AMBULATORY ANESTHESIA
GOALS AND OBJECTIVES
CA2 and CA3 levels
DEFINITION
The resident rotation for CA-2 is four weeks and includes anesthesia for: ambulatory surgery
procedures, GI Endoscopy procedures, surgical procedures for the eye and an introduction to
regional anesthesia techniques used in the Day Surgery OR’s.
The resident rotation for CA-3 residents is elective weeks in the ambulatory ORs with emphasis
on Day Surgery patient selection, advanced imaging for regional anesthesia, and intentional time
management to facilitate efficient room turnover and rapid patient recovery for ambulatory
discharge.
CURRICULUM
Residents at all CA training levels are assigned to ambulatory surgery procedure performed in
the University of Colorado Hospitals Day Surgery Unit located separately from the main ORs
and to non-operative procedures in the ambulatory building (AOP).
MEDICAL KNOWLEDGE: CA-2
At the conclusion of the rotation the CA-2 resident should be able to describe:
1. integration of preanesthesia testing information into the formulation of an anesthesia plan
for ambulatory anesthesia
2. appropriate laboratory testing prior to and on the day of surgery
3. evaluation of coexisting medical conditions such as diabetes, obesity, sleep apnea,
geriatrics, severe developmental disability, and family history of Malignant Hyperthermia
prior the starting intraoperative anesthesia care
4. choices of airway management techniques and muscle relaxant agents for ambulatory
anesthesia
5. preoperative preparation of the ambulatory surgery patient
a. npo status and instructions for children and adults
b. anxiolysis
c. antinausea prophylaxis
d. antacid and H2 receptor antagonist usage
6. differing anesthetic requirements for anterior chamber posterior chamber, eye muscle and
orbital procedures and a variety of regional anesthesia procedures for the eye
7. the choice of and between neuraxial block techniques for ambulatory anesthesia
8. pharmacology of regional anesthetic agents and the prevention of adverse reactions to
regional anesthesia
9. The psychological preparation of patients for general anesthesia, regional anesthesia,
monitored anesthesia care and guidance of the patient through making an informed
choice
10. performance of intraoperative care of patients with general inhalational or intravenous
anesthesia, regional anesthesia, light and deep sedation with attention to the integration of
intraoperative management and rapid post operative recovery
MEDICAL KNOWLEDGE: CA-3
At the conclusion of the CA-3 ambulatory anesthesia rotation the resident should be able to
demonstrate:
1. mastery of the introductory knowledge in ambulatory anesthesia as above
2. proficiency and all airway management techniques and tools
3. accuracy in upper and lower extremity regional anesthesia techniques with and without
ultrasound guidance
4. effective communication with the operating room, preoperative and PACU staff to
facilitate efficient case turnover
5. anticipation of postoperative recovery issues in the choice of intraoperative analgesia
agents, opioids, muscle relaxation and pain management blocks
6. skill in monitoring and sedation of patients with difficult airway anatomy
7. thorough understanding of phase 1 and phase 2 recovery after anesthesia, the progression
of steps from emergence to “home readiness”, and the influence of individualized
anesthesia choices in facilitating that progress
8. understanding of the limitations of Day Surgery care and knowledge of office based
anesthesia limitations
9. effective use of multimodal analgesia and antiemetic agents
10. an understanding of the role of medical director and anesthesiologist in the perioperative
care team in Day Surgery
INTERPERSONAL AND COMMUNICATION SKILLS
1. Interface with the perioperative care team with efficient, effective and cordial
communication
2. provide a calming presence for the awake or semi-conscious patient during sedation and
monitoring cases
PROFESSIONALISM
1.
2.
3.
4.
Timely arrival and preparation for patient care
prioritization of tasks
Adaptability to changing schedules and reassignment
Specific sensitivity to the needs of patients who anticipate returning to home after their
procedure
Rev. 7/2009
2