[Preoperative assessment in an area without continuous medical anesthesia service]

The Swiss Society of Anaesthesia and Resuscitation describes anesthesia as an activity of physicians, and a continuous presence of a medical anaesthesist is required. In small regional hospitals in the alpine region it is impossible to compete with big hospitals in the central area of Switzerland and there is no possibility to afford an anaesthesist for 365 days a year and 24 hours a day. The nurse is able to supervise the patients during the operation, but only groups I and II in the classification of ASA are allowed to be treated during surgery. The monitoring has to be optimal, even better than if anesthesia is done by a medical anaesthesist. The education and the control of this person has to be performed by a medical anaesthesist. This is the only way in keeping the high quality of medical support in the peripheral region specially in the alpine part of our country.