The migration of surgical cases from inpatient settings to ambulatory surgery centers (ASCs) continues to reshape perioperative leadership in 2025. Nationally, the trend is driven by payer incentives, patient preference, and cost pressures, with ASCs now performing more orthopedic, spine, and complex outpatient procedures than ever before. In fact, the…

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Editor's Note A malpractice case involving a 69-year-old man undergoing an endoscopy at an ambulatory surgery center (ASC) spotlights the risks of managing high-comorbidity patients outside a hospital setting. According to a May 13 report in Anesthesiology News, the patient experienced a hypoxic event that led to permanent brain injury…

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By 2022, orthopedic procedures performed in ambulatory surgery centers (ASCs) were already outpacing expectations. For years, total hip and knee replacements were considered too complex for same-day surgery. Yet, total joints replacement volumes jumped nearly 200% between 2020 and 2022—outpatient total knee arthroplasty surged nearly 194%, while total hip arthroplasty…

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Running an ambulatory surgery center (ASC) is not for the faint of heart. ASC leaders are navigating tight margins, stricter-than-ever quality reporting, lean staffing resources, payer squeeze, and a relentless push to be profitable without proper support. And yet, the ASC market is booming. The number of Medicare-certified ASCs has…

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Editor's Note Ambulatory surgery centers (ASCs) continue to face a mounting anesthesia crisis: costs are rising, staffing is tightening, and reimbursement is failing to keep pace. Anesthesia payments have dropped 8.2% over the past decade, while provider salaries have risen by as much as 40%, creating a growing financial burden…

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An estimated 22 million Americans were believed to have obstructive sleep apnea (OSA) in 2019, according to data cited in a February 2019 article published by OR Manager. At that time, up to 80% of cases were undiagnosed, and 30% to 40% of the surgical patient population was believed to…

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Editor's Note The Accreditation Association for Ambulatory Health Care (AAAHC) launched a new pain management toolkit that prioritizes multimodal strategies to improve outcomes and reduce opioid use in ambulatory surgery. Designed for the unique challenges of outpatient care, the resource provides practical, evidence-based guidance to optimize safety, comfort, and recovery.…

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Editor's Note A new international consensus offers the first multidisciplinary definition and set of recommendations for group-based preoperative education programs, sometimes referred to as “surgery schools.” Published June 21 in the British journal Anaesthesia, the expert-driven guidance aims to improve patient preparation, experience, and recovery for those undergoing major elective…

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One of the most sobering moments in the career of anesthesiologist Cornelius Sullivan, MD, occurred not as a caretaker in the OR, but as a patient in the emergency department. Having been knocked out cold by a low-hanging monitor during a surgical procedure at Boston Children’s Hospital, he had to…

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Editor's Note The US Food and Drug Administration (FDA) has designated recent medical device recalls involving GE Healthcare’s Carestation anesthesia system, Medtronic aortic root cannula systems, Zoll Circulation’s AutoPulse NXT Resuscitation System, and Medtronic’s Bravo CF Capsule Delivery Devices as Class 1, the most severe category indicating serious risk of…

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