Outpatient Anesthesia

Abstract

Oral and maxillofacial surgeons have the privilege of being surgeons as well as anesthesia providers. The level of care and preparation does not change in the office setting. The surgeon-anesthetist must have the skill set and knowledge to appropriately manage the medical conditions of the patient, provide appropriate anesthetic care, and be able to treat anesthesia emergencies. Anesthesia is a continuum without any hard stops, and the administration of anesthesia must continually be monitored to ensure patient safety. Part of the safety check is appropriate patient selection, a great degree in depth of medical knowledge, and having a team approach to administration. As an oral and maxillofacial surgeon, airway assessment and control is paramount. The board candidate will have to be able to explain their choices of treatment setting, type of anesthesia they would administer, medications administered, and how to react to possible complications both medically and surgically. This chapter reviews airway anatomy, monitoring, emergency airway management, medications commonly used, and guidelines set by the American Academy of Oral and Maxillofacial Surgeons.

It should be no surprise that it is expected that you will perform safe outpatient anesthesia in your office. Per the AAOMS parameters of care, all patients whom are an ASA class II and above should be considered for consultation with a physician for medical clarification of the patient’s medical condition and clearance to assist in making appropriate decisions for the setting and depth of anesthesia.