An anesthesiologist controlling a patient's airway while inducing anesthesia.
|Focus||Anesthesia, perioperative medicine|
Intensive care medicine|
Critical emergency medicine
Anaesthesiology, anesthesiology, anaesthesia or anaesthetics is the medical speciality 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.
Various names are used for the specialty, and those who practise it, in different parts of the world:
- In North America and China, the medical study and application of anesthetics is called anesthesiology,, and a physician in the specialty is called an anesthesiologist. The word "anesthetist" is used to refer to non-physician providers of anesthesia services such as nurse anesthetists.
- In several countries that are current or former members of the Commonwealth of Nations–namely, United Kingdom, Australia, New Zealand, Ireland and South Africa–the medical specialty is instead referred to as anaesthesia or anaesthetics, with an extra "a". As such, in these countries the same term may be used to refer to the overall medical specialty, the medications and techniques that are used, and the resulting state of loss of sensation. The term anaesthetist is used only to refer to a physician practising in the field; non-physicians involved in anaesthesia provision use other titles in these countries, such as "physician assistant".
- In most other parts of the world, the spelling anaesthesiology is most commonly used when writing in English, and a physician practising it is termed an anaesthesiologist. This is the spelling adopted by the World Federation of Societies of Anaesthesiologists and most of its most of its member societies, as well as the European Society of Anaesthesiology, and it is the most commonly used term found in the titles of medical journals.
Over the past 100 years, the study and administration of anesthesia has become more complex. Historically anesthesia providers were almost solely utilized during surgery to administer general anesthesia in which a person is placed in a pharmacologic coma. This is performed to permit surgery without the individual responding to pain (analgesia) during surgery or remembering (amnesia) the surgery.
Many procedures or diagnostic tests do not require "general anesthesia" and can be performed using various forms of sedation or regional anesthesia, which can be performed to induce analgesia in a region of the body. For example, epidural administration of a local anesthetic is commonly performed on the mother during childbirth to reduce labor pain while permitting the mother to be awake and active in labor & delivery.
In the United States, anesthesiologists attend four years of medical school to earn either a Doctor of Medicine (MD) degree or a Doctor of Osteopathic Medicine (DO) degree and then follow it with four years of residency. Certified Registered Nurse Anesthetists or CRNAs are advanced practice registered nurses with additional post-graduate training in anesthesia. By 2025, all CRNA programs will require a doctorate degree. In the United States, the most common anesthesia care model is where an anesthesiologist and Certified Registered Nurse Anesthetist work as a team (termed medical direction or medical supervision). In 17 states, CRNAs can practice without the supervision of a physician (though physician does not dictate it be an anesthesiologist).
Effective practice of anesthesiology requires several areas of knowledge by the practitioner, some of which are:
- Pharmacology of commonly used drugs including inhalational anaesthetics, topical anesthetics, & vasopressors as well as numerous other drugs used in association with anesthetics (e.g., ondansetron, glycopyrrolate)
- Monitors: electrocardiography, electroencephalography, electromyography, entropy monitoring, neuromuscular monitoring, cortical stimulation mapping and neuromorphology
- Mechanical ventilation
- Anatomical knowledge of the nervous system for nerve blocks, etc.
- Other areas of medicine (e.g., cardiology, pulmonology, obstetrics) to assess the risk of anesthesia to adequately have informed consent, and knowledge of anesthesia regarding how it affects certain age groups (neonates, pediatrics, geriatrics)
- "What is Anesthesiology". Retrieved 5 December 2016.
- "Helsinki Declaration on Patient Safety in Anaesthesiology". European Society of Anaesthesiology. 12 June 2010. Retrieved 1 September 2018.
- American Heritage Dictionary
- "What's in a name?". Australian and New Zealand College of Anaesthetists. 2017. Retrieved 1 September 2018.
- "Anaesthetics National Recruitment Office". Health Education England. Retrieved 1 September 2018.
- "Physicians' Assistant (Anaesthesia)". Royal College of Anaesthetists. Retrieved 1 September 2018.
- "Archived copy". Archived from the original on 2016-08-16. Retrieved 2016-06-08.