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The term anesthesia can be found recorded in Classical Greek literature dating back over 2500 years. Etymologically, it derives from the Greek anaisthēsia (an- [“without”] + aisthēsis [“sensation”]).
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American physician and polymath Oliver Wendell Holmes (1809-1894) suggested the adoption of this term in 1846 to describe the unconsciousness and insensibility to pain produced by the inhalation of sulphuric ether. Today, anesthesia refers to the process of pharmacologically inducing a reversible loss of sensation, with or without a concurrent loss of consciousness, that allows patients to undergo surgical and nonsurgical procedures without the pain or distress they would otherwise experience. In common speech, the term anesthetic refers to both the achievement of this state (eg, “The patient underwent an uncomplicated anesthetic”) and the pharmacologic tool used to achieve this state (eg, “The use of thiopental as an anesthetic has waned over the 20th century”).
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Anesthesiology is the field of medicine dedicated to the science and art of providing anesthesia to patients. Anesthetic practice is most commonly conducted by a physician, known as the anesthesiologist, either alone or in conjunction with a certified registered nurse anesthetist, certified anesthesia assistant, or resident physician training in anesthesiology.
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MODERN PRACTICE OF ANESTHESIA
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Anesthesiology flourished during the 20th century when formal training was established. Ralph M. Waters founded the first anesthesiology residency program at the University of Wisconsin at Madison in 1927. Over time, this medical specialty expanded, and by the 1980s, an emphasis on safety led to the creation of the Anesthesia Patient Safety Foundation whose vision statement is “that no one shall be harmed by anesthesia care.” Today, the professional organization that represents anesthesiologists is the American Society of Anesthesiologists (ASA), which is dedicated to advancing the specialty and “improving health through innovation in quality and safety.”
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The term anesthesia provider refers to a variety of individuals with different educational backgrounds and levels of training who participate in the administration of anesthetics. In the United States, an anesthesiologist is a physician who completed a 4-year undergraduate college degree, 4-year medical school degree, and a 4-year anesthesiology residency program. Upon completing their training, anesthesiology residents may choose to pursue an additional 1 or 2 years of fellowship specialty training in areas such as cardiac anesthesia, critical care medicine, pain management, obstetric anesthesia, and other areas. Generally, after meeting all requirements, including a rigorous examination process, newly minted anesthesiologists become diplomates of the American Board of Anesthesiology (ABA).
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Anesthesiologists are perioperative physicians who provide perioperative care. Outside of the operating room, they provide anesthesia for imaging, endoscopies, electroconvulsive therapies, cardiac catheterizations, and other procedures. Anesthesiologists are also involved in operating room management, patient safety, education, research, and other activities related to the specialty.
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A certified registered nurse anesthetist (CRNA) is a nonphysician who administers anesthetics for surgery or other procedures. CRNAs complete a 4-year ...