What is an Anesthesiologist?
Physicians specializing in peri-operative care, development
of an anesthetic plan, and the administration of anesthetics
are known as anesthesiologists. As with other specialties
within medicine, doctors wishing to specialize in anesthesia
must undertake extensive training. In the U.S., the training
of a physician anesthesiologist typically consists of 4
years of college, 4 years of medical school, 1 year of
internship, and 3 years of residency.
These colleges typically set rigorous examinations, which
must be passed before training is complete. These
examinations encompass the whole field of anesthetic
practice, and are usually split into several parts.
Completion of the written and oral Board examinations by a
physician anesthesiologist allows one to be called "Board
Certified" or a "Diplomate" of the American Board of
Other specialties within medicine are closely affiliated to
anesthetics. These include intensive care medicine and pain
medicine. Specialists in these disciplines have usually done
some training in anesthetics. The role of the anesthetist is
changing. It is no longer limited to the operation itself.
Many anesthetists consider themselves to be peri-operative
physicians, and will involve themselves in optimizing the
patient's health before surgery (colloquially called
"work-up"), performing the anesthetic, following up the
patient in the post anesthesia care unit and post-operative
wards, and ensuring optimal analgesia throughout.
What is anesthesia?
Although many different definitions can be found in the vast
medical literature, a good working definition of surgical
anesthesia is the state by which a patient is rendered
insensible to pain during surgical, obstetric, therapeutic,
and diagnostic procedures. Accordingly, patients can be awake during procedures, as with a
regional nerve block, sedated, or asleep (unconscious).
What are the differences between a general anesthetic and
the term general anesthetic referred to the induction of an
unconscious state usually followed by the insertion of some
type of airway device such as an endotrachial tube into the
patientís trachea to aid with continuous or assisted
ventilation during their surgery. This usually involves the
intravenous administration of medications that produce a
lack of consciousness, amnesia, and analgesia (inability to
feel pain). Once the patient is fully asleep, the
endotrachial tube is inserted into the patient. After
general anesthesia is induced, the patient is maintained in
this state with a combination of gases and intravenous
anesthesia refers to anesthetic techniques that depend on a
group of drugs, called local anesthetics, that produce
transient loss of sensory, motor, and autonomic function in
a discrete portion of the body. Everyday examples include
spinal injections for cesarean sections, lumbar epidurals
placed for labor, upper extremity nerve blocks for hand,
forearm, or elbow surgery. The key here is the injection of
a local anesthetic at the site of specific nerves that
normally innervate a specific area of the body, such as an
arm or leg. In doing so, the patient feels no pain during
the surgery and often has excellent pain relief for hours
after the injection. At the patientís request, mild
sedation can also be administered in conjunction with a
regional anesthetic technique.
Useful links for additional information:
American Society of Anesthesiologists