The changing profile of anesthetic practice: an update for internists.
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Abstract
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.