Outpatient anesthesia is evolving quickly as new tools, techniques and care models emerge.
From artificial intelligence to innovative staffing models, five anesthesia leaders joined Becker’s to discuss the new tools shifting outpatient anesthesia.
Question: What new tools or techniques are making the biggest difference in outpatient anesthesia?
Editor’s note: These responses were edited lightly for clarity and length.
Patrick Giam, MD. President-Elect of the American Society of Anesthesiologists:
Though not yet perfected, it is likely that harnessing AI to analyze OR data (surgical case times, PACU recovery, Pre-op prep) to coordinate schedules and staffing more efficiently will improve OR utilization. There is individual opportunity within institutions to analyze their patient populations and outcomes (complications, unplanned admissions) to see if their patient selection process can be tweaked in terms of allowing more patient access to ambulatory care while maintaining high quality and safety. In addition, implementation of standardized protocols for particular procedures may provide increased patient and surgeon satisfaction while maintaining patient safety, if they are applied intelligently with room for adaptation for individual cases if necessary.
Andrew Hicks, CRNA. Advanced Practice Providers for Cardiothoracic Division of the Ohio State University College of Medicine (Columbus): One of the most impactful tools in outpatient anesthesia today is effective pre-operative screening and assessment. This process adds efficiency by identifying potential risks early, ensuring patients are properly optimized before surgery. It also significantly reduces delays and unexpected cancellations, which can disrupt surgical schedules and affect overall patient care.
Maher Kodsy, MD. President of Elyria (Ohio) Anesthesia Services: We were able to develop a creative model of staffing. We currently enjoy a large pool of PRN providers who are willing to work alongside our employees. This tool helped us eliminate the very expensive locum agencies and allowed us to meet the flexibility of surgery schedule. With everyone rushing for full time/part time hiring, we recognized that some providers prefer to work independently from locum agencies. Surprisingly, despite the high hourly rate, it lowered the overhead expenses due to controlling the number of hours they work.
Christina Menor, MD. President Elect at California Society of Anesthesiologists:
Ambulatory anesthesia depends on the ability to move smoothly and quickly between cases. This requires:
- Timely preoperative assessment of patients.
- Preparation for induction, intraoperative management and emergence.
- Safe and efficient emergence so patients can be transferred promptly to PACU.
When emergence is well-planned, anesthesiologists can often leave the operating room within minutes of surgical completion. This allows the PACU RN to assume care promptly, enabling the room to be cleaned and prepared for the next patient.
Hospital vs. ASC turnover:
Hospital setting: Turnover may take 30–60 minutes.
ASC setting: Turnover is often 10–20 minutes—a key factor in case volume and efficiency.
Successful rapid turnover depends heavily on:
- A collaborative environment where all team members — surgeons, anesthesia, nursing, and support staff — work toward the same goal.
- Mutual respect and shared responsibility for efficiency and safety.
Vigilance remains the cornerstone of anesthesia practice. By combining vigilance with planning and foresight, the ASC team can:
- Maintain high standards of patient safety.
- Improve operational efficiency.
- Optimize patient throughput without compromising care quality.
Eugene Viscusi, MD. Professor of Anesthesiology and Perioperative Medicine at Thomas Jefferson University: In the context of the opioid crisis and greater awareness of opioid adverse events, opioid reduction or elimination is a realistic goal. We have great tools at our disposal. Regional anesthesia and local anesthetic techniques especially with continuous catheters are highly effective and relatively easy with ultrasound guidance. Also, the repertory of regional anesthesia techniques allows effective approaches to most ambulatory surgical procedures. Extended-release local anesthetics may provide prolonged opioid free analgesia. The recently FDA-approved suzetrigine is a non-opioid alternative approved for acute postoperative pain. Of course, nothing beats aggressive multimodal analgesia. Since most ambulatory patients are generally healthier, they can benefit from the full range of standard non-opioid agents. Buprenorphine is finding its way into postoperative pain pathways too. It has a safety profile superior to standard opioids. The buprenorphine patch can be an effective option for ambulatory surgical patients.
