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The changing profile of anesthetic practice: an update for internists
1Department of Cardiothoracic Anesthesia, Cleveland Clinic Foundation, OH 44195.
Background:
Internists are commonly consulted to "clear" patients for anesthesia and surgery. Newer anesthetic agents and techniques now extend limits and possibilities beyond what many internists were taught.
Objective:
To update internists on recent changes in anesthetic management and how they affect the preoperative evaluation.
Summary:
Recent advances in anesthetic management include new monitoring standards, balanced anesthetic technique, new agents, equipment changes, better understanding of human factors, and expanded pain management techniques.
Conclusions:
Postoperative care will likely assume increasing importance in determining anesthesia-related morbidity and mortality. For this reason, increased interaction and cooperation between surgeons, internists, and anesthesiologists are needed.