Anesthesia in the oral and maxillofacial surgery office: past, present and future

In this day and age, the fear of not "waking up" from a general anesthetic has little basis in fact. Serious complications almost never occur in the absence of a preexisting medical problem. By virtue of extensive training, proper patient selection, vigilant monitoring, and judicious use anesthetic agents, the oral and maxillofacial surgeon continues to provide a very high level of anesthetic care. Besides being safe, it is also very cost effective. The surgical removal of four impacted third molars in the office costs four to five times less than a similar procedure in the typical ambulatory surgery unit. Thus, it would appear that the oral surgeon's expertise in delivering office anesthesia not only predates the current popularity of ambulatory surgery, but may well have been the pioneering model from which it arose.