Your question is an excellent one-- I think as in many instances in medicine it can be very doctor or CRNA dependent. I have known many practices who use experienced CRNAs under the supervision of a physician to provide anesthesia services and they have had good results with this approach. In my practice we use Board-Certified Anesthesiologists (MDs) only, but I don't think there is only one right way to provide good care. I would discuss your concerns with your surgeon and even with the CRNA and this may help alleviate any worries you may have.
Thank you for your question! I personally use Board-Certified Anesthesiologists (MDs) only in my practice. I would consult with your doctor with further questions or concerns. Best of luck!Dr Dhaval PatelDouble Board Certified Plastic SurgeonChicago Hoffman Estates Oak Brook
That's an excellent question. At my practice, I
use a board-certified anesthesiologist for every procedure. Board certification
requires that the anesthesiologist has not only undergone years of education
and practical training, but also that he or she has passed rigorous exams and
maintained high standards. This offers my patients a certain peace of mind.
That said, I know many surgeons who work with CRNA's or other anesthesiologists
who are not certified but who have pristine safety records. I recommend you
voice your concerns to your surgeon and to the CRNA and have an open
conversation about safety. Ask how long the CRNA has been performing these
services, how often he or she does them, and what complications have come up.
Your surgeon may also be willing to bring in a board-certified anesthesiologist
for a fee if you would prefer. Good luck in your procedure.
I believe you will be very safe with either a Board Certified Anesthesiologist or a Certified Registered Nurse Anesthetists. I have use the CRNAs in my office based OR since 1995 and feel totally comfortable with them. They put my wife and child to sleep!
Most CRNAs, especially those working in busy accredited outpatient surgical centers, are experienced skilled providers. I often use CRNAs. All anesthesia has risk no matter who the provider. Express your concern with your surgeon. It is likely that he/she has experience with the CRNA and can reassure you.
Thank you for your question about anesthesia for your breast implants
- CRNAs are well trained and the anesthesia they give is usually safe,
- Some are absolutely outstanding and clearly as good as Board Certified Anesthesiologists
- But unless you have worked with them, you do not know who they are.
- For this reason, our surgery center only uses Board Certified Anesthesiologists
- And I request one to give my anesthesia when I have surgery.
- Why? In over 25 years of practice I have never had a competence problem with a Board Certified Anesthesiologist - they prevent problems, recognize and manage early problems, keep anesthesia from being too light or too deep and work smoothly with me. They are just better - as they should be - they have at least 29 years of education, and 9 years of medical training.
- All anesthesia extenders are trained to deal with the normal - they are not so good as recognizing the abnormal. I have had CRNAs not recognize life-threatening emergencies including patients turning blue, and I have had to intervene and I have had to intervene to protect a patient's life.
- If your surgeon has worked extensively with this CRNA however - things should be fine.
- But if it were me, I would ask if it is possible to have a Board Certified Anesthesiologist throughout the case, even if there is an extra fee. Best wishes.
Thank you for your excellent question. It is one that I would have answered differently 5 years ago. I have been in practice for almost 22 years. For the first 19 years of my practice I did all of my surgery at hospitals or a large surgery center, always with board certified anesthesiologists. When I thought of opening my own surgery center I never thought that I would use a CRNA instead of an MD anesthesiologist. Three years ago I finally did get my own surgery center, acquiring a AAAASF accredited facility from another plastic surgeon who was leaving to join a large multispecialty group practice. When a colleague in town heard what I was doing he came to me and suggested I use his CRNA on days when he was not using him. I spoke with a couple of other colleagues who have used CRNAs and decided to put my prejudice aside and give hi a try. It was one of the best decisions I have ever made. He has more years of experience than many of the anesthesiologists I have used in the past. He has a much more patient friendly personality. And, most importantly we have never had an anesthetic complication. If you add the time he has been with my colleague, that is an 18 year record. I also find it amazing that in the past three years I have had no (zero) calls from patients complaining of postoperative nausea and vomiting. So, as long as the CRNA that your plastic surgeon is using has the experience then you should be in good hands. Furthermore there are no studies that show any difference in morbidity and mortality between MD anesthesiologists and CRNAs. As my CRNA says there are good and bad anesthesiologists and good and bad CRNAs. Just make sure you have one of the good ones. I hope this long winded answer puts your mind at ease.
This is a hot topic for debate among both plastic surgeons and anesthesia providers. I use CRNAs in my practice and used them during my residency training. I feel 100% comfortable with my CRNAs and would trust them with my family. I would trust them over any anesthesiologist today, not because CRNAs are better than anesthesiologists, but because I know my CRNAs intimately and know their skill set. I believe strongly that a well trained CRNA who is specifically skilled with outpatient surgery techniques is just as safe as an anesthesiologist with the same skill set. I believe that they are more safe than an anesthesiologist who does not routinely use the type of anesthesia that I typically use for my cases (MAC). In 12 years of operating, I have never encountered an anesthesia problem. If you are a healthy patient and your surgeon is extremely particular about safety, you should be fine with your procedure whether it is being conducted with an anesthesiologist or CRNA assuming that they are specifically trained for the type of anesthesia that is being provided.
It's probably OK, but in our facility we use only board certified anesthesiologists. I read a great article in an anesthesiology journal a few years ago written by a CRNA in which the nurse wrote of how she felt quite knowledgable and capable to give anesthesia until she went to medical school and then took an Anesthesia residency and realized the vast difference in knowledge and skill between the two degrees.
I use two board certified anesthesiologists to help ensure safety.
Kenneth Hughes, MD
Los Angeles, CA.