PURPOSE: Ambulatory office-based anesthesia (OBA) is a relatively new but rapidly growing field. OBA requires a different approach than that used in the hospital, because there are unique considerations that must be recognized when administering anesthesia in a free-standing office facility. This review provides a summary of the important issues and aspects of safe patient care. METHODS: The Medline, Embase, Biological Abstract, Science Citation Index, and Healthstar databases were searched under the key words "office-based anesthesia" for relevant English language articles from 1966 to December 2008. Relevant publications were queried from governing institutions, such as the American Society of Anesthesiologists (ASA), as well as from colleges in various provinces across Canada. PRINCIPAL FINDINGS: Office-based anesthesia remains poorly regulated in many parts of Canada (and the US). Despite continuing concerns regarding patient safety, the rates of death and reported major complications for OBA appear to be very low, especially in accredited facilities. Multiple considerations for facility design, administration, and patient care need to be taken into account. CONCLUSION: Appropriately so, an increasing number of provinces (Canada) and states (US) are beginning to regulate office-based facilities and require accreditation.
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