OBA Emphasis Obscures Dangers of Sedation by Non-Anesthesiologists

Mark E. Wenck, MD

To the Editor

I have noticed the recent Newsletter focus on office based anesthesia safety. However, I find a conspicuous lack of focus on sedation within hospitals by non-anesthesiologists.

Although sedation is not anesthesia, per se, I can think of no better organization than the APSF to address this issue. The JCAHO holds anesthesia departments accountable for overseeing sedation by non-anesthesiologists. This entire issue is a Pandora’s box for anesthesiologists nationwide. Although some non-anesthesiologists would characterize this as a “turf ” issue, safety is at the core. I have done literature reviews on safety of sedation outside the OR by non-anesthesiologists, and there are no good, recent studies on this issue. The older studies showed alarming morbidity and morality rates for patients in this setting. I strongly suspect that we would find that there has not been as big an improvement in outcome in the non-anesthesiologist sedation setting as there has been in OR-based anesthesia and sedation.

I encourage the APSF, and particularly readers of the Newsletter, to address this difficult, but important, issue.

Mark E. Wenck, MD
Green Bay (Wisconsin) Anesthesia Associates, S.C.