Office-Based Anesthesia Rules

New: Inspections of registered OBA locations in Texas to begin in 2014.

In order that we may ensure compliance with Board Rule 192 regarding the provision of anesthesia services in outpatient settings, the Board implemented, starting January 2014, a program to inspect registered OBA locations in Texas.

The Board will provide at least 5 days’ notice prior to inspection. At, or prior to, the time of inspection each physician who has registered an OBA location will be required to provide to the information requested by the Board.Please do not submit any documentation at this time

Since Sept. 1, 2000, physician's offices that do more than local anesthesia or sedation procedures have been required to register with the Texas Medical Board (TMB), pay a registration fee and comply with certain rules.

Download the TMB Rules:

Offices that are already accredited by the joint Commission on Accreditation of Healthcare Organizations, the American Association for the Accreditation of Ambulatory Surgery Facilities, or the Accreditation Associationfor Ambulatory Health Care are exempted.

The TMB has adopted the ASA standards and guidelines (see http://www.asahq.org). Therefore, the same safety measures used in hospitals are incorporated into the office setting. The following are highlights of the rules:

preoperative evaluation,
informed consent (including informing the patient if care is shared with other non-physician providers),
intraoperative monitoring,
secondary power source in the OR,
properly serviced and maintained equipment with service logs for 7 years,
emergency drugs and equipment for CPR and malignant hyperthermia,
transfer agreements in case of emergency.

In addition, the operating surgeon or anesthesiologist shall maintain current competency in ACLS or PALS. At a minimum, at least two persons, including the surgeon or anesthesiologist, shall maintain current competency in basic life support.

Physicians must notify the board within 15 days if a procedure performed results in an unanticipated and unplanned transport of the patient to a hospital for observation or treatment for a period in excess of 24 hours, or a patient's death intraoperatively or within the immediate postoperative period. Immediate postoperative period is defined as 72 hours.

The Texas Medical Board voted to adopt the proposed rules at its meeting on March 31, 2000.

For additional questions or assistance regarding Office Based Anesthesia please contact OBA@tsa.org.