Anaesthesia

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The word literally means "without feeling" and was coined by Oliver Wendell Holmes, Sr.[1] who first used the word "anesthesia". From Wikipedia: In a letter to dentist William T. G. Morton, the first practitioner to publicly demonstrate the use of ether during surgery, he wrote: "Everybody wants to have a hand in a great discovery. All I will do is to give a hint or two as to names—or the name—to be applied to the state produced and the agent. The state should, I think, be called 'Anaesthesia.' This signifies insensibility—more particularly ... to objects of touch." Holmes predicted his new term "will be repeated by the tongues of every civilized race of mankind."

Contents

Introduction

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[2].

In the 21st century anaesthesia is a highly specialised field, with recognisable subspecialties:

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.

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.

Historical Aspects

Clinical Anaesthesia

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:

Basic Sciences for anaesthetists

Other Resources

  • 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..."