthesia" for relevant English language articles from 1966 to December 2008. Relevant publications were queried from governing institutions, such as the American Society of Anesthesiologists (ASA), as well as from colleges in various provinces across Canada.


RESULTS
Office-based anesthesia remains poorly regulated in many parts of Canada (and the US). Despite continuing concerns regarding patient safety, the rates of death and reported major complications for OBA appear to be very low, especially in accredited facilities. Multiple considerations for facility design, administration, and patient care need to be taken into account.


CONCLUSIONS
Appropriately so, an increasing number of provinces (Canada) and states (US) are beginning to regulate office-based facilities and require accreditation.
Kurrek
Matt M
MM
The Department of Anesthesia, University of Toronto, 150 College Street, Room 121, Fitzgerald Building, Toronto, Ontario M5S 3E2, Canada. m.kurrek@utoronto.ca
Twersky
Rebecca S
RS
D000553:Ambulatory Care / Q000379:methods* / Q000592:standards / Q000639:trends; D000554:Ambulatory Care Facilities / Q000592:standards / Q000639:trends; D000556:Ambulatory Surgical Procedures / Q000379:methods* / Q000592:standards; D000758:Anesthesia / Q000379:methods* / Q000592:standards / Q000639:trends; D002170:Canada; D002983:Clinical Competence / Q000592:standards; D004632:Emergency Medical Services / Q000379:methods* / Q000592:standards; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods / Q000592:standards; D018579:Patient Selection; D011182:Postoperative Care / Q000379:methods; D011787:Quality of Health Care / Q000592:standards; D014481:United States