Is A Certified Registered Nurse Anesthetist Safe for Breast Augmentation?

Question

The board certified plastic surgeon that I am considering having perform my breast augmentation uses a CRNA for general anesthesia in a AAAASF accredited facility. This surgeon uses this particular CRNA because he thinks he is really good. He said that if I preferred he could use a board certified anesthesiologist but I'd like him to use someone he's worked with before. Is a CRNA just as safe as a board certified anesthesiologist? I live in the state of California. Thank you.

William J. Hedden, MD · Answer

CRNA and and anesthesiologist are both very good at what they do. As always though I would recommend meeting your CRNA or anesthesiologist to make sure you are comfortable with either. In most hospitals the CRNA is the primary one taking care of you.

Otto Joseph Placik, MD · Answer

I understand that it is difficult fot you to assess the skills of the anesthesia provider whether MD or CRNA and to some degree you must rely on the recommendation of the surgeon. You may want to meet with the provider prior to surgery to allay your fears or verify either's credentials through the department of professional regulation.

Gregory A. Buford, MD, FACS · Answer

The simple answer is that it really depends upon their training, oversight, and their experience.  A title does not assure this.  I would recommend asking them how long they have been practicing and how long they have worked with your surgeon.  These questions can help you better understand how comfortably the two may potentially work together during your surgery.

	That being said, I have worked with both an MD and a Nurse anesthetist and have found that it really does come down to their overall background, etc. 

	I hope that helps!

David Finkle, MD · Answer

Safety is our number one concern when providing elective cosmetic surgery.  Our patients must be healthy and well prepared before any surgical procedure.  During surgery it is paramount that the best anesthesia be provided by a professional licensed anesthesia personal for the best possible outcome.There are two types of licensed anesthesia personal, one takes the path of a nurse before post graduate training (CRNA-Certified Registered Nurse Anesthetist).  One takes the path of Doctor before post graduate training (MD-Medical Doctor).  Both the nurse and the doctor have the same training in their residencies or post graduate training.  They both must pass rigorous examinations during and after their training to become board certified.  In some states CRNA's can perform independently and in some states they must be supervised by an MD anesthesiologist or another MD in the operating room (ie-the operating surgeon).  Most hospitals use a combination of CRNA's and MD's to provide anesthesia for their patients.  Both are equally qualified to provide anesthesia for elective cosmetic surgery.When choosing your plastic surgeon, it is important to know who is providing the anesthesia.  If in a hospital setting, the hospital will assign an anesthesia provider and you and the surgeon may not know who will provide the anesthesia until the day of the procedure.  In the plastic surgeon's own operating theater, the anesthesia person will be known.  Ask who this provider is and their qualifications, you may also talk and/or meet with that person before surgery if you desire.  This is a very important topic, this person is not only putting you to sleep, but also waking you up!  You and your surgeon need to have confidence in this person, whether it is a CRNA or MD really doesn't make any difference, it is the competence of that person that makes the difference.  If your surgeon does not use a board certified anesthesia person, then I would consider not using that surgeon. why put yourself at unnecessary risk!Also, the facility needs to be nationally accredited.  This assures that all the safety features are in place, including board certification of not just the anesthesia personnel, but the doctors and nurses as well.  The AAAASF (American Association for Accreditation of Ambulatory Surgical Facilities) is a nationally recognized organization for accrediting outpatient surgical facilities.Good Luck!

Randy Proffitt, MD · Answer

A CRNA is definitly qualified to perform your anesthesia.  I have used CRNAs for many years and have been very comfortable with them.

Steven Wallach, MD · Answer

A CRNA is a nurse who has experience in anesthesia.  They are very qualified to do office based procedures.  An anesthesiologist is an MD who is more qualified to do anesthesia.

Glenn Vallecillos, MD, FACS · Answer

Hello and thank you for the question.

	CRNAs are perfectly capable of performing anesthesia for aesthetic surgical cases. As with any profession, there are exceptional CRNAs and bad ones, just as there are very adequate anesthiologists and subpar ones. You may want to run your concerns by your plastic surgeon and perhaps ask to meet the CRNA prior to the procedure to ask questions/voice concerns/etc.

	Best,

	Glenn Vallecillos, M.D., F.A.C.S.

Delio Ortegon, MD · Answer

Yes most CRNAs are very good at what they do and if your surgeon feels comfortable with a specific one then he is likely very competent. However, surgeon comfort should not be the only factor used in deciding who does your anesthesia. YOUR comfort is vitally important as well, after all you are the one having surgery. Almost all plastic surgeons have at least one anesthesiologist that they use regularly. If you prefer to have an anesthesiologist then insist on one. You will be happier in the end.

John Whitt, MD (retired) · Answer

There are good and bad CRNAs and anesthesiologists. If your plastic surgeon operates in an AAAASF-accredited facility and is comfortable working with a particular CRNA, you are probably safe in having in having him/her perform your anesthesia. I personally know 25-30 CRNAs whom I would be comfortable giving me or my family members anesthesia.

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