Patient Care

Patient Care and Information

Ambulatory surgical centers are used for performing surgery on patients who do not require hospitalization and who are not expected to require more than a total of 23 hours for preparation, the surgery itself and for recovery General anesthesia as well as local anesthesia may be used.

Each facility must have at least one fully-equipped operating room; an area for preparing patients; x-ray equipment and clinical laboratory services and patient recovery rooms. All surgical centers must have a registered nurse on duty at all times when patients are in the facility.

Anesthesia and Sedation

During most procedures, patients are given different types of anesthetics. These range from local anesthetics to general anesthesia.

What to Expect
Before your procedure, you will meet your anesthesiologist (if applicable) and will be advised of your options and the risks involved. At this time, you can ask any questions that you may have regarding your anesthesia. You may be asked to sign a consent for anesthesia, if applicable. For endoscopic procedures (such as colonoscopies and upper endoscopies) patients receive IV sedation that is administered by the physician doing the procedure.

Types of Anesthesia and Definitions

	General Anesthesia: There are two types of general anesthesia, endotracheal and mask. In endotracheal anesthesia, anesthetic and respiratory gases are passed through a tube placed in the windpipe via the nose or mouth. In mask anesthesia, gases are passed through a mask that covers the nose, mouth and airway.
	Regional Anesthesia: There are three types of regional anesthetics, epidural, spinal and nerve blocks. In epidurals, a small catheter is inserted into the epidural (spinal) space so that anesthetizing agents may be given to prolong the duration of anesthesia. In spinal anesthesia, the anesthetic agent is injected into the spinal subarachnoid space to produce loss of sensation. In nerve blocks, local anesthetizing agents are injected into specific areas to inhibit nerve transmission.
	Monitored Anesthesia Care (MAC): This type of anesthesia includes the monitoring of at least blood pressure, oxygenation, pulse and mental state, with supplementing sedation and analgesia supplied as needed by an anesthesiologist.
	IV Sedation: This type of sedation is similar to MAC except that monitoring is done by the physician doing the procedure and a registered nurse.
	Local Anesthesia: Anesthetizing agents are injected or infiltrated into a small area of the body, usually the surgical site. Topical agents can also be applied on the skin or mucous membranes.

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