shorter anesthesia group and two in the longer--developed major complications, including respiratory failure, nervous system deficit and an adverse reaction to medication. "Contrary to reports that longer procedure duration causes a higher incidence of intractable postoperative nausea, vomiting and pain, thus necessitating higher precautionary hospitalization rates if performed in the office-based environment, we had no cases with any of these complications," the authors report. "Overall, we had no cases of major morbidity in which procedure duration was directly related to the complication or in which inpatient care would have prevented major morbidity events from occurring or being treated optimally."

"When regulatory bodies consider creating surgical guidelines, a detailed understanding of specific risks associated with different types of surgery is needed to avoid generalization and inappropriate, nondata-driven regulation," they conclude. "Although this is the largest study to date that specifically evaluates consecutive cases in which anesthesia lasted more than 240 minutes, larger series of outcomes data should be compiled to guide further evaluation of morbidity risks and ensure appropriate outcomes in office-based surgery."

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Contact: Jacqueline Weaver
203-432-8555
JAMA and Archives Journals
16-Jan-2006

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