Desai Meena S
Nova Anesthesia Professionals, Villanova, Pennsylvania, USA.
Curr Opin Anaesthesiol. 2008 Dec;21(6):699-703. doi: 10.1097/ACO.0b013e328313e879.
Office-based anesthesia has grown and continues to grow very rapidly in the ever-changing medical environment. The demand of patients, surgeons and the evolving economic environment has set off a dynamic growth explosion. This explosion has created aggressive and tumultuous enhancements, some of which have been adapted well and some of which have led to disastrous results.
As we institute rules and regulations to govern this 'wild west' of anesthesia, the landscape is set with some new guidelines that continue to evolve.Practice recommendations have been outlined for fire safety especially on patient fires. Closed claim studies offer valuable recommendations for MAC claims in the office based setting. Anesthesia Patient Safety Foundation and the ASA have outlined valuable information regarding the nonsilencing of equipment alarms.New equipment enhancements have generated successful mobile general anesthesia platforms. Finally, as we forge ahead we must construct measurements of our safety and success as outcome parameters are developed.
The review of recent literature and technological advances has provided some valuable lessons in the evolution of patient safety and office based technology for the surgical office-based environment. As this specialty grows, measures of its outcome parameters will allow a gauge of performance.
在不断变化的医疗环境中，门诊麻醉发展迅速且持续快速增长。患者、外科医生的需求以及不断演变的经济环境引发了动态的增长热潮。这种热潮带来了激进且混乱的改进，其中一些改进适应良好，而一些则导致了灾难性后果。
在我们制定规则和法规来管理这片麻醉“蛮荒之地”时，一些新的指导方针不断涌现并持续演变。针对消防安全，尤其是患者火灾方面，已经概述了实践建议。针对门诊环境下的监测麻醉管理（MAC）索赔，结案研究提供了有价值的建议。麻醉患者安全基金会和美国麻醉医师协会（ASA）已经概述了有关设备警报不应静音的重要信息。新的设备改进催生了成功的移动全身麻醉平台。最后，随着我们不断前进，随着结果参数的制定，我们必须构建安全和成功的衡量标准。
对近期文献和技术进展的综述为基于门诊手术环境的患者安全和技术发展提供了一些宝贵经验。随着这一专业的发展，其结果参数的衡量标准将有助于评估其表现。
