American Association of Nurse Anesthetists222 S. Prospect Ave.

Park Ridge, IL 60068-4001(847) 692-7050

www.aana.comwww.AnesthesiaPatientSafety.com

Supporting Our Members—Protecting Our Patients

WHAT EVERY

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Certified Registered Nurse Anesthetists:A Tradition of Quality CareCertified Registered Nurse Anesthetists(CRNAs) are anesthesia specialists who admin-ister approximately 65 percent of all anestheticsgiven to patients in the United States each year.

CRNAs represent a commitment to high stan-dards in a demanding field. The educationalrequirements to become a CRNA are exten-sive. Prior to applying for admission to agraduate program in nurse anesthesia, a candi-date must have a four-year bachelor of sciencedegree in nursing or other appropriate bac-calaureate degree, acurrent license as aregistered nurse,and a minimum ofone year’s acutecare nursing expe-rience. The mas-ter’s degree nurseanesthesia programitself is 24-36months, dependingon universityrequirements.CRNAs are boardcertified, andmandatory contin-uing education isrequired for recertification every two years.

Nurse anesthetists provide high-quality anes-thesia services combined with personal con-cern for the health and welfare of patients.They are happy to assist you and offer informa-tion about what to expect with your anesthesia. TO PREPARE FOR

SURGERY AND

ANESTHESIA IN A

PHYSICIAN’S OFFICE

Office Surgery andAnesthesia:A Growing DemandSurgery and anesthesia provided in an officesetting is a safe alternative to hospitals andambulatory surgical centers (ASCs).

There are many reasons why more and morepatients are choosing the office setting: accessto care, lower costs, efficiency, confidentiality,and comfort with the surroundings.

Today, plastic sur-geons, podiatrists,ophthalmologists,dentists, and otherspecialists providesurgical and otherservices in officesettings—servicesthat used to beavailable only inhospitals and ASCs. Working closely with aqualified anesthesia professional, such as aCertified Registered Nurse Anesthetist (CRNA)or physician anesthesiologist, these practition-ers enable their patients to safely and comfort-ably undergo procedures as complex as lipo-suction, face lifts, breast augmentation,lithotripsy, and arthroscopic knee surgery.

Before AnesthesiaPrior to your surgery,you will talk withyour anesthesia pro-fessional. In mostoffice settings, thiswill be a CRNA.

This confidentialinterview providesyour CRNA with information vital to your care.Being open and honest with your nurse anes-thetist is key to the selection of the best anes-thetic for you. Be sure to follow instructionsclosely regarding your intake of medications(including herbal), food, or liquids before anes-thesia. Such substances can react negativelywith anesthetic drugs. You also need to tell yourCRNA about previous surgeries you have had,and whether you are or have been a smoker.

• The AANA offers a brochure titled BeforeAnesthesia: Your Active Role Makes a Difference,which contains a “Preanesthesia Questionnaire”that you can check off and give to your nurseanesthetist at your interview.

After AnesthesiaFollowing surgery, you will rest in the recoveryroom. Office procedures are usually same-daysurgeries, which means you will be able to gohome the day of your surgery. When you leave,you might still feel some effects from your anes-thesia. So you will need to have someone driveyou home. Closely follow the directions for yourhome care. Some routine activities you may notbe able to do for a period of time include driving,using complex equipment, and making importantdecisions or signing legal documents.

• The AANA offers a brochure titled AfterAnesthesia: Your Active Role Assists You inRecovery, which contains a list of thingsyou should and should not do followinganesthesia.

A free copy of the Before Anesthesia andAfter Anesthesia brochures can be obtainedby calling 847-692-7050.

Is Office Anesthesia Safe?Due to improvements in drugs, technology, anes-thesia techniques, and provider education, anes-thesia care is safer than it has ever been. In fact,the Institute of Medicine reported in 1999 thatanesthesia is nearly 50 times safer today than it wasin the early 1980s.

The same standard of anesthesia care for hospi-tals and ASCs also applies to office settings,regardless of whether the anesthesia professional

is a CRNA oran anesthesiol-ogist.

The first andmost compre-hensive“Standards forOffice BasedAnesthesiaPractice” weredeveloped by

the American Association of Nurse Anesthetists(AANA) and adopted in 1999. They can beviewed at: www.aana.com/crna/prof/obstandards.asp

In addition, many states have adopted laws, regu-lations, or guidelines concerning office surgeryand anesthesia practices as the demand for theseservices grows.

The Anesthetic ExperienceAnesthesia allows you to be comfortable during your surgical procedure. There are several kinds of anesthesia:

• Sedation and analgesia

• Local anesthesia

• Regional anesthesia

• General anesthesia

The anesthesia option chosen for you will bebased on your physical condition, reactions tomedications, type of surgery, and other factors.

Partners in Safety—Youand Your AnesthetistHow can you find out if an office truly is safe forsurgery and anesthesia? By becoming a partnerin safety with your CRNA. Patients who knowwhat to look for in the office setting and whatquestions to ask their CRNA can better deter-mine how safe a facility is.

On the back of this tear-off section is a checklist of questions that you should ask your anesthesia pro-fessional prior to deciding whether to undergo a procedure in an office.

Safe-Office Necessities*• Well-defined patient selection guidelines

(because not everyone is a candidate foroffice surgery/anesthesia)

• Monitoring equipment with a backup electrical source

• Adequate numbers of well-trained staff tosupport the surgery and anesthesia

• Ability to treat problems and emergencies

• Plans for transferringpatients to other healthcare facilities ifnecessary

• A sterile environment,including strictlyenforced guidelinesfor hand washing and equipment use

• Minimal testing before surgery, includingrequired consultations

• Routine equipment maintenance

• Clearly defined procedures for patient recovery and discharge

• Procedures for follow-up care

*Adapted from Standards for Office BasedAnesthesia Practice, American Association ofNurse Anesthetists, 2002.

Are you a Certified Registered NurseAnesthetist or a board certifiedanesthesiologist?

Do you regularly provide anesthesia care inoffice settings? Have you worked in this particular office before?

Will you stay with me throughout my surgery?

Will you perform a thorough and complete preanesthesia assessment prior to my surgery?

Will you develop a care plan for my anes-thesia care based on the assessment andother information?

If I am considered to be a questionable orinappropriate patient for office surgery andanesthesia, will I be informed of this?

Once I leave the operating room, who willbe responsible for my care in the recoveryroom? Will that caregiver stay with methroughout my recovery?

Will I be left alone at any time following myprocedure while I am still a patient in thefacility?

What precautions will be taken to mini-mize my risk of infection?

Will you develop a plan to safely manageany pain I experience after surgery?

Office Anesthesia QuestionnairePrior to receiving anesthesia in an office setting,ask the following questions of your anesthesia pro-fessional:

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