Office-Based Anesthesia: How Safety Is Built Into the Private Practice Setting

Selected procedures, including plastic and aesthetic surgery, may be performed in office-based facilities rather than hospitals. Privacy and comfort may influence a patient's choice of setting, but they do not establish its clinical suitability. The safety of this setting depends on applying the ASA standards that govern anesthesia care in any facility.

The same standard of monitoring

The American Society of Anesthesiologists (ASA) Standards for Basic Anesthetic Monitoring apply to general anesthesia, regional anesthesia and monitored anesthesia care, and require continual evaluation of oxygenation, ventilation, circulation and temperature, with temperature monitored when a clinically significant change is intended, anticipated or suspected.¹ The ASA Statement on Office-Based Anesthesia recommends appropriate emergency equipment and drugs, qualified staff with resuscitation capability, compliance with applicable laws and regulations, and physician responsibility for a documented discharge decision.²

Depth of anesthesia and rescue capability

Sedation exists on a continuum, and patients can move between levels unexpectedly. The ASA states that practitioners should be able to rescue a patient from a deeper level than intended, which requires the training, equipment and assistance needed to recognize unintended deep sedation and perform rescue.³ A practice should confirm who supplies each of those three before the first case.

Patient and case selection

Patient evaluation, procedural requirements and facility capabilities should jointly determine whether office-based care is appropriate or a higher-acuity setting is indicated. Preoperative evaluation — medical history, airway assessment, and conditions such as obstructive sleep apnea — is where that assessment begins.

Dr. Seitz provides anesthesia for office-based procedures, including preanesthesia assessment and the documented discharge decision.

Sources

1. American Society of Anesthesiologists. Standards for Basic Anesthetic Monitoring. Original approval October 21, 1986; last amended October 15, 2025.
2. American Society of Anesthesiologists. Statement on Office-Based Anesthesia. Original approval October 13, 1999; last amended October 23, 2024.
3. American Society of Anesthesiologists. Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia. Original approval October 13, 1999; last amended October 23, 2024.