An anesthesiologist is a doctor of medicine who has completed four years of medical school, one year of internship and three years of residency training. Sometimes additional specialized training is undertaken leading to a fellowship in a subspecialty such as cardiac anesthesia, pediatric anesthesia, or pain management. Once residency training is completed, the anesthesiologist becomes eligible to take the board certification exam given by The American Board of Anesthesiology. All Anesthesiologists employed by ASPA are board certified by The American Board of Anesthesiology or are in the process of becoming board certified.
A CRNA is a Certified Registered Nurse Anesthetist who works under the supervision of an anesthesiologist. These practitioners are certified registered nurses who have undergone additional training and education in the field of anesthesia. Once they graduate from an accredited school of nurse anesthesia they become eligible for certification by the American Association of Nurse Anesthetists (AANA). All of the CRNAs employed by ASPA are certified by the AANA.
There are a number of factors that have improved the practice of anesthesia. Anesthesiologist and Nurse Anesthetist training programs have improved the quality of knowledge and skill in new graduates through exposure to clinical and laboratory research, cutting edge techniques, and exposure to the most current methods and practices in anesthesia. Board certification examinations have ensured a strict standard of quality amongst new graduates. Continuing medical education programs enforced by state licensure requirements ensure that our staff is trained in the most up-to-date techniques in anesthesia and in the the most up-to-date knowledge base available. There have been numerous advances made in the drugs available for your anesthetic care as well as advances in the monitoring equipment used to assist us to ensure your safety during surgery.
There are four basic types of anesthesia: local anesthesia, Monitored Anesthesia Care (MAC), regional anesthesia, and general anesthesia.
Sometimes there may be an overlap in these types of anesthesia. We often combine a regional block with general anesthesia. In this situation, the purpose of the regional block is to provide the patient numbness to the site of surgery beyond the duration of the surgery itself. Although this might not eliminate the occurrence of postoperative pain, it usually accounts for what is perceived as the most intense pain (that which occurs immediately after surgery) and may affect the intensity of the pain through the entire postoperative period through a principle known as “pre-emptive analgesia”.
If you are an inpatient, we will try to speak with you and review your chart the day before surgery. Unfortunately, there are circumstances that may prevent us from speaking with you until the hour before your surgery. Nevertheless, you will always have an opportunity to speak to your anesthesiologist prior to having surgery. As an outpatient we will try to reach you by telephone or we may ask you to come in and speak with a member of our department before your surgery date. Once again, you will have the opportunity to speak to your Anesthesiologist and Nurse Anesthetist the day of surgery prior to your procedure. At this time the Anesthesiologist and Nurse Anesthetist will perform a medical assessment and a brief but focused physical exam. Your Anesthesia Care Team will then discuss and recommend your anesthetic options. Please feel free to ask questions throughout this process.
A Registered Nurse will interview you while you are in the surgery preparation area (or prep and holding area). Subsequently, you will have your anesthesia interview. You may have an intravenous (IV) line placed that may be used to administer a sedative to help you relax, if necessary. In a same day surgery center setting, you are unlikely to receive a sedative. The environments in these areas are less stressful and we allow one visitor to stay with you to help alleviate your anxiety until you are taken back for your procedure. The IV you receive will also be used during your procedure to administer other medications and fluids. There are also instances in which we may insert special monitoring devices after you have had some sedation. Regional nerve blocks are frequently placed at this time as well.
In the operating room (O.R.) we place monitors on you, such as a blood pressure cuff, EKG patches, awareness monitor, and a pulse oximeter. For general anesthesia, you will be given a mask of oxygen to breath and then administered medicines through your IV causing you to “sleep” or as we prefer to say, "become anesthetized". We monitor your vital signs frequently and adjust medications and fluids when necessary throughout your procedure. There will be someone from our staff present at all times during your surgery. At the end of your procedure, we will discontinue the anesthetic. You will awaken and then be transferred to the Post Anesthesia Care Unit (PACU), where specially trained Critical Care Nurses will help you throughout your recovery.
Our staff will remain with you in the PACU (recovery room) until your vital signs are stable. We will then provide the nursing staff with orders regarding your postoperative pain relief.
The risk of anesthetic complications varies with your medical condition, procedure and anesthetic plan. Minor complications are usually transient or easily treatable. These may include a sore throat and/or nausea and vomiting. Rarely, a spinal headache may occur if spinal or epidural anesthesia was administered. Though rare, major complications may include heart attack and stroke. Death is extremely rare and occurs approximately once in every 250,000 anesthetics given. Malignant Hyperthermia (MH) is a life-threatening inherited disease strongly linked to anesthesia. Fortunately, if your anesthesia care team knows that you are a patient at risk for MH, they can provide a MH-safe anesthetic. This can be said for nearly any medical condition that you may have. If the Anesthesia Care Team is made aware of your particular medical condition, the medicines you take as well as other substances, a safe anesthetic care plan can be formulated for you and therefore minimize your risk of perioperative complications. Therefore, it is extremely important to let your Anesthesiologist know if anyone in your family has ever been diagnosed with MH or had any other serious reaction to anesthesia or medications.
Yes, you will receive a separate bill for our services in addition to any hospital charges. Our bill will only be for professional anesthesia services whereas your hospital bill may contain charges for the equipment and medications used during your surgery. Please see our Billing Section for additional information.
For further information and questions regarding anesthesia, please see the following links:
American Society of Anesthesiologists Patient Education Page
www.asahq.org/patientEducation.htm
Anesthesia Patient Safety Foundation
www.gasnet.org/societies/apsf
Preparing for Surgery | Day
of Surgery (Before) | Day
of Surgery (Operation) | Day of Surgery (After)
Frequently Asked Questions | Glossary of Terms
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