Cleveland Clinic's Anesthesiology Institute unites all specialists in pain management, general anesthesia, pediatric and congenital heart anesthesia, cardiothoracic anesthesia and critical care, regional practice, outcomes research and education within one fully integrated model of care to improve diagnosis, medical management and quality of life for our patients.

This innovative model of care allows patients to better access the services they need through our six specialized, multidisciplinary departments and more than 15 subspecialized sections. We strive to advance anesthesia through clinical excellence, education, innovation and people. Our internationally recognized medical staff and dedicated support team perform more than 200,000 procedures annually.

Our organizational structure is an employed model, with staff anesthesiologists supervising residents, fellows, nurse anesthetists and student nurse anesthetists. We have one of the largest anesthesiology residency training programs in the country, accepting about 30 new residents annually. Cleveland Clinic also has the nation's largest fellowship program, offering subspecialized anesthesiology fellowships in cardiac, vascular, transplant, obstetrics, pain management, pediatrics, neuroanesthesiology, critical care and outpatient and advanced anesthesiology.

Letter From the Chairman

Letter From the Chairman

Cleveland Clinic Anesthesiology Institute invites you to learn more about our comprehensive anesthesia services, including our specialists in general, cardiothoracic, pediatric and congenital heart anesthesia, critical care medicine, pain management and outcomes research. Enhancing the effectiveness of our practice by identifying opportunities to advance patient care is a leading priority for the Anesthesiology Institute. Daily we gather data in our efforts to continually improve upon the quality of care for our patients, the development of new techniques and technologies, and challenging educational opportunities for our residents and fellows.

The numbers speak for themselves:

  • 200,000 procedures performed per year.
  • 80 residents and fellows trained per year.
  • 11 fellowship programs (four accredited and seven non-accredited).
  • Pain Management physicians at over 20 Northeast Ohio locations.

When considering what is important to share with our team and those considering joining our team, two anonymous quotes come to mind.

First, 'Teamwork: Simply stated, it is less me and more we.' And second, 'Wild ducks make a lot of noise, but they also have the sense to benefit from occasionally flying in formation.'

It is my hope that I will have an opportunity to meet you and share the excitement we have in caring for our patients and our team - while flying in formation!


Christopher J. Troianos, MD
Chairman, Anesthesiology Institute



Christopher Troianos, MD Christopher Troianos, MD
Chair, Anesthesiology Institute
Serle Levin, MD Serle Levin, MD
Chair, Department of Regional Practice Anesthesiology
Maged Argalious, MD Maged Argalious, MD
Vice Chair for Education
James Rowbottom, MD James Rowbottom, MD
Vice Chair for Clinical Affairs
Nikolaos Skubas, MD Nikolaos Skubas, MD
Chair, Department of Cardiothoracic Anesthesiology
Daniel Sessler, MD Daniel Sessler, MD
Chair, Department of Outcomes Research
Richard Rosenquist, MD Richard Rosenquist, MD
Chair, Department of Pain Management
Dorothea Markakis, MD Dorothea Markakis, MD
Chair, Department of Pediatric Anesthesiology
Eric Kaiser, MD Eric Kaiser, MD
Chief, Center for Critical Care
Publications & Accomplishments

Publications & Accomplishments

Papers, journals and manuscripts

From 2001 to 2013, staff members from the division generated more than 200 peer-reviewed abstracts and more than 100 papers per year. The division has been the number-one producer of peer-reviewed abstracts presented at the American Society of Anesthesiologists meeting in four out of the last seven years.

Accomplishments in anesthesiology

  • Pioneered the use of sodium nitroprusside for controlling high blood pressure during and after cardiac surgery and its use in elective hypotensive anesthesia in 1960.
  • First use of intravenous nitroglycerin in coronary artery bypass surgery.
  • Founded the first specialized department for cardiac anesthesia.
  • First to test all modern potent opioids and most of the modern muscle relaxants, making anesthesia practice safer and more effective.
  • Built the largest pain management center, serving over 116,000 patients yearly.
  • Hosts the largest accredited fellowship pain management training program.
  • Championed clinical engineering advances, including continuous cardiac output monitoring and the development of practical patient transport monitoring.
  • First program to offer certification for TEE to all cardiac fellows and all residents.
  • Developed new medical equipment leading to more than two dozen U.S. and multiple foreign patents and several commercialized devices.
  • Only division in anesthesia anywhere once led by a chair who has authored two New York Times #1 bestsellers.
  • First anesthesia division with a department of outcomes research.
  • Developed a web-based preoperative, postoperative and pain assessment program that fine-tunes itself to each patient's individual characteristics and develops an accurate evaluation report.
  • Responsible for:
    • Care of 200,000 patients yearly undergoing operative or other procedures requiring anesthesia.
    • 44,000 plus critical care days in more than 124 critical care beds.
    • 116,000 plus pain management visits.
  • Division staff have developed major insights into temperature and oxygen control to reduce perioperative infection. More than 10 major New England Journal of Medicine and Lancet articles.
  • Division staff responsible for 24 drugs now in new drug application process with the FDA.
Institute History

Institute History

Founded in 1946 as the “Department of Anesthesiology,” Cleveland Clinic Anesthesiology Institute has grown from a small group of 12 anesthesiologists to nearly 225 anesthesiologists, critical care specialists, and pain management specialists. Over the years the small department evolved into a division – with specialized departments for cardiothoracic anesthesiology, general anesthesiology, pediatric anesthesiology, pain management, regional practice anesthesiology, anesthesiology research, and outcomes research; and in 2007 became one of Cleveland Clinic’s institutes. Throughout its history, the Anesthesiology Institute has been deeply involved in research, innovation and education as well as providing world-class patient care.

Christopher A. Troianos, MD, FASE, is Chair of the Anesthesiology Institute of the Cleveland Clinic, which unites all anesthesiology providers in general anesthesiology, cardiothoracic anesthesiology, pain medicine, pediatric and congenital cardiac anesthesiology, critical care medicine, regional practice, outcomes research, education, and more than 15 subspecialized sections within one fully integrated model of care. Dr. Troianos joined the Cleveland Clinic in 2016 from the Allegheny Health Network in Pittsburgh, where he was Chief of Anesthesiology at West Penn Hospital and Professor of Anesthesiology Temple University School of Medicine.

Dr. Troianos received a Bachelor of Science degree with University Honors in Chemistry from Carnegie Mellon University and his medical degree from the University of Pittsburgh School of Medicine. He completed a residency in anesthesiology and served as anesthesiology chief resident at Mercy Hospital of Pittsburgh, followed by a cardiothoracic anesthesiology fellowship at the Hospital of the University of Pennsylvania in Philadelphia. He is board-certified in anesthesiology and is a senior oral board examiner with the American Board of Anesthesiology.

Dr. Troianos has earned a national and international reputation as a cardiac anesthesiologist and participated on several national task forces that required collaboration among multispecialty societies to develop practice guidelines. He was part of the original task force that developed training guidelines in perioperative TEE and subsequently quality improvement guidelines in perioperative TEE. Most recently, he was the lead author for practice guidelines for ultrasound guided vascular access. He has shared his expertise in numerous peer-reviewed publications, authored the anesthesiology textbook, “Anesthesia for the Cardiac Patient.”, and has been an invited speaker to national and international scientific educational conferences. His experience with graduate medical education spans two decades, having served as a Residency Program at two institutions, and as Chair of the Graduate Medical Education Committee at Mercy Hospital in Pittsburgh.

Dr. Trolanos is currently serving as President-Elect of the Society of Cardiovascular Anesthesiologists (SCA), and will become President of the SCA in 2017. He also serves on the Board of Directors for the National Board of Echocardiography, which develops certification examinations and recognizes physicians who fulfill the requirements for board certification in echocardiography. He has served as a Co-Program Director for one of the largest annual echocardiography meetings of its kind — the Comprehensive Review of Perioperative Echocardiography sponsored by the SCA and American Society of Echocardiography (ASE). In recognition of his accomplishments, Dr. Troianos has been designated as a Fellow of the ASE.

In the area of economics related to practice management, Dr. Troianos has served as the Chair of the Society of Cardiovascular Anesthesiologists (SCA) Economics Committee and as the cardiac anesthesia liaison for the American Society of Anesthesiologists (ASA) Committee on Economics. This committee focuses on ensuring fair payment from all payers for anesthesiology services, and is one of the most important committees of the ASA on a national level. The committee is also charged with advising the society’s leadership on economic issues, and represents the society on the American Medical Associations’ Current Procedural Terminology (CPT) Advisory Committee and the AMA/Specialty Society Relative Value Scale Update Committee (RUC).

Dr. Michael Roizen, was appointed in 2005 and served until 2007, when he became the Chief Wellness Officer for Cleveland Clinic. Dr. Roizen has authored and co-authored more than 155 peer-reviewed publications, 100 book chapters, 40 editorials, and has 12 U.S. and multiple foreign patents to his credit. He has also authored two #1 New York Times Bestsellers (both of which displaced Harry Potter in 1999, and again in 2005, from #1 on the Amazon.com list) that deal with patient safety and motivate healthy behaviors. Both of these works arose from his emphasis on reducing perioperative risk by motivating healthier behavior of patients prior to and after surgery.

Dr. F. G. Estafanous was appointed in 1986 and served as chairman until 2005. Under the direction of Dr. Estafanous, the division grew significantly both on the main campus and at numerous regional sites. During his chairmanship, Dr. Estafanous served on the Cleveland Clinic Board of Governors and was active in professional organizations. Dr. Estafanos has published numerous publications in the areas of hypertension and cardiac anesthesia.

With an interest in critical care, Dr. Azmy Boutros, chairman from 1977-1986, was a graduate of the Faculty of Medicine of Cairo University. He developed and received accreditation for Cleveland Clinic's present anesthesiology residency program. He wrote many papers regarding patient monitoring and was very interested in critical care medicine.

Dr. John Viljoen, chairman from 1973 to 1976, was one of the founders of the Association of Cardiac Anesthesiologists. He also pioneered the use of IV nitroglycerin to prevent and control ischemia in the cardiac patient.

Dr. Kenneth Potter, chairman from 1970 to 1973, was credited with starting the first anesthesiology residency program in Ohio at Huron Road hospital and was very active nationally in the ASA.

In 1967, Dr. Carl Wasmuth became the department head. He was the first to use sodium nitroprusside for hypotensive anesthesia. He served as president of the American Society of Anesthesiologists (ASA) and as Chairman of the Cleveland Clinic Board of Governors.

Dr. Donald Hale, the first head of the department of anesthesia at Cleveland Clinic wrote the textbook Anesthesiology. Dr. Hale served as department head from 1946 to 1967. He was a graduate of the Medical School of the University of Pennsylvania.



Anesthesiology Institute

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