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About Anesthesia

Anesthesiologists: Experts in pain medicine

The anesthesiologist is the perioperative physician (“peri-” meaning “all-around”) who provides medical care to each patient throughout his or her surgical experience. This includes medically evaluating the patient before. During surgery the anesthesiologist plays a central role in the operating room, consulting with the surgical team, providing pain control and supporting life functions during surgery. They typically are the first to diagnose and treat any medical problems that may arise during surgery. After surgery anesthesiologists are involved with supervising care, diagnosing and treating problems that may occur while in recovery, and discharging the patient from the recovery unit.

The practice of anesthesiology is broad and transcends the operating room as well. Anesthesiologists are experts in pain medicine. They help patients with chronic disease live better lives through pain management treatments for everyday. Additionally, they may also work in trauma and critical care units treating patients with multiple complications from pulmonary and cardiac issues to infection control and advanced life support.

Anesthesiologists are physicians with medical school and residency training. Some anesthesiologists pursue additional fellowship training in subspecialties such as cardiac anesthesia, pediatric anesthesia, obstetric anesthesia, critial care, and pain medicine.

Certified Registered Nurse Anesthetist (CRNA)

A Certified Registered Nurse Anesthetist (CRNA) is an advanced practice registered nurse (APRN) with specialized graduate education who administers anesthesia and provides anesthesia-related care before, during, and after surgical, diagnostic, and obstetrical procedures, managing patient airways, vital signs, and recovery, often working with surgeons in diverse settings. They are highly trained professionals responsible for patient comfort, safety, pain management, and emergency response during complex medical procedures. They work under the direction of physician anesthesiologists.

Types of Anesthesia

General Anesthesia

General Anesthesia is a drug-induced loss of consciousness during which you have no awareness even to painful stimulation. The ability to adequately breathe on your own may also be affected, requiring assistance or even complete intervention by the anesthesiologist.

Regional Anesthesia

With regional anesthesia your anesthesiologist injects medication near a bundle of nerves that supply signals to a specific part of the body. This results in temporary loss of sensation and motor function to parts or regions of the body that requires surgery. Regional anesthesia is often combined with either monitored anesthesia care (MAC) or general anesthesia. Regional anesthesia is also used to help relieve or minimize post-operative pain after certain surgeries. This may be done before or after the surgery. There are several types of regional anesthesia. The most common types are peripheral nerve blocks, epidurals, and spinals.

Peripheral Nerve Block – A Peripheral Nerve Block is when local anesthetic medication is injected around specific nerves that supply signals to a specific part of the body like an arm or leg. This results in temporary loss of sensation and motor function to that part of the body. An ultrasound is used to visualize the injection in real time.

‍Epidural Anesthesia – Epidural Anesthesia is when a catheter is placed into the epidural space of your back to allow infusion of a local anesthetic medication into that space. It bathes the nerve roots that come out of the spinal cord which results in a gradual loss of sensation and possible motor function below the area where the catheter was placed. This effect can last for as long as the medication is infused in this space. Epidurals are often used to provide pain relief after surgery for several days.

‍Spinal Anesthesia – Spinal Anesthesia is produced by injecting local anesthetic medication directly into the space where the spinal cord is located. This results in temporary loss of sensation and motor function below the level of injection.

Monitored Anesthesia Care (MAC)

MAC is another name for Monitored Anesthesia Care. It encompasses a wide spectrum of sedation from lightly sedated and awake all the way to asleep but responsive to arousal depending on the procedure. What differentiates MAC anesthesia from other sedation is that it must be provided by qualified anesthesia personnel and must include monitoring of all critical bodily functions. In addition to giving sedation and pain medications, the provider must be able to diagnose and treat any problems that may occur during the procedure and the provider must be prepared and qualified to convert to general anesthesia if the need arises. Lastly, it requires a pre-operative evaluation before surgery and post procedure anesthesia management in addition to intra-operative sedation and care.