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The specialty or discipline of anaesthesia is an integral and essential component of modern medicine. Anaesthetists are involved in the care of about 60% of patients in UK hospitals.
In the 21st century anaesthesia is a highly specialised field, with recognisable subspecialties:
- Paediatric anaesthesia
- Obstetric anaesthesia
- Cardiac anaesthesia
- Thoracic anaesthesia
- Neuro anaesthesia
- Critical care medicine
and an overlap into the management of Chronic pain
Anaesthesia is becoming increasingly sub-specialised. Some element of specialisation in upper GI surgery, plastic surgery, regional anaesthesia or other specific types of surgery is often needed within hospitals. Increasingly perioperative medical care as a whole is becoming part of anaesthetic services with specialist pre-assessment and post anaesthetic care units (PACU) run by anaesthetists.
Most medical practitioners should be sufficiently familiar with local anaesthesia to be able to provide it where required but if the patient or procedure mandates a higher level of care this will be provided by a practitioner whose sole duty is the conduct of the anaesthetic and care of the patient. Where general anaesthesia or regional anaesthesia are administered it is almost universal in the developed world for a professional anaesthetist to do this and to afford the patient their undivided attention. In the UK anaesthetist invariably means a registered medical practitioner with postgraduate training in the speciality. In other jurisdictions many anaesthetists come from a nursing background and in the USA the term anesthesiologist is reserved for trained physician anaesthetists. Non physician anaesthetists outside the UK are usually supervised by physician anaesthetists or (notionally) the operating surgeon. The disparity of remuneration and comparative merits of physician and nurse anaesthetists have been a source of considerable acrimony, especially in the USA. The spelling anesthetist is used in North America.
- Preanaesthetic assessment
- Basic forms of anaesthesia
- Airway management
- Regional anaesthesia
- Crisis management
- Emergence and Post-anaesthetic complications
- Peri-operative care
- Anaesthesia awareness
Pharmacology of Anaesthetic agents
In very basic terms general anaesthesia is "controlled poisoning", where the patient is rendered into a controlled state of unconsciousness using various anaesthetic drugs. These include:
- Induction agents usually meaning intravenous drugs (eg: Propofol, Thiopentone)
- Intravenous agents
- Inhalational agents (eg: Halothane, Isoflurane, Sevoflurane, Desflurane, Nitrous oxide the so called "laughing gas")
- Opioids (eg: Fentanyl or Morphine)
- Benzodiazepines (eg: Midazolam)
- Local anaesthetics
Basic Sciences for anaesthetists
- www.wikithesia.com - Wikithesia was a dedicated anaesthesia wiki with a UK focus, but the domain name is apparently for sale as of August 2013
- AnaesthesiaUK "an educational site with training resources for anaesthetic professionals. It provides interactive practice questions, journal abstracts and reference articles for the Primary FRCA, Final FRCA, Irish FCARCSI, American Board examinations..."