|Focus||Anesthesia, perioperative medicine|
Terminology varies between countries. In North America, the medical speciality is called anesthesiology, a doctor practising it is termed an anesthesiologist, and the treatment delivered is referred to as anesthesia. By contrast, in the United Kingdom and other countries following the British tradition, both the medical speciality and the treatment delivered are referred to as anaesthesia or anaesthetics, and the physician who performs them is termed an anaesthetist (in North America, the word anesthetist indicates a certified anesthesiologist assistant who delivers anesthesia under the supervision of a physician) or certified registered nurse anesthetist who in most states in the U.S. do not require physician supervision.
One of the fundamental practices of anesthesiologists is that of general anesthesia in which a person is placed in a medical coma. This is performed to permit surgery without the individual responding to pain (analgesia) during surgery or remembering the surgery.
If general anesthesia is not necessary, then regional anesthesia 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 the pain while permitting the mother to be awake and active in labor & delivery (general anesthesia would not permit this).
In the United States, anesthesiologists attend 4 years of medical school and then follow it with 4 years of residency. Nurse anesthetists are registered nurses with additional post-graduate training in anesthesia with at least one year of work experience in an intensive care unit, who work either under the supervision of an anesthesiologist or independently depending on state law.
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)
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