Hausman Laurence M, Frost Elizabeth A M
Ambulatory Surgery, Mount Sinai Medical Center, New York, NY, USA.
Middle East J Anaesthesiol. 2007 Jun;19(2):291-310.
Office-based anesthesia (OBA) has developed in the United States as an important field for the anesthesia provider. Both the numbers and types of procedures performed in offices around the country have steadily increased, as has the invasiveness of these procedures. New anesthetic considerations arise. For example, most training programs have not addressed this area of practice. Indeed many practitioners are unfamiliar with practice outside the hospital operating room setting. Information as to how to provide quality care in a location where one may be the sole anesthesiologist must be readily available. Many of the safety mechanisms we take for granted in a hospital setting are often not present in a surgical office, and it becomes the responsibility of training centers to help in establishing standards. As the 'safety' of many surgical offices where anesthesia care is provided has been challenged, medical societies have begun to issue recommendations as to the standards of care that should exist. Different anesthetic techniques are also emerging that are appropriate to the office setting. But as office-based anesthesia continues to mature as a specialty, we the anesthesia providers, must be proactive in establishing guidelines and recommendations to ensure safe practice.
门诊麻醉（OBA）在美国已发展成为麻醉医生的一个重要领域。全国各地门诊所开展的手术数量和类型都在稳步增加，这些手术的侵入性也在增加。由此产生了新的麻醉考量因素。例如，大多数培训项目都未涉及这一实践领域。事实上，许多从业者对医院手术室以外的实践并不熟悉。必须随时提供有关如何在可能只有一名麻醉医生的场所提供优质护理的信息。我们在医院环境中视为理所当然的许多安全机制在外科门诊往往并不存在，因此培训中心有责任帮助制定标准。由于许多提供麻醉护理的外科门诊的“安全性”受到质疑，医学协会已开始就应存在的护理标准发布建议。也出现了适合门诊环境的不同麻醉技术。但随着门诊麻醉作为一个专业不断成熟，我们麻醉医生必须积极主动地制定指南和建议，以确保安全实践。
