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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.
General anaesthesia (UK) or general anesthesia (US) is a method of medically inducing loss of consciousness that renders a patient unarousable even with painful stimuli. This effect is achieved by administering either intravenous or inhalational general anaesthetic medications,which often act in combination with an analgesic and neuromuscular blocking agent. Spontaneous ventilation is often inadequate during the procedure and intervention is often necessary to protect the airway. General anaesthesia is generally performed in an operating theater to allow surgical procedures that would otherwise be intolerably painful for a patient,or in an intensive care unit or emergency department to facilitate endotracheal intubation and mechanical ventilation in critically ill patients.
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.
Awareness under anesthesia,also referred to as intraoperative awareness or accidental awareness during general anesthesia (AAGA),is a rare complication of general anesthesia where patients regain varying levels of consciousness during their surgical procedures. While anesthesia awareness is possible without resulting in any long-term memory of the experience,it is also possible for victims to have awareness with explicit recall,where they can remember the events related to their 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.
A post-anesthesia care unit,often abbreviated PACU and sometimes referred to as post-anesthesia recovery or PAR,or simply recovery,is a part of hospitals,ambulatory care centers,and other medical facilities. Patients who received general anesthesia,regional anesthesia,or local anesthesia are transferred from the operating room suites to the recovery area. The patients are monitored typically by anesthesiologists,nurse anesthetists,and other medical staff. Providers follow a standardized handoff to the medical PACU staff that includes,which medications were given in the operating room suites,how hemodynamics were during the procedures,and what is expected for their recovery. After initial assessment and stabilization,patients are monitored for any potential complications,until the patient is transferred back to their hospital rooms.
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.
Operating room management is the science of how to run an operating room suite. Operational operating room management focuses on maximizing operational efficiency at the facility,i.e. to maximize the number of surgical cases that can be done on a given day while minimizing the required resources and related costs. For example,what is the number of required anaesthetists or the scrub nurses that are needed next week to accommodate the expected workload or how can we minimize the cost of drugs used in the Operating Room? Strategic operating room management deals with long-term decision-making. For example,is it profitable to add two additional rooms to the existing facility? Typically,operating room management in profit-oriented health-care systems emphasizes strategic thinking whereas in countries with publicly funded health care,the focus is on operational decisions.
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.
The International Anesthesia Research Society (IARS) is an international,professional medical society dedicated to improving clinical care,education and research in anesthesia,pain management,and perioperative medicine. It was founded in 1922 by Francis Hoeffer McMechan.
Chi Ho Ban Tsui is a Canadian anesthesiologist known for medical innovation in the field of anesthesia. Examples include describing the Tsui Test and developing the StimuLong Sono-Tsui for ease of pediatric epidural placement. Recently along with his son,Dr. Jonathan Jenkin Tsui,Dr. Tsui developed a catheter-over-needle kit allowing a continuous catheter placement to be performed with the ease of a single shot during peripheral nerve blocks.
Kathryn Ann Kelly "Kelly" McQueen is an American anesthesiologist and global health expert. She currently practices anesthesiology at the UW Health University Hospital in Madison,Wisconsin and serves as the chair for the Department of Anesthesiology at the University of Wisconsin School of Medicine and Public health.
Mervyn Maze,MD,MB ChB has been a Professor in the Departments of Anesthesia and Pain Medicine,Intensive Care at the University of California,San Francisco since 1988. He has also served as Professor and Chair at Imperial College London.
No Pain Labor &Delivery –Global Health Initiative is a non-for-profit organization. Founded in 2006,the program focuses on correcting the unnecessarily high caesarean delivery rate and the poor utilization of neuraxial labor analgesia in China.
Obstetric anesthesia or obstetric anesthesiology,also known as ob-gyn anesthesia or ob-gyn anesthesiology,is a sub-specialty of anesthesiology that provides peripartum pain relief (analgesia) for labor and anesthesia for cesarean deliveries ('C-sections').
Alex Bekker is a physician,author and academic. He is a professor and chair at the Department of Anesthesiology,Rutgers New Jersey Medical School. He is also professor at the Department of Physiology,Pharmacology &Neurosciences. He serves as the Chief of Anesthesiology Service at the University Hospital in Newark.
References
- 1 2 "Alex Macario MD MBA – Stanford University School of Medicine".
- ↑ "2004 Annual Meeting: Attendees Walk Away Winners". Asa Newsletter. 68 (12): 17–20. December 2004.
- ↑ "BOARD OF DIRECTORS".
- ↑ "ABA Board Member Committee Assignments: 2022-2023".
- ↑ "Why I Became an Anesthesiologist".
- ↑ "River Campus Undergraduate: 1980s".
- ↑ "Ep 052 – Being a Physician MBA with Dr. Alex Macario". 18 August 2017.
- ↑ "Anesthesiology".
- 1 2 MacArio, Alex (August 2006). "Are Your Hospital Operating Rooms "Efficient"?: A Scoring System with Eight Performance Indicators". Anesthesiology. 105 (2): 237–240. doi: 10.1097/00000542-200608000-00004 . PMID 16871055. S2CID 9595374.
- ↑ "A Macario – Google Scholar Profile".
- ↑ "RFID chips could help surgeons avoid leaving sponges in patients, Stanford researcher finds".
- ↑ "Doctor, your sponge is beeping". NBC News .
- ↑ "Sostenibilitat i eficiència de l'àrea quirúrgica". YouTube .
- ↑ MacArio, Alex; Vitez, Terry S.; Dunn, Brian; McDonald, Tom (1995). "Where Are the Costs in Perioperative Care?: Analysis of Hospital Costs and Charges for Inpatient Surgical Care". Anesthesiology. 83 (6): 1138–1144. doi:10.1097/00000542-199512000-00002. PMID 8533904.
- ↑ MacArio, Alex; Weinger, Matthew; Carney, Stacie; Kim, Ann (1999). "Which Clinical Anesthesia Outcomes Are Important to Avoid? The Perspective of Patients". Anesthesia & Analgesia. 89 (3): 652. doi: 10.1213/00000539-199909000-00022 .
- ↑ MacArio, Alex; Weinger, Matthew; Truong, P.; Lee, M. (1999). "Which Clinical Anesthesia Outcomes Are Both Common and Important to Avoid? The Perspective of a Panel of Expert Anesthesiologists". Anesthesia & Analgesia. 88 (5): 1085–1091. doi:10.1213/00000539-199905000-00023.
- ↑ MacArio, Alex (August 2006). "Are Your Hospital Operating Rooms "Efficient"?: A Scoring System with Eight Performance Indicators". Anesthesiology. 105 (2): 237–240. doi: 10.1097/00000542-200608000-00004 . PMID 16871055. S2CID 9595374.
- ↑ MacArio, A. (2010). "What does one minute of operating room time cost?". Journal of Clinical Anesthesia. 22 (4): 233–236. doi:10.1016/j.jclinane.2010.02.003. PMID 20522350.
- ↑ "Alex Macario MD MBA".
- ↑ "American Society of Anesthesiologists recognizes Alex Macario, M.D., M.B.A., with its Excellence in Education Award".
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