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Ước tính khoảng 70% của tất cả các phẫu thuật tự chọn được thực hiện trong một thiết lập ngoại trú [1], và hơn 50% của bác sĩ phẫu thuật thẩm mỹ nhựa thực hiện hầu hết các thủ tục của họ trong một thiết lập văn phòng [2] | Part II Part II Anesthesia Chapter 8 Anesthesia for Liposuction Gary Dean Bennett 8 8.1 Introduction An estimated 70 of all elective surgery is performed in an outpatient setting 1 and more than 50 of aesthetic plastic surgeons perform most of their procedures in an office setting 2 . Economic considerations play a major role in the shift to ambulatory surgery. Because of greater efficiency these outpatient surgical units have greater cost-effectiveness 3 . Advances of monitoring capabilities and the adoption of monitoring standards of the American Society of Anesthesiologists ASA are credited for a reduction of perioperative morbidity and mortality 4 . Advances in pharmacology have resulted in a greater diversity of anesthetic agents with rapid onset shorter duration of action and reduced morbidity 5 . The advent of minimally invasive procedures has further reduced the need for hospital-based surgeries. Regulatory agencies such as the American Association of Accreditation of Ambulatory Surgery AAAASF and the Accreditation Association for Ambulatory Health Care AAAHC have helped establish minimum standards of care for surgical locations where anesthesia is administered. As a consequence of the shift away from hospitalbased surgery the surgeon has adopted a more important role in the medical decision-making with respect to anesthesia. Frequently the surgeon decides on the location of surgery the extent of the preoperative evaluation the type of anesthesia to be administered the personnel to be involved in the care and monitoring of the patient the postoperative pain management and the discharge criteria used. Therefore it is incumbent on the surgeon to understand current standards of anesthesia practice. If the surgeon chooses to assume the role of the anesthesiologist then he or she must adhere to the same standards that are applied to the anesthesiologist. While the morbidity and mortality of anesthesia has decreased 6 7 risk awareness of anesthesia and surgery .
