As Drs. Mason and Mahmoud discuss in this edition of the ASA NEWSLETTER, providing anesthesia care outside of the O.R. has become much more common over the last two decades.1 This is certainly true in my academic practice of anesthesiology. As a service line, anesthesia departments are being requested more and more often to step further away from the O.R. to provide care for procedures ranging from plastic surgery to dental restoration, from interventional pulmonary work to hysteroscopy. One major difference about these non-operating room anesthetics (NORAs) is that compared to the early days of outpatient surgery, where patient selection was prospectively controlled to promote the best outcomes, it seems as though these NORAs are often on patients whose condition poses a significantly greater risk to their own good outcome.
We are suffering from the benefits of our own success. Modern anesthetic agents allow us to provide safe,...