Surgery is a medical specialty that uses manual and instrumental techniques to diagnose or treat pathological conditions, to alter bodily functions, to reconstruct or improve aesthetics and appearance, or to remove unwanted tissues or foreign bodies. The subject receiving the surgery is typically a person, but can also be a non-human animal.
Anesthesia or anaesthesia is a state of controlled, temporary loss of sensation or awareness that is induced for medical or veterinary purposes. It may include some or all of analgesia, paralysis, amnesia, and unconsciousness. An individual under the effects of anesthetic drugs is referred to as being anesthetized.
Anesthesiology, anaesthesiology, or anaesthesia is the medical specialty concerned with the total perioperative care of patients before, during and after surgery. It encompasses anesthesia, intensive care medicine, critical emergency medicine, and pain medicine. A physician specialized in anesthesiology is called an anesthesiologist, anaesthesiologist, or anaesthetist, depending on the country. In some countries, the terms are synonymous, while in other countries, they refer to different positions and anesthetist is only used for non-physicians, such as nurse anesthetists.
A nurse anesthetist is an advanced practice nurse who administers anesthesia for surgery or other medical procedures. Nurse anesthetists (NA's) administer or participate in administration of anesthesia services in 107 countries, working with or without anesthesiologists. Because of different historical backgrounds, anesthetist responsibilities and roles vary widely between countries. Depending on the locality, their role may be limited to intraoperative care during anesthesia itself or may also extend before and after. The International Federation of Nurse Anesthetists was established in 1989 as a forum for developing standards of education, practice, and a code of ethics.
Oral and maxillofacial surgery is a surgical specialty focusing on reconstructive surgery of the face, facial trauma surgery, the oral cavity, head and neck, mouth, and jaws, as well as facial cosmetic surgery/facial plastic surgery including cleft lip and cleft palate surgery.
Perioperative mortality has been defined as any death, regardless of cause, occurring within 30 days after surgery in or out of the hospital. Globally, 4.2 million people are estimated to die within 30 days of surgery each year. An important consideration in the decision to perform any surgical procedure is to weigh the benefits against the risks. Anesthesiologists and surgeons employ various methods in assessing whether a patient is in optimal condition from a medical standpoint prior to undertaking surgery, and various statistical tools are available. ASA score is the most well known of these.
The ASA physical status classification system is a system for assessing the fitness of patients before surgery. In 1963 the American Society of Anesthesiologists (ASA) adopted the five-category physical status classification system; a sixth category was later added. These are:
- Healthy person.
- Mild systemic disease.
- Severe systemic disease.
- Severe systemic disease that is a constant threat to life.
- A moribund person who is not expected to survive without the operation.
- A declared brain-dead person whose organs are being removed for donor purposes.
In the United States, anesthesia can be administered by physician anesthesiologists, an anesthesiologist assistant, or nurse anesthetist.
The Outcomes Research Consortium is an international clinical research group that focuses on the perioperative period, along with critical care and pain management. The Consortium's aim is to improve the quality of care for surgical, critical care, and chronic pain patients and to "Provide the evidence for evidence-based practice." Members of the Consortium are especially interested in testing simple, low-risk, and inexpensive treatments that have the potential to markedly improve patients' surgical experiences.
Cardiothoracic anesthesiology is a subspeciality of the medical practice of anesthesiology, devoted to the preoperative, intraoperative, and postoperative care of adult and pediatric patients undergoing cardiothoracic surgery and related invasive procedures.
David L. Reich is an American academic anesthesiologist, who has been President & Chief Operating Officer of The Mount Sinai Hospital, and President of Mount Sinai Queens, since October 2013.
Geriatric anesthesia is the branch of medicine that studies anesthesia approach in elderly.
Neurosurgical anesthesiology, neuroanesthesiology, or neurological anesthesiology is a subspecialty of anesthesiology devoted to the total perioperative care of patients before, during, and after neurological surgeries, including surgeries of the central (CNS) and peripheral nervous systems (PNS). The field has undergone extensive development since the 1960s correlating with the ability to measure intracranial pressure (ICP), cerebral blood flow (CBF), and cerebral metabolic rate (CMR).
The World Health Organization (WHO) published the WHO Surgical Safety Checklist in 2008 in order to increase the safety of patients undergoing surgery. The checklist serves to remind the surgical team of important items to be performed before and after the surgical procedure in order to reduce adverse events such as surgical site infections or retained instruments. It is one affordable and sustainable tool for reducing deaths from surgery in low and middle income countries.
Certified anesthesiologist assistants (CAAs) are highly trained master’s degree level non-physician anesthesia care providers. CAAs are integral members of the anesthesia care team as described by the American Society of Anesthesiologists (ASA). This designation must be disambiguated from the Certified Clinical Anesthesia Assistant (CCAA) designation conferred by the Canadian Society of Respiratory Therapists. All CAAs possess a baccalaureate degree, and complete an intensive didactic and clinical program at a postgraduate level. CAAs are trained in the delivery and maintenance of all types of anesthesia care as well as advanced patient monitoring techniques. The goal of CAA education is to guide the transformation of student applicants into competent clinicians.
The Alliance for Surgery and Anesthesia Presence is a multidisciplinary society of surgeons, anesthesiologists, obstetricians and public health specialists organized to improve the delivery of surgical care, particularly in low and middle income countries. The body, named the Burden of Surgical Disease Working Group at its founding in 2007, was renamed in 2010. It became an international society in 2013 under the umbrella of the International Surgery Society.
Beverley Anne Orser is a Canadian anesthesiologist. As a professor at the University of Toronto, Orser was elected a member of the National Academy of Medicine for "her discovery of the unique pharmacological properties of extrasynaptic GABA-A receptors and their mechanistic role in anesthetic- and inflammation-induced impairment of memory, and for her leadership in academic anesthesiology.
Lee Alan Fleisher is an American anesthesiologist. In 2020, Fleisher was named Chief Medical Officer and Director of the Centers for Medicare & Medicaid Services Center for Clinical Standards and Quality. He previously served as Chair of Anesthesiology and Critical Care at the Perelman School of Medicine at the University of Pennsylvania.
Alex Macario is an American anesthesiologist, academic and author. He is a vice-chair for education, a professor in the Department of Anesthesiology, Perioperative and Pain Medicine, and program director for the anesthesiology residency at Stanford University School of Medicine.
Isabella Epiu is a Ugandan anesthesiologist and critical care medicine specialist who is reported to be the first female anesthesiologist in the countries of the East African Community, to graduate with a Doctor of Philosophy degree. In 2023, she graduated from the University of New South Wales in Sydney, Australia with a PhD in Medicine, specializing in neuro-respiratory physiology and health economics.
