Members of the Care Team

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  • Anesthesiologist - An anesthesiologist is a physician who has earned an undergraduate degree and completed four years each of medical school and residency training in the medical specialty of anesthesiology. Many anesthesiologists have additional experience or fellowship training in anesthesiology specialties, including obstetric anesthesia, pediatric anesthesia, cardiac anesthesia, pain medicine, critical care management and neuroanesthesia.
  • Anesthetist - An anesthetist is an advanced practice provider who assists an anesthesiologist in the delivery of quality anesthesia care. Anesthetists have a nursing, pre-medicine or science based undergraduate background and completed an accredited master’s program focused on the delivery and maintenance of anesthesia care and patient monitoring techniques.

Types

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  • General Anesthesia - When general anesthesia is used, the entire body, including the brain, is put into a state of deep sleep. While in this state the patient is unconscious and has no awareness and no sensation of discomfort. During general anesthesia the patient is carefully monitored, controlled and treated by his or her anesthesiologist, who uses sophisticated equipment to track all major bodily functions.
  • Local Anesthesia - Local anesthesia is when medicine is injected into the tissue to numb just the specific location of the body requiring minor surgery, for example a hand or foot.
  • Regional Anesthesia - In regional anesthesia an injection is made near a cluster of nerves to numb the area of the body that requires surgery. The patient may remain awake, or may be given a sedative to help relax.
  • Sedation Anesthesia - With sedation anesthesia the patient is deeply relaxed. He or she may be sleeping, but is able to be awakened easily and can respond to questions or physical stimulation.

Services Provided

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  • Acute Pain - Acute pain is temporary and typically results from an injury, surgery or infection. Anesthesiologists provide acute pain management services to patients during and immediately after surgery. Acute pain management is normally conducted in the hospital, but modified techniques can be offered at home with the help of a home care team. Pain management techniques include prescription medicines, nerve blocks, continuous epidurals, spinal blocks, nerve stimulators and narcotic infusions.
  • Ambulatory Care Anesthesia - Ambulatory surgery is a specialized area of care that allows patients to have surgery and then return home the same day. These centers are also called outpatient surgery centers. All types of anesthesia, including general, regional, sedation and local, can be used in an ambulatory care setting. The anesthesiologist monitors the patients closely to ensure their pain is controlled and that they are able to return home the same day.
  • Anesthesia Awareness - Anesthesia awareness is a rare event in which a patient undergoing general anesthesia may regain consciousness and be able to recall some events during surgery. General anesthesia is the only type of anesthesia where anesthesia awareness may occur. Other forms of anesthesia such as sedation, regional and local are not associated with anesthesia awareness.
  • Ankle Block - The ankle block is common for surgery of the foot and is administered around the ankle.
  • Axillary Block - The axillary block is used for surgery involving areas of the upper body such as the hand, elbow or forearm.
  • Bier Block - The bier block is primarily used in procedures lasting less than forty minutes that involve the arm, wrist or forearm.
  • Cardiovascular Anesthesia - Cardiovascular anesthesia, or cardiac anesthesia, is a unique and challenging subspecialty involving an array of complex procedures performed on patients. Cardiovascular anesthesiologists have fellowship training in anesthesia for cardiac (heart), thoracic (lungs), and vascular (blood vessels) surgeries. Cardiac patients frequently have additional medical problems such as hypertension, diabetes or lung disease, which can complicate medical management. The additional training that cardiovascular anesthesiologists receive along with state-of-the-art cardiac monitoring helps assure a safe outcome during surgery.
  • Catheters - Catheters are fine plastic tubes that are used to help anesthesiologists administer anesthesia and pain medications as a continuous infusion. These catheters are inserted near bundles of nerves to provide medications that can be used to treat post-operative pain. Local anesthetics are the usual medications that are used for catheter-treated post-operative pain. Ropivicaine is the most common local anesthetic administered through catheters. Catheters are usually placed in the pre-operative area before the start of surgery.
  • Chronic Pain - Chronic pain is reoccurring or continuous pain that persists for longer than two weeks. It is usually caused by a disease or the body’s abnormal reaction to injury or stimulus, tends to be less intense than acute pain, but can be just as debilitating. Anesthesiologists specializing in pain management have the expertise and training to be able to diagnose and treat complex pain cases. Chronic pain management techniques vary greatly from patient to patient. Some techniques used include prescription medicines, nerve blocks, continuous epidurals, spinal blocks, nerve stimulators and narcotic infusions.
  • Continuous Epidural Analgesia or Patient Controlled Epidural Analgesia (PCEA) - Epidural analgesia delivers anesthetic medication to nerves within the epidural space in the vertebra. The physician places a small tube, or catheter, so medication can be administered throughout surgery and beyond for comfort. Frequently the patient can be given control over the dosing mechanism. This technique is called patient-controlled epidural analgesia, or PCEA. This type of pain control is particularly well suited for chest, abdominal or pelvic surgeries, and childbirth.
  • Controlling Nausea and Vomiting After Surgery -

    While common side effects of anesthesia, nausea and vomiting after anesthesia not only makes the patient uncomfortable, but can cause significant stress on incisions and the abdominal cavity. By controlling nausea and vomiting, patients feel better and may experience decreased recovery time. Some of the techniques anesthesiologists use to control nausea and vomiting include:

    • Giving medications to prevent nausea before surgery starts in “at risk” patients
    • Maintaining nausea preventing medications throughout surgery
    • Ensuring that there are anti-nausea medications available after surgery
  • Controlling Pain After Surgery - Many techniques are available that can help patients achieve high levels of comfort and safety following surgery, including interventional methods as well as pain medications. Pain control after surgery contributes to the healing process. If pain is not adequately controlled following surgery, patients may not be able to perform the functions necessary to heal satisfactorily. Functions like taking deep breaths, getting out of bed and walking can be difficult after surgery and sometimes require interventional pain management methods. If pain is allowed to persist the resulting inactivity can lead to severe problems such as pneumonia or an embolism.
  • Critical Care Anesthesia - Critical care is a medical term referencing the treatment of patients with life threatening illnesses. Also known as intensive care (ICU), patients in critical care units require constant monitoring and specialized care. Anesthesiologists that specialize in critical care medicine are be able to manage anesthesia associated with acute respiratory, cardiovascular, metabolic, cerebral, and renal problems in patients ranging from infants to older adults. They must also manage multiple organ failures, life threatening diseases and disorders that fall into many specialties.
  • Epidural or Epidural Steroid Injection -

    An epidural is the injection of anesthesia medication into the epidural space of the lower back and most often involves the placement of a continuous catheter. This procedure can also include a local anesthetic block, a narcotic, and/or an epidural steroid injection. There are several types of epidurals that are used to stop the transmission of pain along the nerve pathways:

    • Continuous Epidural Analgesia or Patient Controlled Epidural Analgesia (PCEA)

    • Walking Epidural

  • Femoral Block - The femoral block is used for surgery involving the knee, including knee replacement and ACL reconstruction.
  • Interscalene Block - An interscalene block is a nerve block injection around the group of nerves that supplies feeling to the arm and shoulder.
  • Intravenous or "IV" Medications - These are pain-relieving medications that are injected into a vein to decrease the sensation of pain during early labor and are prescribed by the patient’s obstetric caregiver. Because the medications are often narcotics, they may make the patient and the baby sleepy.
  • Local Anesthesia - Local anesthesia is when medicine is injected into the tissue to numb just the specific location of the body requiring minor surgery, for example a hand or foot.
  • Lumbar Plexus Block - The lumbar plexus block is used for surgery involving the hip, including hip replacement surgery.
  • Nerve Blocks -

    A nerve block is a form of regional anesthesia where an anesthesia medication is injected directly next to the nerve to block the transmission of nerve signals. Common regional blocks used by anesthesiologists include:

    • Axillary Block

    • Lumbar Plexus Block

    • Femoral Block

    • Popliteal and Saphenous Blocks

    • Ankle Block

    • Bier Block

    • Interscalene Block

    • Spinal Block

  • Neurosurgical Anesthesia or Neurological Anesthesia - Neurosurgical anesthesia, or neuroanesthesia, focuses on patients undergoing brain or spinal cord surgery. This type of surgery is called neurosurgery. There are many similarities between neurosurgical and general anesthesia. Neuroanesthetic management, however, is different because it can have a major effect on the brain and spinal cord through the control of blood flow, blood pressure and energy consumption of these organs.
  • Obstetric Anesthesia -

    Obstetric anesthesia is a subspecialty of anesthesia devoted to the time right before a baby is born, during delivery and post-delivery pain management. Obstetric anesthesia medicine and procedure types include:

    • Intravenous or "IV" Medications
    • Local Anesthesia
    • Regional Blocks
  • Orthopedic Anesthesia -

    Orthopedic anesthesia is a subspecialty of anesthesia that deals with the bones or skeletal system. Anesthesiologists are trained specifically to handle the complex nature of orthopedic surgery and a variety of techniques to customize care specific to the needs of orthopedic surgery patients. These techniques include, but are not limited to:

    • Special positioning to avoid intraoperative nerve injury
    • Hypotensive anesthesia, the act of inducing arterial hypotension (or an abnormally low blood pressure) to minimize blood loss
    • Isovolemic hemodilution, a mechanism to minimize blood loss
  • Patient Controlled Analgesia - Epidural analgesia delivers anesthetic medication to nerves within the epidural space in the vertebra. A physician places a small tube or catheter so medication can be administered throughout surgery and beyond for comfort. Frequently the patient can be given control over the dosing mechanism. This technique is called patient-controlled epidural analgesia, or PCEA. This type of pain control is particularly well suited for chest, abdominal or pelvic surgeries, and childbirth.
  • Pediatric and Neonatal Anesthesia - Pediatric anesthesia is a specialty with expertise, focus and sensitivity to the particular needs of children and their parents. The reason that a child needs anesthesia for procedures, like MRIs or endoscopies, is because it ensures that they will remain very still and calm. This enables the technician to obtain all the results and photos they need for the physician to diagnose and treat the child. Furthermore, the anesthesia ensures that the child will feel no pain or discomfort during the procedure.
  • Pediatric Cardiac Anesthesia - Pediatric cardiac anesthesia is a subspecialty of anesthesia specific to heart disease in children. Anesthesiologists who subspecialize in pediatric cardiac anesthesia have the training to understand the effects of anesthesia on a child with heart disease, and are experts in the management of children with congenital heart abnormalities.
  • Popliteal and Saphenous Blocks - The popliteal and saphenous nerve blocks are used for surgery involving the foot and ankle.
  • Regional Blocks - Regional blocks for labor are better known as an "epidural," "spinal," or combination of the two. In short, an epidural involves placement of a catheter (a very small tube) in the back. An epidural can remove most or all of the pain of labor and delivery. A spinal is similar but involves a single injection of anesthetic medicine without the catheter.
  • Spinal Block - This is a nerve block injection into the lower back where the spinal nerves are located. It will block the feeling and movement of the lower half of the body.
  • Transplant Anesthesia - Transplant anesthesia is the specialty of anesthesia that manages surgeries involving organ transplants. Anesthesiologists that specialize in organ transplant anesthesia understand and have the expertise to manage both the organ recipient and the organ donor.
  • Trauma Anesthesia - Trauma anesthesia is the subspecialty of anesthesia focused on trauma patients and their comprehensive acute requirements. All types of anesthesia, including general, regional, sedation and local, may be used when treating a trauma patient.
  • Walking Epidural - The walking epidural provides pain relief for early labor and for periods following surgical procedures. Medications delivered through a catheter are quite effective but do not numb or weaken the legs or lower abdomen. This epidural is an analgesic rather than an anesthetic because its purpose is to reduce pain, not eliminate all sensation.

How should I prepare for my procedure?

It is important that you provide your primary clinical provider with a list of all medications and herbal supplements you are taking and discuss any allergies, heart problems or reactions to anesthesia you experienced in the past. An anesthesiologist will review your medical history and consult with your clinical provider so he or she can provide guidance regarding:

  • When and what you can eat and drink prior to the procedure
  • Instructions regarding which medications to take prior to the procedure

You should also try and stay well hydrated and avoid alcohol in the days prior to your procedure.

What can I expect on the day of my procedure?

Your anesthesia care team will provide for your safety and comfort during and immediately after your procedure, while helping provide optimal conditions for your procedure. Prior to your procedure, your anesthesiologist will perform an in-depth medical history and physical exam, order or review lab tests and diagnose any potential risks to prescribe an appropriate anesthesia care plan for you.

Your anesthesiologist will perform your anesthesia and you will remain under his or her care during your procedure and recovery. Patients undergoing general anesthesia are monitored throughout their procedure with sophisticated medical equipment. With these devices your anesthesia clinicians can monitor your vital signs, breathing, blood oxygen level, lung carbon dioxide levels and the concentration of inhaled and exhaled anesthetic gases.

If you’ve undergone a surgery, your recovery room stay and pain control will be directed by your anesthesiologist. When your pain is controlled and you meet criteria to leave the recovery room, you will be discharged to home or to your hospital room.

What do I need to know after my procedure?

The physician who conducted your procedure will offer recommendations regarding when you can begin eating or drinking again and will prescribe pain medication as needed once you leave the recovery area.

If you plan on going home following your procedure, you must have a responsible adult drive you and stay with you for the entire evening. You must not drive or operate heavy machinery for 24-hours following anesthesia.

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