There is an increasing movement today to perform surgery of many types outside of the operating room - in many cases, the surgery and anesthesia are being done in the surgeon's own office. That these procedures used to be restricted to the operating room or outpatient surgical center reflects growing economic pressures as well as advances in medical techniques. It is likely that this trend will continue - that is, more and more surgeries are likely to be performed in less intensive medical settings.

The fact that this is occurring does raise some questions for anesthesiologists and for patients that are undergoing these surgeries. For anesthesiologists, it is important that standards of care and practice parameters be firmly established in order to maintain quality of care and patient safety. If you are a patient thinking about having office based surgery and anesthesia, there are a whole new set of questions to ask as a result of this trend - things that were previously assumed about personnel, equipment, emergency procedures, etc. may not hold true once you venture away from the closely regulated hospital environment.

There are a number of valid reasons that surgeries that once required hospitalization can now be done on an outpatient basis - and that some of these can actually be done in an office setting:

1. The first of these is that surgical techniques have improved. As a result, surgeries can now be done through smaller incisions and are less invasive - thus causing less injury to the patient.

2. The second reason is that anesthesia techniques and medications have improved. Shorter acting anesthetics are now available that allow patients to wake up quickly after surgery and return more quickly to "normal function". Improvements in pain relief techniques also allows the patient to return home faster after a surgery.

3. The third reason is that economic pressure is forcing change. This is usually regarded by many as a negative - but there is validity to finding those surgeries that can be done in a better and cheaper way. While a balance must be maintained between proper care and economic concerns, the new techniques and medications mentioned above does make it possible in some cases to save money while maintaining patient safety and quality of care.

4. Lastly, patients prefer shorter stays and avoidance of hospitalization when possible. Most patients would rather spend only the time that is absolutely necessary in the hospital. The surgeon's office is often less intimidating and more convenient for the patient as well. In addition, there is often less paperwork, scheduling problems, etc. since the surgeon's own office staff can take care of arrangements.

Read on to find out about new standards needed for anesthesiologists and questions that patients should make sure to ask before their office based surgery...