Office-based ambulatory anesthesia: Outcomes of clinical practice of oral and maxillofacial surgeons

Purpose: The delivery of office-based ambulatory anesthesia services is an integral component of the daily practice of oral and maxillofacial surgeons (OMSs). The purpose of this report was to provide an overview of current anesthetic practices of OMSs in the office-based ambulatory setting. Materials and Methods: To address the research purpose, we used a prospective cohort study design and a sample composed of patients undergoing procedures in the office-based ambulatory setting of OMSs practicing in the United States who received local anesthesia (LA), conscious sedation (CS), or deep sedation/general anesthesia (DS/GA). The predictor variables were categorized as demographic, anesthetic technique, staffing, adverse events, and patient-oriented outcomes. Appropriate descriptive and bivariate statistics were computed as indicated. Statistical significance was set at less than or equal to.05. Results: The sample was composed of 34,191 patients, of whom 71.9% received DS/GA, 15.5% received CS, and 12.6% received LA. The complication rate was 1.3 per 100 cases, and the complications were minor and self-limiting. Two patients had complications requiring hospitalization. Most patients (80.3%) reported some degree of anxiety before the procedure. After the procedure, 61.2% of patients reported having no anxiety about future operations. Overall, 94.3% of patients reported satisfaction with the anesthetic, and more than 94.7% of all patients would recommend the anesthetic technique to a loved one. Conclusion: The findings of this study show that the office-based administration of LA, CS, or DS/GA delivered via OMS anesthesia teams was safe and associated with a high level of patient satisfaction. (C) 2003 American Association of Oral and Maxillofacial Surgeons.