Conscious sedation/local anesthesia in the office-based surgical and procedural facility

The safety, efficacy, and rapid recovery of conscious sedation/local anesthesia make this anesthetic technique useful in the ambulatory setting. The care of the sedated patient requires a team effort. The individual role and responsibility of patient, surgeon, anesthesia provider, and nursing staff are discussed. Using data obtained from a series of 1400 consecutive cases, the authors' experience with conscious sedation/local anesthesia is presented. The current technique, using low-dose propofol, is described in detail. Using conscious sedation, the patient's level of consciousness is depressed, but respiratory drive and airway reflexes are maintained and anesthesia is provided by infiltration of local anesthetic.