Anesthesiologist

What is an anesthesiologist?

An anesthesiologist is a medical doctor who directs your anesthesia care, pain management and critical care before, during and after surgeries and invasive procedures.

What is anesthesia?

Anesthesia is a medical treatment that keeps you from feeling pain during procedures or surgery. The medications anesthesiologists and other healthcare providers use to block pain are called anesthetics.

Different types of anesthesia work in different ways. Some anesthetic medications numb certain parts of your body, while other medications numb your brain to induce sleep for more invasive surgical procedures, like those within your head, chest or abdomen.

If you’re having a relatively simple procedure that covers a very small area of your body, such as a dental filling, the provider performing your procedure will often administer a local anesthetic, which only works to block pain at a certain (local) area of your body.

Is an anesthesiologist a doctor?

Yes, a physician anesthesiologist is a doctor, just like your surgeon and primary care provider. They have a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree, and together with their college degree and residency training after medical school, have 12 to 14 years of training in total.

What does an anesthesiologist do?

Similar to your primary care doctor, your physician anesthesiologist manages all aspects of your medical care (blood pressure, diabetes, asthma and heart conditions), while administering an anesthetic that makes you or part of your body unaware of pain from the procedure being performed.

Anesthesiologists help to ensure your safety when you’re undergoing surgery or an invasive procedure, making sure your body parts are well padded and protected from injury while you’re unaware of your surroundings.

Anesthesiologists have important responsibilities before, during and after a surgery or procedure:

• Before surgery: Your anesthesiologist is responsible for assessing your health and test results, your fitness for the planned surgery and determining the safest anesthesia plan for you.
• During surgery: Your anesthesiologist monitors your vital signs during surgery, manages your medical conditions, and administers fluids, blood products and medications to support your bodily functions, such as the function of your heart, lungs and kidneys. They may work alone or with an anesthesia care team that may consist of nurse anesthetists or physician anesthesiologists in training.
• After surgery: Your anesthesiologist is responsible for your wellbeing after surgery while you’re recovering from the effects of anesthesia. They’re typically the healthcare provider who decides when you have recovered from the effects of anesthesia and are ready to go home or go to another room in the hospital.

Anesthesiologists also have an important role in taking care of people who are having minor surgery or who may not need to be unconscious with a general anesthesia, such as people in labor ready to deliver a baby.

They care for people after major surgery in the intensive care unit. They also help people who have serious pain from an injury or chronic pain, such as ongoing back pain, within a pain management team in the hospital or in an office setting.

What’s the difference between a certified registered nurse anesthetist (CRNA), a certified anesthesiologist assistant (CAA) and an anesthesiologist?

A certified registered nurse anesthetist (CRNA) is a registered nurse who has completed an accredited nurse anesthesia training program. Nurse anesthetists are advanced practice nurses (non-physician anesthetists) who specialize in providing anesthesia care in their nursing practice. CRNAs are often supervised by a physician anesthesiologist, similar to how a hospital nurse cares for you on the floor based upon direction from your surgeon or primary care provider.

A certified physician assistant (CAA) is a mid-level provider who works similarly as a CRNA but has a science background or pre-medical type of college degree, rather than a nursing degree from college.

A physician anesthesiologist is a medical doctor who specialized in anesthesia training after medical school. Physician anesthesiologists spend four years in general anesthesia training after medical school. But they often train for an additional one to two years to further subspecialize in areas such as pediatrics, cardiac, obstetrics, intensive care or pain management.

What are some common surgeries and procedures that require an anesthesiologist?

Most surgeries and procedures generally require some type of anesthesia and the expertise of an anesthesiologist. The following are the types of anesthesia used by an anesthesiologist:

• General anesthesia.
• Sedation.
• Regional anesthesia.

If you need a local anesthetic for a minor procedure, the healthcare provider performing the procedure will often give it to you.

Common surgeries that require general anesthesia (being unconscious) include:

• Head or back surgery.
• Heart surgery.
• Lung surgery.
• Surgical procedures in your abdomen.

Common procedures that typically require regional anesthesia (numbing a large area of your body) with a spinal, epidural or regional anesthesia block (of an arm or a leg) include:

• Hip or knee surgery.
• Hand or foot surgery.

Common procedures that typically require IV (intravenous) sedation (medication to make you feel relaxed with varying levels of consciousness) include the following, which may or may not involve a local anesthetic (numbing of the area):

• Bronchoscopy.
• Colonoscopy.
• Cystoscopy.
• Dental surgery.
• Minor bone fracture repair.
• Minor skin surgery.
• Plastic or reconstructive surgery.
• Upper endoscopy.

Anesthesiologists also perform epidurals to manage the pain of childbirth for vaginal delivery and provide anesthesia for a cesarean birth (C-section).

What can I expect during an appointment with an anesthesiologist?

In the days or weeks before your surgery, you’ll meet with your anesthesiologist. During the appointment, your anesthesiologist will make sure you’re fit for surgery.

They’ll ask questions about your:

• Overall health.
• Existing specific health conditions, such as heart disease, diabetes or asthma.
• Medications, including prescriptions, over-the-counter medications and supplements.
• Allergies.
• Your personal and family history with anesthesia to determine if you or someone related to you has experienced any issues with anesthetic medicine before. It’s especially important to tell your anesthesiologist if you’ve ever had any difficulty waking up after anesthesia, remained on a ventilator (breathing machine or breathing tube left in for longer than expected), had a fever reaction to an anesthetic medication or gas, or experienced severe nausea and vomiting after surgery.

They’ll perform a physical examination of your:

• Airway (your teeth, throat, neck and nasal passages).
• Heart.
• Lungs.
• Pulse (heart rate).

They’ll also review any blood tests, X-rays, ultrasound tests and electrocardiograms (EKGs) that you’ve had to prepare for the procedure.

Based upon their overall review and assessment, they’ll prescribe your anesthetic plan, such as general, regional block, spinal/epidural or some combination. Don’t be afraid to ask your anesthesiologist questions about what they’re recommending and what to expect.

How does someone become an anesthesiologist?

To become an anesthesiologist, a person must complete all of the following:

• Four years of pre-medical education at a college or university, resulting in a bachelor’s degree.
• Four years of medical school, resulting in a Doctor of Medicine (MD) or Doctor of Osteopathic Medicine (DO) degree.
• Four years of residency in an anesthesiology program.
• Optional one to two years of fellowship training to subspecialize in a more focused area, such as cardiac, neuro, pediatric, obstetrical, intensive care or pain management.

After residency, most anesthesiologists take the American Board of Anesthesiology (ABA) written and oral exam to become board certified.

Like all medical professionals, anesthesiologists need to complete continuing medical education through attending conferences and classes throughout their careers to keep up with advances and technology in their field of medicine. Some may be involved in research to discover new and better techniques that improve how they administer anesthesia.

How long does it take to become an anesthesiologist?

It generally takes at least 12 years to become an anesthesiologist, which includes pre-med education, medical school and a residency program. Some anesthesiologists pursue a fellowship in a specialty field of anesthesiology, which takes an additional year or two if combined.

What are some subspecialties of anesthesiology?

Some subspecialties of anesthesiology include:

• Pain management.
• Cardiac anesthesia.
• Pediatric anesthesia.
• Neuro-anesthesia.
• Obstetric anesthesia.
• Critical (intensive) care.
• Regional anesthesia / acute pain management.
• Hospice and palliative care.

A note from Cleveland Clinic

Needing to undergo surgery or an invasive procedure can be stressful. Know that your anesthesiologist has specialized knowledge and skills to make sure you’re safe during your surgery. They’ll create an anesthesia plan developed specifically for you. Don’t be afraid to ask your anesthesiologists questions. They’re available to help you feel more comfortable and confident about your surgery.