Office-based anesthesia (OBA) is a form of ambulatory anesthesia that has experienced exponential growth over the last two decades and is currently the fastest growing subspecialty of anesthesiology in the United States. With the advent of smaller, mobile monitoring devices and refined anesthetic techniques, select surgical procedures can be performed in the comfort and convenience of your physician or dentist’s office.

Yes. MAC performs your anesthetic with the same medications available in a hospital, appropriately equivalent monitors, and the same array of emergency medications in the extremely rare event of a concern. For appropriately chosen patients and procedures, studies are reflecting an overall complication rate essentially comparable to care provided in a surgery center.

OBA, performed by MAC, provides several significant benefits:

  • Experience a higher level of comfort and convenience by having procedures performed in a place where you are already familiar
  • Enjoy increased privacy by being cared for in your personal physician or dentist’s office
  • Avoid a separate visit to your primary care physician for a history and physical prior to you or your child’s procedure. Our MAC physicians will accomplish that for you on your scheduled procedure date
  • Individualized one-on-one anesthesia care provided by physician anesthesiologists
  • Potential cost savings compared to surgeries performed at hospitals
  • In an era where many patients express sentiments that healthcare encounters leave them feeling like they’re simply moving through rushed assembly-lines, MAC strives to provide genuine, individual attention and personal, concierge-style care

Office-based anesthesia is not suitable for everyone. Patients have to be medically and physically suitable for receiving anesthesia and surgical care in the office. This will be determined through evaluation by your anesthesiologist in coordination with your surgeon/dentist and with your primary care physician if necessary.

The MAC Team consists of highly trained medical professionals. The anesthesia will be administered by a board-certified physician anesthesiologist. Furthermore, for pediatric patients, the vast majority will be cared for by one of our anesthesiologists additionally board certified in the subspecialty of pediatric anesthesiology. MAC is the only physician staffed, office-based anesthesia service in the metropolitan Kansas City area. In addition, your pre and post procedure care will be expertly managed at all times by a sub-specialty qualified Registered Nurse.

Anesthesiologists are highly skilled medical doctors (M.D. or D.O.) who specialize in the field of anesthesiology. They have significantly longer and more extensive training than other classifications of anesthesia practitioners, so they are the most qualified to make anesthesia- related perioperative medical decisions.

Anesthesiologists are primarily responsible for the safety and well-being of patients before, during and after surgery. This may include:

  • Placing the patient in the state of controlled unconsciousness called “general anesthesia”
  • Providing “regional anesthetics,” in which only a portion of the body is made numb
  • Administering sedation when indicated for the relief of pain or anxiety

All of these anesthetics provide continuous pain relief and sustain patients’ critical life functions as they are affected throughout surgical, obstetrical or other medical procedures.

The role of the anesthesiologist extends beyond the operating room. The anesthesiologist is responsible for the preoperative assessment of the patient, an evaluation process that carefully considers both the patient’s current state of health and the planned surgical procedure. This evaluation allows anesthesiologists to make judgments about the safest anesthesia plan for each individual patient. The anesthesiologist also is responsible for the well being of the patient postoperatively, while the patient emerges from the effects of anesthesia. They often are involved in the management of acute postoperative pain, as well as chronic and cancer pain; cardiac and respiratory resuscitation; blood transfusion therapies; and respiratory therapy.

Anesthesiologists in the United States complete the following education and training:

  • four year undergraduate college degree
  • four years of medical school
  • four year anesthesiology residency program.

Although anesthesiologists complete a minimum of eight years of medical training after college, many elect to spend an additional fellowship year of specialty training in specific areas such as pediatric anesthesia, pain management, cardiac anesthesia, neuroanesthesia, obstetric anesthesia or critical care medicine. Upon completion of training, anesthesiologists are eligible for board certification by the American Board of Anesthesiology. They may also seek certification in one of following subspecialties, which require additional training and examinations: pediatric anesthesiology, critical care medicine, hospice and palliative medicine and pain medicine. The physicians of Mobile Anesthesia Care are all board certified, and some have additional board certifications in anesthesia subspecialties.

Although some patients may have mild side effects such as nausea or a sore throat, general anesthesia is exceptionally safe, even for children and adults with complex medical histories. The risk of complications correlates more closely to the specific type of procedure a patient is undergoing and his or her underlying health problems than to the actual anesthesia itself. With office-based anesthesia – for properly selected procedures, thoroughly screened patients, and with an experienced anesthesia provider – the risk is indeed very low. With the advent of more sophisticated monitoring, a better understanding of individual responses to anesthesia and surgery, and improved anesthesia agents, the safety of anesthesia has dramatically increased over the last two decades. The risk of mortality from anesthesia is estimated to be 1:200,000 – 1:400,000 for healthy patients undergoing elective procedures. Indeed, the most risky part of the surgical day is potentially the car trip home.

The risks of anesthesia can be decreased by providing thorough information regarding your past medical history to your anesthesiologist, abiding by preoperative fasting instructions, and continuing medications unless instructed by your anesthesiologist or surgeon to do otherwise. Also ensure that any chronic illnesses are being optimally treated. For children undergoing office-based anesthesia, having an anesthesiologist with significant pediatric experience is also recommended.

NPO (nothing per oral) instructions will be provided by the MAC scheduling team once the schedule is confirmed (approximately 4-6 working days prior to the procedure). NPO instructions will be based on patient arrival time, not scheduled procedure time.

NPO Patient Requirements/Instructions:

  • Adult patients (18 years and older): No solid food/milk/broth 8 hours prior to office arrival
  • Pediatric patients: No solid food/milk/broth 6 hours prior to office arrival
  • Patients of all ages: No clear liquids (apple juice, water) 2 hours prior to office arrival.

Please Note:

  1. Clear Liquids include: water, sport drinks (i.e. Gatorade/Powerade), fruit juices without pulp, carbonated beverages, clear tea, black coffee, Jello without fruit.
    **This does not include alcohol beverages.
  2. Solid Foods includes: food, milk, orange juice, broth, coffee including creamer/milk, gum, and candy. A light meal is recommended and does not include meat, cheese, fried or fatty foods, which can slow gastric emptying times.
  3. We strongly encourage patients to eat/drink as close to the designated times provided, in order to stay hydrated and ease hunger concerns.
  4. Certain medical conditions slow gastric emptying and/or put patients at higher risk for pulmonary aspiration, such as diabetes, renal disease, slow gastric motility, GERD, dysphagia, chronic constipation, and hiatal hernia. The anesthesia provider may adjust NPO times according to patient health history.

Adult Patients (18 years and older):

Patients will be able to drink and eat until eight (8) hours prior to scheduled arrival time. After that time period, the patient will be allowed to have clear liquids (such as water, clear juices, Gatorade or Pedialyte) until two (2 hours) before scheduled arrival time. Patients should have nothing in their mouth two (2) hours prior to your arrival time for the procedure, including gum, life savers, hard candy, etc.

Pediatric Patients:

Patients will be able to drink and eat until six (6) hours prior to scheduled arrival time. After that time period, the patient will be allowed to have clear liquids (such as water, clear juices, Gatorade or Pedialyte) until two (2 hours) before scheduled arrival time. Patients should have nothing in their mouth two (2) hours prior to your arrival time for the procedure, including gum, life savers, hard candy, etc.

As we go off to sleep the ability to cough and protect ourselves from fluids passively coming up from the stomach and attempting to enter the lungs is greatly diminished. Ensuring an empty stomach reduces the possibility of a very severe form of pneumonia that could result if stomach contents are aspirated.

This is the time needed to complete the check-in and registration process. It also includes time for possible pre-medication. You will also have time to ask questions of your dentist, surgeon, anesthesiologist, and assigned nurse.

Specific instructions regarding medications will be given to you by the MAC scheduling team. Medication timing may need to be altered to adhere to the eating and drinking restrictions prior to the procedure. If you or your child take medications that need to be mixed with foods such as apple sauce, or pudding, please make the MAC team aware so specific guidance may be provided.

Though we very much respect your desire to be with your loved one during the actual procedure, we will ask instead that you relax in the waiting area. The primary reason is our overwhelming concern for safety and high quality care – best guaranteed when we are free to concentrate totally on monitoring our patients with our undivided attention.

Once our staff and you feel comfortable, you will be allowed to begin your travel home. All patients receiving anesthesia will need a ride home by an adult (18 years or older). For pediatric patients, it is ideal for two adults to be present for the car ride home – one to assist with the patient’s needs, and the other adult to insure a safe driving journey home. Being drowsy and a bit fussy is not uncommon immediately post-op (especially for pediatric patients), and on occasion nausea might be expected. For the remainder of the procedure day, we recommend you refrain from performing any activities that might necessitate high degrees of balance, coordination, or mental alertness that might impact on the safety of you or your loved one (i.e. sports).

The most common side effects of having general anesthesia are nausea, vomiting, and a sore throat. Patients will not be discharged from our care until they have met our discharge criteria. Your nurse will review discharge instructions and provide you with an information sheet to take home that includes the MAC phone number for any concerns that you may have.

In general, you will receive a phone call from our team within the week preceding the procedure. If by chance you are not at home when this important phone call arrives, please make every effort to promptly return the call to MAC at (913) 428-2939 as soon as possible. In order for us to provide safe and efficient care, it is vital that our team speak with you during the week prior to the procedure.

Patient Rights and Responsibilities

Each patient has the right:

  • To access medical care.
  • To participate in decisions about your care.
  • To be treated with respect, consideration, and dignity.
  • To privacy and security.
  • To request information about his/her care and to know risks, benefits, and alternatives, except in an emergency or to refuse treatment to the extent permitted by law.
  • To have access to an interpreter if needed.
  • To receive care in a safe environment free from all forms of abuse, neglect, or mistreatment.
  • To know the names of physicians, nurses, and all other health care team members directing and/or providing his/her care as well as their credentials.
  • To confidentiality of his/her medical records and to approve or refuse their release except when required by law.
  • To understand the fees for services and payment policies.
  • To agree or refuse to participate in research, marketing, or educational projects.
  • To understand provisions for after-hours and emergency care.
  • To receive information regarding methods for voicing grievances regarding treatment or providing feedback to the organization
  • To request another healthcare provider

Each patient is responsible for:

  • Providing complete and accurate information about his/her health history, including present condition, past illnesses, allergies, medications, vitamins, herbal products, hospital stays and any other matters that pertain to his/her health, including perceived safety risks.
  • Asking questions when information or instructions are not understood.
  • Following the treatment plan prescribed by his/her provider
  • The consequences and outcomes if the treatment plan is not followed or if care is refused
  • Treating all healthcare professionals, visitors, and other patients with courtesy and respect
  • Providing complete and accurate health insurance information, paying bills in a timely manner, and accepting personal financial responsibility for any charges not covered by his/her insurance
  • Keeping appointments or calling the healthcare provider when unable to do so
  • Providing a responsible adult to transport him/her home from the facility and remain with him/her for 24 hours, if required by his/her provider

Discrimination is Against the Law
Mobile Anesthesia Care complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Mobile Anesthesia Care does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex.
Mobile Anesthesia Care:
• Provides free aids and services to people with disabilities to communicate effectively with us, such as:
○ Written information in other formats (large print, audio, accessible electronic formats, other formats)
• Provides free language services to people whose primary language is not English, such as:
○ Qualified interpreters via telephone
o Information written in other languages
If you need these services, contact Holly O’Hare, Practice Manager.
If you believe that Mobile Anesthesia Care has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Mary Burnett, HR Director, 8717 West 110th Street, Ste 600, Overland Park, KS 66211, Phone: 913-428-2900, Fax: 913-428-2951, e-mail: [email protected]. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Mary Burnett, HR Director is available to help you.
You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at https://ocrportal.hhs.gov/ocr/portal/lobby.jsf, or by mail or phone at:
U.S. Department of Health and Human Services
200 Independence Avenue, SW
Room 509F, HHH Building
Washington, D.C. 20201
1-800-368-1019, 800-537-7697 (TDD)
Complaint forms are available at http://www.hhs.gov/ocr/office/file/index.html.

Information on interpretation services may be found by following this link:  interpreting-services-language-list-top-101

 

Having worked exclusively with children in the operating room we have unique insight into their emotional needs. We are very adept at putting your child at ease with games, playful questions, and imaginative approaches to their experience.

We recommend bringing a change of clothes. If your child is currently potty training, you may consider bringing a pull-up for the procedure. Feel free to bring any favorite items (blanket, stuffed animal, favorite small toy, etc.) that may help to soothe your child. Be honest with your child to help prepare them for the procedure.

Your child will need a parent or legal guardian to bring them the day of the procedure and stay throughout. We will obtain signed consent from the legal guardian for the anesthesia, and will have further important discharge information for this individual from both the MAC team and the dentist to help assure your child’s successful recovery.

Yes. Our physician anesthesiologist will exclusively care for your child during the course of the procedure and general anesthetic, until care is transferred for the recovery period to the MAC subspecialty RN.

Your dentist has made a professional decision that in order to obtain the best possible dental results for your child, general anesthesia is necessary. Some dental procedures can be quite lengthy, often requiring multiple office visits to complete. When a child is under general anesthesia, it is more likely all dental work can be completed at a single appointment. Our anesthetic will allow the dentist full visualization, uninterrupted access, and the ability to be more efficient. Our ability to monitor your child and administer appropriate medications enhances safety.

For many children (and even adults), a trip to the dentist is a particularly high anxiety experience. If a pediatric patient has a traumatic dental encounter, this difficult experience may negatively impact the child for all future visits to the dentist – perhaps for a lifetime. Using various techniques, OBA minimizes this possibility and aims to keep your child’s procedure as comfortable as possible.