Conscious Sedation for

Office-Based Surgery

Information for Surgeons:

At 922 Anesthesia, our goal is to provide professional, high-quality mobile anesthesia services to our patients and surgeon customers in the greater Memphis area. We provide the optimum level of intravenous conscious sedation, allowing patients to tolerate in-office procedures that might otherwise require referral to a hospital.

We bring everything necessary to provide intravenous conscious sedation and continuous monitoring in your office, leaving nothing for you to buy.

Below are answers to commonly asked questions:

Why perform surgery in my office?

Patient Safety, Satisfaction and Comfort: Patients have their procedures performed in a familiar setting, cared for by doctors and nurses they know. Intravenous narcotics and anti-anxiety medications are superior supplements to a local anesthetic block. All medications, including anti-inflammatories, anti-nausea medications and antibiotics, can be given through a small IV, requiring only one needle-stick for the patient.

Increased Practice Revenue and Patient Savings: Insurance companies are providing substantial incentives for surgeons to perform less-invasive surgical procedures in the office, saving patients thousands of dollars in facility charges while increasing practice revenue. Patient satisfaction with in-office surgery can lead to more referrals. You can also advertise that your practice performs office-based surgery in consultation with a board-certified physician anesthesiologist.

Convenience: Cases can be performed while you continue to see non-surgical patients in your office. This eliminates the need for you to rearrange your hospital surgery schedule. Patients can recover with Dr. Moran at their side while the room is turned over and the equipment is disinfected, eliminating the need for a recovery area or recovery nurse. Patients can be transported by wheelchair or walk from the procedure room straight to their caregiver's car for the ride home. Dr. Moran is available by phone to treat all post-anesthetic questions, problems or complaints.

Why Consult Dr. Moran?

Risk Management: There is no higher level of anesthesia care available for your patients than continuous monitoring and conscious sedation administered by a board-certified anesthesiologist with over 28 years of experience. Dr. Moran is certified by the American Heart Association as an advanced cardiac life support provider for adults and children. Consider the advantages of consulting an experienced anesthesiologist to coordinate direct patient care, document medical board and DEA compliance, perform pre-operative evaluation and post-operative follow-up and to implement risk-reduction strategies for your office-based surgery practice.

Will I still need to perform a local anesthetic block?

Patients consistently have a better experience when local anesthesia is combined with sedatives, anti-anxiety medications, non-steroidal anti-inflammatories and narcotics. Modifications of the standard technique can minimize the risk of systemic absorption of local anesthetics. To reduce risk, slow injections with smaller volumes of local anesthetic without epinephrine using frequent aspiration is recommended. In addition, Lidocaine and Mepivicaine have a faster onset and a more desirable cardiac safety profile than Bupivicaine.

Dr. Moran will sedate your patient prior to the local block for their comfort. He will monitor them for early signs and symptoms of systemic local anesthetic absorption, vagal reflexes or allergic responses and be there to help support them in the rare instance that symptoms progress.

Will my malpractice premiums go up?

We are unable to confirm this commonly quoted rumor. According to State Volunteer Mutual Insurance Company's Underwriting Department, there would be no increase in premiums for surgeons choosing to perform in-office surgery. Check with your malpractice provider to confirm details for your practice.

Will we have to buy anything?

The representatives from the companies that sell the equipment and disposable devices used for in-office surgery would be delighted to meet with you and explain how using their equipment and devices in your office can improve patient satisfaction, save you time and increase your practice revenue, depending on your agreements with third-party payers. Dr. Moran will be happy to arrange or facilitate a financial impact analysis with a representative of the device manufacturers.

Will we have to modify our office?

Probably not. You can use your largest procedure room. Dr. Moran brings oxygen, suction, equipment, medications and everything else required to provide vigilant care for your patients.

How much will anesthesia cost my patient?

Dr. Moran no longer accepts insurance for in-office procedures. Fees for anesthesiology services can be paid by the patient or surgeon and they start at $600. Call for details.

How do we get started?

Call Dr. Moran at 901-432-0173 if you would like to discuss details about conscious sedation for patients in your office, or if you would like to arrange a meeting. Surgeon references are available at your request.

What should I know about the Tennessee Medical Board's Rules for Office-Based Surgery and Anesthesia?

We will help you meet the standards and comply with the rules for office-based surgical procedures and conscious sedation as defined by the Tennessee Board of Medical Examiners on the state's website, specifically pages 63-84, which can be downloaded in pdf format HERE.

We can also provide deep sedation, spinal or general anesthesia in any office-based surgical suite that has been surveyed and certified by the Tennessee Department of Health.

How do we order medications?

Initially, it will take a few days to order and receive sedatives and narcotics for use at your office. After that, cases may be scheduled at your convenience. If you prefer, we can take care of all of the paperwork for you. We pay for and deliver all medications.

Where should the controlled substances be stored?

These medications should be kept in your office, locked in a secure location. Dr. Moran will provide you with the inventory control documentation required by the DEA.

What if I want to order the Schedule II and Schedule IV medications myself?

If you would like to take care of your own paperwork, you can speed things up by ordering Form 222 from the DEA using your DEA registration number HERE.

Your DEA number must be registered at the office address where the office-based surgery will physically take place. If you need to change the address of your DEA registration to match your office location before ordering the forms you can do so HERE.

Just log in using the information on your current certificate and change your address. Then you can order Form 222 to be delivered to your new address. When you get Form 222, call Dr. Moran and he will talk you through the rest.

Other Information:

922 Anesthesia® and the 922 Anesthesia® logo are registered trademarks of Dr. Eddie Moran.

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