Anesthesia shortages are moving from an intermittent disruption to a defining scheduling constraint for operating rooms and ASCs. As drug supply gaps persist, staffing shortages deepen and costs rise, perioperative leaders are reworking anesthesia coverage, workflow and daily case planning to protect access, throughput and financial stability.
Anesthesia strain isn’t just a pharmacy or workforce issue, it’s increasingly reshaping how OR schedules are built, staffed and executed, day to day.
Here are five developments showing how anesthesia shortages are changing OR scheduling and perioperative operations:
1. Persistent anesthetic shortages are disrupting OR scheduling and forcing workflow changes: Operating rooms and ASCs are facing persistent shortages of anesthetic agents, forcing anesthesia teams to substitute drugs and alter workflows, changes that can directly disrupt day-to-day OR scheduling and perioperative operations.
As of June 19, the FDA listed 194 drugs in shortage, including ketamine hydrochloride injection, and shortages of injectables are particularly disruptive because of limited suppliers.
Erin Fox, PharmD, senior director of drug information and support services at Salt Lake City-based University of Utah Health, told Becker’s the most common shortages involve “cheap, generic, injectable medications that have been used at hospitals for a long time,” including lidocaine and saline.
To lessen disruption, some systems are adjusting EHR order sets to steer clinicians toward alternatives, while others are diversifying suppliers.
2. Anesthesia workforce shortages are increasing day-of-surgery disruption — including delayed or canceled procedures: With fewer anesthesiologists and CRNAs available, ASC leaders say staffing shortages are driving up labor costs while also creating direct operational instability, including room closures, delayed procedures and canceled cases when coverage falls short.
Several ASC leaders told Becker’s anesthesia subsidies and contract coverage, including locums, are among their most significant and growing costs, and some reported room closures or canceled cases when anesthesia staffing isn’t available.
“The biggest challenge we face with anesthesia is the nationwide shortage of anesthesia staff,” Tina Driggers, administrator of DSC Day Surgery Center in Winter Haven, Fla., told Becker’s. “This leads to room closure and cancelling of cases which in turn ends up with economic stresses to the surgery center.”
3. Anesthesia staffing shortages are becoming a scheduling chokepoint as ASCs take on more complex cases: As ASCs expand into higher-acuity procedures, leaders say anesthesia coverage is becoming a critical constraint, and unreliable access to anesthesiologists and CRNAs is threatening schedules, margins and long-term growth plans.
“The lack of anesthesia providers for ASCs in many markets will continue, and anesthesia compensation will continue to rise,” Adam Spiegel, CEO of NorthStar Anesthesia, told Becker’s.
In many markets, ASCs are pivoting to CRNA-only or hybrid coverage models to maintain operations, while others are experimenting with in-house anesthesia teams, contracting through temp agencies and reworking perioperative workflows to make demands leaner.
4. Reliance on temporary anesthesia coverage is rising — increasing schedule volatility and cost pressure: As anesthesia workforce shortages persist, ASCs are leaning more heavily on temporary providers to maintain coverage, but leaders say the shift is driving up costs and making day-to-day operations less stable when coverage gaps emerge.
Facilities are increasingly relying on costly temporary anesthesia providers, with locum tenens usage up 17% since 2024 and projected to climb another 5% in 2025. Several ASC leaders also told Becker’s anesthesia subsidies and contract coverage, including locums, are among their most significant and growing costs, squeezing margins and causing room closures or canceled cases when coverage isn’t available.
5. ASCs are redesigning scheduling and anesthesia alignment to protect throughput and coverage stability: As anesthesia shortages persist, ASC leaders say sustaining OR efficiency increasingly depends on tighter alignment with anesthesia teams and more intentional scheduling strategies to maximize limited coverage.
Alex Andrade, COO at Dubuque, Iowa-based Medical Associates, told Becker’s that after insourcing anesthesia, the goal is to leverage the team to drive “operating efficiencies” and “increase throughput” as part of an end-to-end process. Nathan Garner, director of area operations at Sacramento, Calif.-based Sutter Surgery Center Division, also told Becker’s that ASCs have had to scramble for coverage, sometimes using costly locum tenens or minimum guarantees, and that uncertainty around coverage and new costs have strained relationships among ASCs, anesthesia groups and surgeons.
