Is it safe to have my surgery at an Office Based Operating Room?
Well actually we prefer the term " Single Specialty Surgical Center". This term more accurately reflects the specialized care you get from a focused surgical team. The surgeons we work with have the highest possible credentials: they are board certified within their specialty of training, and they maintain admitting privileges at nearby hospitals, so their performance is reviewed by their piers. Furthermore, we ourselves are a group of board certified Anesthesiologists... physicians...that are committed to supporting you in your surgical experience. We ONLY work with board certified surgeons who work in nationally accredited operating facilities. At the time that you are most vulnerable, it is an anesthesiologist, a doctor specifically trained to provide anesthesia, who prepares you for your surgery, personally cares for you in the operating room, and oversees your recovery. Yes, in these unique and exceptional circumstances it is not only safe, but perhaps more desirable to have your procedure done in a Single Specialty Surgicenter than at the busy hospital.

My friend is an Anesthetist/CRNA ? What's the difference between a Nurse Anesthetist and an Anesthesiologist?
A Nurse Anesthetist, or a CRNA, is a practioner who has been trained as a nurse and after adequate nursing experience studies to become certified as a Nurse Anesthetist/CRNA.

An Anesthesiologist is a physician. The training involved is intensive, requiring 4 years of college or university and acceptance into Medical School. Medical School acceptance is very exclusive with only 5 candidates out of 100 gaining admission. Medical School has an emphasis on teaching clinical judgment rather than a nurse’s training to follow pre-made algorithms. The physician then trains in a 1 year internship and a 3 year Anesthesiology residency. Average work week hours in this portion of training can range from 65-100 hours a week. So after high school, an Anesthesiology MD has prepared for a minimum of 12 extra years! To become Board Certified is the last aspect of obtaining an elite distinction among physicians. Again intensive study and commitment is demanded to be certified by the ABA, the American Board of Anesthesiology.

Most anesthetics in this country are performed by CRNA's under the supervision of an Anesthesiologist. The Anesthesiologist can be responsible for managing up to 4 CRNAs and patients at a time. In addition, the CRNA will be present only for the administration of the anesthetic whereas the Anesthesiologists at Rest Assured MD will plan your care and speak to you before your surgery, personally perform the anesthetic and then manage your postoperative care in the recovery area. You can imagine what a unique privilege it is to have the undivided attention of a superiorly trained Anesthesiologist and a board certified Surgeon providing you a safe and comfortable surgical experience from before you enter the operating room to when you leave to go home. This environment actually reflects a higher level of care than is typically offered at your hospital!

What is the difference between "twilight anesthesia" and general anesthesia?
"Twilight anesthesia" is a term used to describe a monitored anesthetic where the patient receives enough medication to render them partially unaware of the physical and emotional aspects of surgery. A "general anesthetic" is "drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation." The term "twilight anesthesia" is actually a poor term that’s used instead of the accepted terminology of “conscious sedation”. However, if you are not aware of the surgery, then this is not conscious sedation or twilight…. it’s General Anesthesia! And the facility may not be adequately prepared to deliver a general anesthetic, which is why some surgical practices come up with these unaccepted terms like “twilight anesthesia” or “room air general”.

In our practice, we sincerely believe that all anesthetics should be administered and monitored by qualified professional doctor i.e....an Anesthesiologists. These physicians are compelled by standard practices and their own experience and training to provide and anesthetic that balances the needs of the surgeon with the risk of the patient. This requires the clinical judgment learned in Medical School and Residency as patients are prepared and informed of all aspects of their upcoming procedure. Anytime anyone is given drugs to alter their consciousness in any capacity we are on full alert to manage ALL of their health needs. Our mandates are VIGILANCE, SAFETY AND COMFORT regardless of the length or nature of the surgery that is performed.

"I tend to get nauseated after surgery. Is there anything that can be done to prevent this?"
Yes! We live in a wonderful modern era with many techniques and drug regimens available to us. We do not administer anesthetics in a "cookbook" fashion. All patients are individuals with specific needs. An Anesthesiology doctor trained and experienced in outpatient surgical procedures will tailor your anesthetic to avoid nausea and vomiting. You will also be given definitive guidelines pre and postoperatively to avoid the possibility of stomach upset. In hospitals, the national rate for nausea and vomiting are approximately 20-25%. We are obviously succeeding as our nausea and vomiting RATES ARE < 1%! Again, our goals are for you to exceed your expectations and optimize your entire surgical experience.

"Lately there has been a lot of information in the news about the anesthesia drug Propofol. What is Propofol and is it safe?"
Propofol is a short-acting, intravenously administered hypnotic agent. Its uses include the induction and maintenance of general anesthesia, sedation for mechanically ventilated adults, and procedural sedation. It is an excellent drug used for many years to facilitate anesthesia. Patients that are allergic to eggs, egg products, soy or soy product should avoid Propofol. It is a major benefit to patients because of it's quick onset and recovery profile. Furthermore, compared to other anesthetics used in the same capacity, it is associated with less nausea and vomiting. Of course, as with all anesthetics, it requires VIGILANT MONITORING BY SKILLED AND WELL TRAINED ANESTHSESIA PROVIDERS, and optimally by physician anesthesiologists such as those at Rest Assured Anesthesiology.

"I have been told by my Surgeon to have nothing to eat or drink after midnight. Is that really necessary?"
The purpose of fasting guidelines is not to prevent nausea per se, but to minimize the volume of the stomach contents. Depression of protective reflexes may occur during anesthesia. One of the most basic protective reflexes is the body's natural ability to prevent stomach contents from entering the airway. As our primary goal is always SAFETY FIRST, we strive to prevent a condition called "aspiration", where stomach contents enter the lungs. If this were to occur, gas exchange may prove difficult or impossible. Obviously, this is a very dangerous scenario. We strictly follow the recommendations of our certifying board, the American Society of Anesthesiologists, and as fellow physicians we provide guidance to our surgical colleagues. So yes, follow the surgeons request and remember we are always available to answer questions.

Take comfort. In the operating room you are being constantly monitored and assessed by a BOARD CERTIFIED ANESTHESIOLOGY DOCTOR who is trained to be the authority on airway management and perioperative risk stratification. So yes, REST ASSURED!