Office-based anesthesia is not suitable for all patients. Below is a list of health conditions which would exclude patients from being eligible for office-based anesthesia. Patients with a complex medical history who have any of the absolute contraindications listed below should not have anesthesia in an office-based setting, and should not be scheduled. Patients with relative contraindications listed below should have medical clearance from specialists, i.e. cardiologist, pulmonologist, etc. Anesthesia provider should be notified with sufficient time for follow-up. If unsure, we would be happy to review the medical history and speak with the patient prior to scheduling. We strive to provide the safest anesthetic possible and want the best outcomes for everyone involved. Complying with these guidelines will help minimize potential anesthetic complications.

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ABSOLUTE CONTRAINDICATIONS

Patients with any of the conditions below are not suitable to receive office-based anesthesia.

❖ Congestive Heart Failure with Ejection Fraction less than 30%.

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❖ End Stage Renal Disease dependent on dialysis.

❖ Decompensated Liver Cirrhosis with significant acites, jaundice, esophageal varices, or hepatic encephalopathy.

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❖ BMI greater than 50

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❖ New onset A-fib- if no cardiac evaluation.

❖ Heart attack within previous 6 months

❖ Stroke within previous 6 months

❖ Recent respiratory infection (cold, cough, pneumonia, bronchitis, strep throat) within previous 2 weeks.

❖ Pregnancy

We recommend all women of childbearing age obtain a negative pregnancy test prior to anesthesia.

 

❖ Recent illicit drug use

Patients must have stopped cocaine and/or methamphetamines use at least 4 weeks prior to anesthesia. Substance abuse issues should be reported to anesthesia provider before scheduling.

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RELATIVE CONTRAINDICATIONS

Notify anesthesia provider about any of the following conditions.

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❖  Known difficult airway

Requires in person airway assessment with anesthesia provider.

 

❖  Congestive Heart Failure with ejection fraction greater than 30%.

Need cardiac clearance and results of most recent echocardiogram.

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❖ Severe Asthma or COPD

Pulmonary consult and pulmonary function test if available.

 

❖  Uncontrolled diabetes

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❖  Uncontrolled high blood pressure

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❖  Patients dependent on home oxygen

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❖  Patients currently on blood thinners

Require consult from prescribing physician with recommendation to hold or continue.

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❖  Heart attack greater than 6 months ago

Require cardiac clearance.

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❖  Pacemaker

Cardiac clearance and most recent pacemaker interrogation if available.

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❖  Stroke greater than six months ago.

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❖  BMI greater than 45

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❖  Heart Valve disease

Requires cardiac clearance and echocardiogram if available.

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❖  Severe and untreated gastroesophageal reflux disease (GERD).

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❖  The weight loss medication Phentermine must be stopped 14 days prior to anesthesia.