Your anesthesia team consists of senior physicians who are certified as medical specialists in anesthesiology by the American Board of Anesthesiology. Senior members may be assisted by board-eligible physician anesthesiologists and by certified registered nurse anesthetists.
All team members are trained to provide the highest quality of care in the various subspecialties of anesthesiology.
Thanks to advances in anesthetic technique, it is possible to enter the hospital, recover from an anesthetic, and leave for home on the same day.
Ambulatory patients visit the pre-admission testing area a day or two prior to anticipated surgery. A pre-operative questionnaire is completed and patients are directed to other areas for necessary lab tests and procedures such as x-rays and electrocardiograms. All of the information is reviewed and evaluated by the anesthesiologist prior to surgery to determine an optimal anesthetic technique.
Inpatients receive a visit by the anesthesiologist - usually the day before surgery. Information gathered from this interview and the current medical charts allows the anesthesiologist to plan a safe and effective course of anesthesia for the intended surgical procedure.
For emergency patients a thorough evaluation may not be possible. This is not a problem because our anesthesiologists are thoroughly experienced in handling surgical emergencies and major trauma.
During your operation, your anesthesiologist's job is threefold:
To perform these functions, the anesthesiologist has available a variety of anesthetic techniques. Based upon the anesthesiologist's understanding of surgical requirements and the medical condition of the patient, an anesthetic course is chosen and administered. The patient is appropriately positioned on the operating table for the particular surgical procedure.
To help the anesthesiologist care for the patient in the operating room, state-of-the-art devices monitor the patient's cardiac function, lung function, and temperature, as well as the proper functioning of all anesthesia equipment.
Following a surgical procedure, the patient is brought to the surgical recovery room under the supervision of the anesthesiologist in consultation with a specially-trained recovery room nurse. After a period of continuous monitoring, the anesthesiologist will either discharge the patient to the ambulatory surgery unit or return the patient to his or her hospital room for anticipated follow-up care.
Critically ill or medically unstable patients will be followed by the anesthesia team into the surgical intensive care unit. There, along with surgeons and medical specialists, the anesthesiologist will contribute to the critical management of these patients.
In addition, anesthesiologists are frequently called upon to perform special tests or to administer therapeutic anesthetics as one component of multidisciplinary approaches to diagnosis and therapy for patients with special medical problems. Our anesthesia services extend to the endoscopy, radiology, CT scanner and MRI.
The practice of anesthesiology is highly individualized. The types of anesthesia
include general, regional (spinal and epidural), nerve block, and conscious
sedation.
The anesthetic technique selected for each case is adapted to the physical,
medical and psychological state of the patient as well as to the complexities
of the pending surgical procedure, the specific needs of the operating surgeon,
and the experienced judgement of the anesthesiologist.
Except in the direst emergency, the anesthesia options are thoroughly discussed with the patient and an informed consent is reached between the patient and anesthesiologist.
When a general anesthetic is administered for an operation, unconsciousness
is induced and maintained for the duration of the surgical procedure. This
method uses injection of intravenous agents for induction of anesthesia as
well as inhalation of mixtures of specific anesthetic gases with oxygen to
maintain the unconscious state. While the patient is asleep, an endotracheal
tube is placed in the windpipe to protect the patient's lungs and to ensure
that air and gases are delivered to the lungs.
The patient is cared for continually over the entire time of surgery by the
anesthesiologist
Spinal anesthesia involves placement of a needle in the back so that an anesthetic agent can be injected into the space below the end of the spinal cord. The anesthetic moves in the fluid that bathes the spinal cord and the nerves arising from it, making the patient numb from the waist down. Spinal anesthesia is extremely useful for the patient who does not want general anesthesia and is having a procedure on the lower abdomen, groin, or lower extremities.
In some cases, the anesthesiologist may feel that the most efficacious anesthesia
technique for surgical procedures on the arm or leg is a local nerve block.
Usually a mild sedative is given to the patient to allay anxiety during placement
of the nerve block and to make the stay in the operating room more pleasant.
A fine needle, usually with a nerve stimulator attached, is placed near the
nerve supply of the area to be operated upon and then sufficient anesthetic
to numb the nerves is injected. This ensures a comfortable and pain-free surgical
procedure under the care of the anesthesiologist.
For some non-surgical procedures, the physician may chose to perform the procedure
in a hospital treatment room, procedure room, or operating room. In these instances,
conscious sedation can be induced to allay anxiety during the the procedure.
A mild sedative is usually introduced by intravenous injection. If necessary,
the anesthesiologist has the option of administering a wider range of sedation
and even anesthesia. During the entire stay in the procedure room, the anesthesiologist
cares for the patient and electronically monitors the patient's wellbeing.
Occasionally, the surgeon will inject local anesthetic around the area to be
operated upon. Such procedures often include cataract surgery, certain hernia
repairs, and some cosmetic surgery.
In most cases, the surgeon has chosen to perform this operation in the operating
room, instead of the office, so that the anesthesiologist has the option of
administering a wider range of sedation and anesthesia, if necessary, as well
as the ability to monitor the patient electronically.