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You Are Not “Asleep” Under Anesthesia

Ed Mariano

Just before the start of anesthesia, a patient may hear the operating room nurse saying, “Think of a nice dream as you go off to sleep.” While these statements are intended to soothe patients during a stressful time, they gloss over this critical fact: Anesthesia is not like normal sleep at all.

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WHO WILL BE PROVIDING ANESTHESIA CARE 10 YEARS FROM NOW?

The Anesthesia Consultant

This will require an operating room staffed with a surgeon, a nurse, a scrub technician, and an anesthesia professional. If the current trend of inadequate numbers of anesthesia clinicians in the United States is not reversed, this insufficient supply will be a major problem. Imagine this: It’s the year 2034.

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SMART GLASSES IN THE OPERATING ROOM

The Anesthesia Consultant

Anesthesia vital signs monitor display A second and more compelling use for smart glasses would be the display of a patient’s vital sign monitoring in real time on the smart glass screen, so that an anesthesiologist is in constant contact with the images of the vital sign electronic monitors. Will I Have a Breathing Tube During Anesthesia?

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DENTAL ANESTHESIA DEATHS. GENERAL ANESTHESIA FOR PEDIATRIC PATIENTS IN DENTAL OFFICES

The Anesthesia Consultant

GENERAL ANESTHESIA FOR DENTAL OFFICES CASE PRESENTATION: A 5-year-old developmentally delayed autistic boy has multiple dental cavities. The dentist consults you, a physician anesthesiologist, to do sedation or anesthesia for dental restoration. Potent inhalation anesthesia (sevoflurane). What do you do?

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ANESTHESIOLOGISTS COVERING THREE OR FOUR OPERATING ROOMS AT ONCE CAN INCREASE RISKS 

The Anesthesia Consultant

This was a landmark paper on the topic of anesthesiologist:CRNA staffing ratios, which documented that having physician anesthesiologists direct three or four operating rooms simultaneously for major noncardiac inpatient surgical procedures increased the 30-day risks of patient morbidity and mortality.

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NURSE ANESTHESIOLOGY?

The Anesthesia Consultant

Will it be a nurse or will it be a physician? Very few patients die in the operating room, but significant numbers die in the weeks that follow. At times, physician anesthesiologists employ certified registered nurse anesthetists (CRNAs) to assist them in what is called the anesthesia care team (ACT) model.

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EXTUBATION IS RISKY BUSINESS. WHY THE CONCLUSION OF GENERAL ANESTHESIA CAN BE A CRITICAL EVENT

The Anesthesia Consultant

The most invasive type of airway tube used in anesthesia is called an endotracheal tube, or ET tube. At the onset of general anesthesia anesthesiologists place an ET tube through the mouth, past the larynx (voice box), and into the trachea (windpipe). Why Did Take Me So Long To Wake From General Anesthesia?