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Office-Based Anesthesia Position Statement Certified Registered Nurse Anesthetists (CRNAs), also referred to as nurse anesthesiologists or nurse anesthetists, have long been the predominant anesthesia professional and leaders in providing anesthesia services in ambulatory or office settings. As the professional organization representing CRNAs/nurse anesthesiologists, the American Association of Nurse Anesthesiology (AANA) advocates high-quality, appropriate standards of care for all patients in any environment where anesthesia is delivered, including the office-based practice setting. As in other settings, CRNAs/nurse anesthesiologists work collaboratively with professional colleagues such as physicians, surgeons, physician anesthesiologists, and, where authorized, podiatrists, dentists, and other healthcare professionals to deliver anesthesia to patients requesting or requiring such services. AANA has been at the forefront in establishing clinical practice standards, including patient monitoring standards. The document for care in the office setting is congruent with the AANA Standards for Nurse Anesthesia Practice and the AANA Dental Office Sedation and Anesthesia Care Position Statement. These documents are intended to support the delivery of patientcentered, consistent, high-quality, and safe anesthesia care and assist the public in understanding the CRNA’s role in anesthesia care. Although this position statement is intended to promote high-quality patient care, it cannot ensure specific outcomes. There may be patient-specific circumstances (e.g., informed consent for emergency cases that may be difficult to obtain, mass casualty incidents) that require modification. The CRNA must document modifications in the patient’s healthcare record, along with the reason for the modification. When integrating new technologies or skills into practice, the CRNA will obtain any necessary education and evidence competency. Anesthesia in the Office Setting There are some unique and specific responsibilities that should be considered prior to the administration of anesthesia in the office setting. When considering an office-based practice, anesthesia professionals should determine if there are appropriate resources to manage the various levels of anesthesia for planned surgical and invasive procedures and patient conditions. Some office-based practice settings are not regulated. Therefore, the CRNA should have the appropriate education, training, and experience for the specific setting and the patient population. Additionally, the CRNA should work with facility leadership to ensure that the facility, its equipment, and its policies can support the patient's safety during surgical, invasive and anesthesia procedures in the office setting. At a minimum, the CRNA must determine that there are policies to address: a. Patient selection criteria b. Preoperative testing, patient verification, assessment and evaluation, site marking, timeout, and appropriate consultations c. Monitoring equipment with a sufficient backup electrical source to power life-support systems for a minimum of 2 hours is recommended d. Adequate numbers of appropriately trained personnel to support the planned surgery/procedure and anesthetic plan, including patient preoperative preparation, 1 of 9 American Association of Nurse Anesthesiology 10275 West Higgins Road, Suite 500 | Rosemont, IL 60018 Professional Practice Division l 847-655-8870 l practice@aana.com