Anesthesia Assistants (Nurses and Non-nurses) in Japan: A Narrative Review

There is a marked shortage of anesthesiologists in Japan due to the aging population, with an increasing demand for anesthesia services. To shift the burden of intraoperative tasks from anesthesiologists, an increasing number of medical personnel, both nurses and non-nurses, have taken on responsibilities in anesthesia care. We conducted this narrative review to summarize the roles of professions involved in anesthesia assistance in Japan and to consider the standardization of surgical anesthesia delivery and personnel training, referencing global trends. A literature search was conducted using PubMed, the Japanese Igaku Chuo Zasshi database, and the websites of relevant professional associations using keywords relevant to assistance by non-physician providers during anesthesia care. Nurses are the major providers of anesthesia assistance. For nurses, there is a national training program that includes anesthesia-related tasks (Specified Medical Acts Training) as well as several other programs (Perianesthesia Nurse: PAN, Nurse Practitioner: NP, Certified Nurse: CN, Perioperative Management Team: PMT) accredited by various academic organizations. The scope of intraoperative anesthesia assistance is almost the same regardless of certification. Only PAN offers a postgraduate course in anesthesia nursing. For clinical engineers, PMT certification is available in addition to in-house facility certifications. Their anesthesia assistance duties are nearly the same as those provided by nurses. Many providers responsible for intraoperative anesthesia assistance are nurses, and their educational backgrounds or certification programs vary. It is expected that the national government and related organizations will integrate and standardize the qualifications and education of both nurses and clinical engineers.