Society for Ambulatory Anesthesia: Past, Present, and Future

The Society for Ambulatory Anesthesia (SAMBA) was conceived in 1984 from a question raised by Bernard V. Wetchler, MD, asking whether the time was right to start an ambulatory anesthesia society. This was followed by a formative meeting attended by 20 invited anesthesiologists, held in New Orleans, Louisiana, on October 29, 1984, at the ASA annual meeting. The first meeting of the fledgling society was held in Williamsburg, Virginia, in April 1985, where the name “Society for Ambulatory Anesthesia” was proposed and accepted (Ambulatory Surgery 1993;1:77-9). Since then, SAMBA, in parallel with the subspecialty of ambulatory surgery, has continued to grow and evolve. In 2020, SAMBA expanded to formally include office-based anesthesia (OBA) and nonoperating room anesthesia (NORA).Figure 1: SAMBA's mission and the benefits of membership.SAMBA strives to be the leader in ambulatory anesthesiology, including NORA and OBA, perioperative care of the ambulatory surgical patient, medical education, patient safety, research, and practice management. The mission and vision of SAMBA encompass the following goals: To advance the practice of ambulatory anesthesia in all ambulatory venues To promote high ethical and professional standards To provide professional guidance for the practice of perioperative care of ambulatory surgical patients To foster and encourage education and research. There are several drivers for the explosive growth of ambulatory surgery, especially recently. One is the value provided by the outpatient setting in terms of efficiency, productivity, and improved outcomes compared to the inpatient setting (AMA Surg 2018;153:e176233; Ann Surg 2021;273:909-16). Another is the evolution of innovative technological platforms and procedures that allow for reduced surgical stress response, lower incidence of postoperative complications, and rapid recovery, thus enabling more procedures to be performed in the outpatient setting (Anesth Analg 2021;133:1391-1401; Curr Opin Anaesthesiol 2020;33:711-7). In addition, the Centers for Medicare & Medicaid Services has been adding more procedures to the ambulatory surgery center-covered procedures list, which accounts for the migration of greater numbers of procedures to the various outpatient settings. We are all ambulatory anesthesiologists, irrespective of our practice locations, because we all care for patients who are discharged home on the same day as the surgery. SAMBA embraces that concept and aims to provide guidance and educational materials to assist in safe ambulatory perioperative care. These materials take the form of guidelines and position statements, webinars by content experts, continually updated bibliographies, a series of “Did You Know” emails sent out to members biweekly discussing innovative or interesting concepts applicable to ambulatory anesthesia practice, and a quarterly newsletter. Most recently, the updated SAMBA consensus statement on blood glucose management in the adult patient undergoing ambulatory surgery was published by Rajan et al. in the September 2024 issue of Anesthesia & Analgesia (Anesth Analg 2024;139:459-77). In the same issue, the SAMBA position statement on the care of the pediatric patient undergoing outpatient adenoidectomy and or tonsillectomy by Brennan et al. was published (Anesth Analg 2024;139:509-20). SAMBA has made these important publications available for free to members. In the works are a few excellent combination webinars to promote intersociety collaboration and education. The first two of these took place over the spring and summer and included collaborations with the Society for the Advancement of Geriatric Anesthesia and Society for Obstetric Anesthesia and Perinatology (SOAP). Collaborative webinars with SAPQI, the Society for Pediatric Anesthesia, ASRA Pain Medicine, the Society of Cardiovascular Anesthesiologists, and the Canadian Anesthesiologists' Society are coming next. More exciting offerings in the form of a “Did You Know” series on enhanced monitoring in the outpatient setting will be rolled out this month. Members also have access to discussion forums where they can post questions and join in lively discussions with their peers and SAMBA leaders. SAMBA also offers numerous resources and unique educational content for medical directors. The role of the physician is evolving. The business of health care has changed significantly in the last decade and requires all physician leaders to develop managerial and interpersonal skills to deliver value to their patients. Business acumen will improve the leadership and decision-making skills of anesthesiologists, vital to improving the efficacy of health care delivered around the world. SAMBA and The Ohio State University Fisher College of Business have collaborated to offer SAMBA members a unique business training certification program. This virtual program will provide the opportunity to gain business, operational, strategic, and leadership acumen through Fisher College of Business executive education. All courses take place online and are part of the Fisher College of Business' Working Professional MBA program. More recently, SAMBA has expanded this offering to physicians from all specialties. I encourage readers to visit the SAMBA website at sambahq.org for more information. There is exciting news on the meetings front. We just had our mid-year Medical Directors and OBA Meeting in October in Philadelphia just before ANESTHESIOLOGY® 2024. This unique meeting provides sessions on business topics such as leadership and financial understanding relevant to an ASC and OBA practice, administrative topics currently faced by medical directors in ASCs and OBA practices, and strategies to address management issues facing ASCs and OBA practices. SAMBA holds this meeting every year either in person or in a virtual format. The 2025 SAMBA Annual Meeting will be in Phoenix, Arizona, from May 15-17. There are numerous lively and thought-provoking educational sessions planned in addition to invaluable networking and mentorship opportunities. The 2026 SAMBA Annual Meeting will be a collaboration with the Ambulatory Surgery Center Association. This will be a unique meeting featuring sessions of interest to administrators and medical directors, in addition to the SAMBA ambulatory anesthesia track. Abstract submissions are currently open for the 2025 SAMBA Annual Meeting. Abstract submissions will be accepted in one of three categories: Original Research, Medically Challenging Cases, and Quality Improvement. We also offer many award opportunities: Dr. Rebecca S. Twersky Research Award: $2,000 award for the highest-rated research or quality improvement abstract by a junior attending. QA/Ambulatory Patient Safety Research Award (presented by both SAMBA and the Anesthesia Patient Safety Foundation): $500 for the abstract rated highest in research quality and promotion of patient safety. Excellence and Innovation Award: First, second, and third place for the highest-rated abstract submission. White Mountain Award: $1,000 split among first, second, and third place for the best research by an anesthesia trainee. SAMBA Travel Award: $1,000 travel award to an anesthesia trainee whose original research abstract is accepted for presentation. Figure 2: SAMBA 2024-2025 officers.We encourage members to submit abstracts by visiting our website (asamonitor.pub/495DeyY). The inaugural Dr. Rebecca S. Twersky Research Award was bestowed at the 2024 SAMBA Annual Meeting in Savannah, Georgia, on May 2, 2024, in honor of Dr. Rebecca Twersky. Dr. Twersky served as SAMBA President in 1998-1999 and is universally regarded as an authority on ambulatory anesthesia. She was the inaugural Chief of Anesthesia at the Josie Robertson Surgery Center at Memorial Sloan Kettering Hospital and played an enormous role in the genesis of the ambulatory surgery unit at Long Island College Hospital, widely recognized as a model for other such units. She was also a mentor and guide to numerous junior faculty and residents. SAMBA membership opens the door to numerous mentorship opportunities. Physicians with mentors have been found to be more productive, experience less burnout, make better-informed career decisions, and have an overall enhanced sense of well-being compared to their counterparts without mentors. Being a mentor can expand one's network, spur future collaborations, and foster a sense of personal satisfaction through the success of a mentee (Health Sciences Review 2021;1:100004). SAMBA offers both faculty mentorship and resident and medical student mentorship. SAMBA offers free membership and meeting registration for residents and medical students. More recently, SAMBA has offered a unique experience to medical students interested in pursuing anesthesiology – the SAMBA OBA Mentor/Mentee program, which provides exposure to an ambulatory anesthesia rotation. Further information and a video can be found on the SAMBA website (samba.memberclicks.net/oba-mentor-mentee-experience). SAMBA also aims to be a world leader and content expert in ambulatory anesthesiology. To that end, SAMBA maintains a thriving relationship with the International Association for Ambulatory Surgery (IAAS). The IAAS offers an international platform for dissemination of SAMBA guidelines and the extensive research carried out by SAMBA members. Most importantly, SAMBA influences development of recommendations and guidelines produced by the IAAS, ensuring uniform guidance. Due to the multidisciplinary nature of IAAS, SAMBA is able to provide guidance on best practices to surgical specialties, nurses, and hospital managers involved with ambulatory surgical care, in addition to anesthesiologists. Continuing the theme of global advancement of care of the ambulatory surgical patient, SAMBA also has existing and upcoming affiliations with numerous international anesthesiology societies. The SAMBA Board of Directors is working hard to bring our members educational offerings and numerous opportunities to connect, network, and consult with experts in the field. So, wait no longer, and join SAMBA to avail yourself of all these fantastic opportunities.Niraja Rajan, MD, FASA, SAMBA-F, President, Society for Ambulatory Anesthesia, ASA Committee on Ambulatory Surgical Care, ASA Educational Track Subcommittee on Ambulatory Anesthesia, Professor of Anesthesiology and Perioperative Medicine, Department of Anesthesiology and Perioperative Medicine, Penn State Health, and Medical Director, Hershey Outpatient Surgery Center, Hershey, Pennsylvania.

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