As facility managers and anesthesia providers move beyond the rhetoric and search for real answers to eliminating post-operative nausea and vomiting (PONV) and pain, growing numbers have moved to a minimally invasive anesthetic (MIA) approach for minimally invasive procedures. Rather than using benzodiazepines, muscle relaxants, inhalational agents and opioids, an MIA approach takes advantage of the surgeon's use of local anesthesia for the analgesia portion of the hypnosis analgesia = anesthesia equation.