Ronald L. Harter, M.D. is Professor and Chair of the Department of Anesthesiology, Ohio State University Wexner Medical Center, Columbus, Ohio. He has authored an insightful editorial in December’s ASA Newsletter in his capacity as Vice Speaker, ASA House of Delegates on professional assertiveness for anesthesiologists. After introducing the topic by way of the self-deprecating humor of an actuary friend of his, he urges us to “embark boldly into … new territory, keeping one foot firmly planted in the O.R., while we stride further into peri-operative leadership.” The line that caught my eye: “The spectrum of acute pain management options we offer our patients has never been broader, and our skill and expertise at ultrasound-guided regional nerve blocks frequently allows earlier patient discharge and results in high levels of satisfaction for our patients.”
While the development of anesthesiology has been the basis for most modern surgical interventions, its use initially posed risks to patients. Over the course of the 20th century, however, practices and technology improved, allowing the profession to now attribute only one intraoperative death in 200,000 to anesthesia, down from one in 1,500 in the 1970s. Additionally, since the 1970s, the number of anesthesiologists in the United States has more than doubled.
One member of this new generation of anesthesiologists, John Gerancher, has made contributions to his profession by developing new approaches in regional and multi-modal analgesia, as well as in antibiotic prophylaxis in surgery. To do this, he designed and implemented documentation processes that relied on patient catheter connectors and computer software, to guide anesthesiologists in caring for patients during surgery. Patient safety during surgery continues to improve because of the dedication and ingenuity of practitioners.
John Charles Gerancher honed an expertise in anesthesiology during more than a decade as a doctor and a professor. This article briefly expounds upon three types of anesthesia and their uses.
1. Local. When a patient undergoes local anesthesia, he or she is given a shot of the anesthetic drug into the affected area. Surgery can then be completed with a significantly decreased amount of pain.
2. Regional. Through using spinal or epidural anesthesia, the two types of regional anesthesia, doctors inject the patient with anesthetic medicine near a cluster of nerves. This numbs the area, and the patient will not feel the surgery. He or she may remain awake during surgery or may have received a sedative or even general anesthesia in addition to regional.
3. General. Doctors use general anesthesia when the patient should be unconscious throughout the surgical procedure. General anesthesia can be given to a patient through an intravenous method, by breathing mask or tube, or through both routes of administration.