Administration of general anesthesia for outpatient orthognathic surgical procedures

The administration of anesthesia has shifted away from the traditional hospital setting to an enormous increase in the use of outpatient facilities. The development of short-acting anesthetics, advances in surgical techniques, and paradigm shifts accepting targeted hospital admission and preoperative testing have allowed the acceptance of outpatient anesthesia for a wide variety of surgical procedures, including orthognathic procedures. Furthermore, the cost savings associated with office-based surgery and the declining insurance coverage for procedures such as orthognathic surgery have helped to increase the demand for surgery in this setting. The administration of anesthesia for orthognathic surgery in an outpatient setting requires preoperative preparation, preoperative patient assessment and selection, use of short-acting anesthetic agents and techniques, presence of emergency drugs and equipment, appropriate recovery protocols and staff, and the presence of adequate caregivers upon home discharge. Anesthetic techniques and agents allowing multiple orthognathic procedures to be performed in the outpatient setting are described.