Anesthesia Outside of the Operating Room

Richard D. Urman, MD, MBA is Assistant Professor of Anesthesia, Harvard Medical School and Director of Procedural Sedation Management and Education at the Brigham and Women's Hospital. He has special interest in patient safety related to office-based anesthesia practice, operating room efficiency, novel anesthetic agents, and patient education. He also currently serves as officer of the Institute for Safety in Office-Based Surgery. Wendy L. Gross, MD, MHCM practices cardiac anesthesiology at Brigham and Woman's Hospital. She is Medical Director of Periprocedural Services for the Division of Cardiovascular Medicine and is Director of Non-OR Cardiac Anesthesia. Her current interests include the medical and financial implications of the ongoing migration of surgery from the OR to interventional suites, applications of Transesophageal Echocardiography to percutaneous cardiology procedures and cost accounting for modeling of integrated services. Beverly K. Philip, MD is the Founding Director of the Day Surgery Unit at the Brigham and Women's Hospital and Professor of Anaesthesia at Harvard University. Her areas of interest are the pharmacology of inhaled and intravenous agents, and the specialized administrative approaches to ambulatory surgery, including patient-focused, cost-effective care and facilitated 'fast-track' recovery. Dr. Philip is a founding member and past President of the Society for Ambulatory Anesthesia, past Chair of the Ambulatory Surgical Care Committee of the American Society of Anesthesiologists, and an Editor-in-Chief of the international journal "Ambulatory Surgery."

Foreword
Preface
Contributors
1. Challenges of Anesthesia Outside the Operating Room
2. Preoperative Patient Evaluation for Anesthesia Care Outside of the Operating Room
3. Patient Monitoring
4. Anesthetic Techniques
5. Patient Recovery
6. Management of Staffing and Case Scheduling for OOOR Anesthesia
7. Procedural Sedation by Non-Anesthesia Providers
8. Anesthesia and Sedation Outside of the Operating Room: Outcomes, Regulation, and Quality Improvement
9. CT and PET/CT-guided Interventional Radiology Procedures
10. MRI and Ultrasound-guided Percutaneous Interventional Radiology Procedures
11. Interventional Neuroradiology Procedures
12. Interventional Radiology Procedures
13. Anesthesia for Diagnostic and Therapeutic Radiologic Procedures
14. Anesthesia in the Radiation Oncology Suite
15. Gastrointestinal Endoscopy Procedures
16. Anesthesia for Gastrointestinal Endoscopic Procedures
17. Anesthesia for Interventional Pulmonology
18. Anesthetic Implications of Natural Orifice Translumenal Endoscopoic Surgery (NOTES) and Single Incision Laparoscopic Surgery (SILS)
19. New Challenges for Anesthesiologists Outside of the OR: The Cardiac Catheterization and Electrophysiology Laboratories
20. Anesthesia for In Vitro Fertilization (IVF)
21. Anesthesia for Urologic Procedures
22. Anesthesia for Procedures in the Emergency Department
23. Office-Based Anesthesia
24. Pediatric Anesthesia Outside of the Operating Room
25. Anesthesia For Procedures in the Intensive Care Unit and the Neonatal Intensive Care Unit
26. Electroconvulsive therapy (ECT)
27. Pain Management Procedures
28. Anesthesia in the Military Setting
29. Anesthetic Considerations in Homeland Disasters
30. Anesthetic Considerations During Flight
31. Anesthetic Considerations in Dental Practice
32. Ultra Rapid Opiate Detoxification Procedures
33. Telemedicine, Teleanesthesia, and Telesurgery
Appendix 1: Pre-Use Check of Anesthesia Equipment
Appendix 2: Malignant Hyperthermia
Appendix 3: Selected ASA Guidelines
Index