- Also spelled:
- anaesthesiology
- Related Topics:
- medicine
- anesthetic
- anesthesia
anesthesiology
anesthesiology, medical specialty dealing with anesthesia and related matters, including resuscitation and pain.
Historical developments
The emergence of anesthesiology as a distinct medical specialty was driven largely by the inherent risks associated with early anesthetic practices, which relied on carefully measured amounts of highly toxic substances to suppress pain. During much of the 19th century, anesthesia was considered a secondary task in the operating room and was typically administered under the direction of the surgeon, often by an assistant with limited training. As surgical procedures became more complex and new anesthetic agents and techniques were introduced, the need for dedicated practitioners with specialized knowledge grew. This shift, along with advances in patient monitoring and airway management, ultimately led to the recognition of anesthesiology as an essential and independent field within medicine. In mid-1930s the specialty was officially recognized with the establishment of societies such as the American Board of Anesthesiology for certifying appropriately trained physician anesthetists. Today, in virtually every medical school, anesthesiology functions either as an autonomous academic department or as a division of surgery.
Role in modern medicine
- Manage procedures for rendering a patient insensible to pain and emotional stress before, during, and after surgical, obstetrical, and certain other medical procedures.
- Administer general anesthesia, regional anesthesia, and monitored anesthesia care.
- Apply specific methods of respiratory therapy.
- Support vital functions under the stress of anesthetic and surgical manipulations.
- Manage critically ill patients in the intensive care unit (ICU), performing cardiac or respiratory resuscitation and applying advanced airway management when necessary.
- Manage various fluid, electrolyte, and metabolic disturbances during procedures and recovery.
The introduction into clinical anesthesia of drugs aimed specifically at relaxing muscles may have facilitated the surgeon’s tasks but deprived patients of the ability to breathe spontaneously, thus creating a need for artificial respiratory support during the operation. As a result, anesthesiologists are specialists in respiratory and circulatory physiology, as well as in devices used to support and monitor these systems and in drugs that act upon them. This breadth of knowledge and skill allows for complex operations to be undertaken, such as open-heart surgery, organ transplantation, and even neonatal surgery, where very precise drug dosing and patient monitoring are essential. In addition, the individualized attention provided to patients in the operating room cannot be terminated abruptly upon completion of a procedure, and therefore anesthesiologists also are involved in the monitoring of patients during recovery.
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Anesthesiology was originally concerned entirely with the administration of general anesthetics, and the anesthesiologist’s activities were confined to the operating room. In the modern era, techniques such as regional anesthesia—particularly the use of local anesthetics injected into the fluid surrounding the spinal cord—have become an important part of anesthetic practice.