Anesthesiology: the Operating Room and Beyond
Anesthesiology is the specialty dedicated to the relief of pain and the medical care of patients before, during and after surgery.
4/13/2004 - At NorthShore University HealthSystem’s hospitals, the perioperative scope of the specialty includes medical evaluation of patients before surgery, consultation with other members of the surgical team and support of life functions during surgery. Postoperatively, anesthesiologists provide medical care in the recovery areas and often provide care after discharge from the Post Anesthesia Care Unit in areas such as the Intensive Care Units.
Jesse Marymont, MD, is one of several anesthesiologists who subspecialize in cardiac anesthesia
Wilmette resident Leigh Ann Harmon recalled vividly her preoperative experience at Highland Park Hospital last fall. "Dr. (Vandana) Kulkarni came to my room and introduced herself," said Harmon. "She went over the details of my surgery and possible postoperative effects of the anesthesia. She clearly knew who I was and was very familiar with my medical history before we met. I felt very reassured before going into surgery." Unfortunately, in some cases, the sedatives administered before and during surgery can produce an amnestic effect, keeping patients from remembering their encounter with their anesthesiologist.
The Department of Anesthesiology is a broadbased practice whose members focus, first and foremost, on the safety and comfort of the 38,000 patients they care for each year, according to Jeffery S. Vender, MD, Chairman of Anesthesiology, who also is Director of Critical Care Services. The department uses the anesthesia care team model. The team includes 30 board-certified anesthesiologists, 30 certified registered nurse anesthetists (CRNA), and a varying number of anesthesiology resident physicians and nurse anesthesia students. In addition to the traditional operating room environment, its members care for patients in areas outside the surgical suite, such as Labor and Delivery, the Intensive Care Units, GI and Cardiac Catheterization Labs and Radiology.
Many anesthesiologists subspecialize in such specific areas of expertise as cardiac surgery, neurosurgery, pediatrics, obstetrics or pain management. Those physicians are responsible for keeping the department abreast of new advances in their subspecialty areas.
The department values NorthShore University HealthSystem’s institutional role as a top teaching and research facility. Many anesthesiologists are involved in pioneering research to advance patient care. "A number of our physicians are engaged in clinical pharmacologic and technologic studies in both the operating rooms and critical care environments," said Joe Szokol, MD, Vice-Chairman of Anesthesiology. "Others are investigating new technologies for monitoring patients during surgery." Alice Wyrwicz, PhD, heads up the Department of Anesthesiology’s bench science research in MRI spectroscopy at the NorthShore University HealthSystem Research Institute.
The department’s commitment to education is also significant. Its residency program is through the McGaw Medical Center of Northwestern University, where 22 of the department’s anesthesiologists are on faculty. Martin Nitsun, MD, and Joanne Ross, CRNA, direct the clinical activities with the NorthShore University HealthSystem School of Anesthesia, a master’s-level program which provides training and certification for nurse anesthetists in conjunction with DePaul University.
As the complexities and variables inherent in new procedures have expanded, so, too, has the ability of anesthesiologists to tailor anesthesia care for each procedure – and for each individual patient’s underlying medical condition and level of stability.
"In the OR, the anesthesiologist is a key member of the team responsible for the patient’s care as well as an advocate for that individual," said Dr. Vender. "Our mission is to provide optimal clinical care and stabilization of the patient, which requires balancing surgical and patient needs. Our focus is always on safety and quality."
Hugh Gilbert, MD, Frank Clark, MD, PhD, and Eun- Kyu Koh, MD, treat patients suffering from chronic and/or acute pain caused by a variety of conditions at the Pain Management and Treatment Center at Evanston Hospital.
Improved surgical techniques, minimally invasive procedures, and novel anesthetic agents allow anesthesiologists to continually hone their craft; most of our anesthesiologists have completed anesthesia fellowships, but the specialty training doesn’t stop there. For example, the Pain Management and Treatment Center at Evanston Hospital, part of the Department of Anesthesiology, is staffed by three physicians board-certified in anesthesiology and pain management who treat patients suffering from chronic and/or acute pain resulting from cancer, spinal problems, surgery, and other ailments. Those three specialists – Hugh C. Gilbert, MD; Frank M. Clark, MD, PhD; and Eun-Kyu Koh, MD – have national certification in their area of expertise.
"As we have come to understand more about pain through clinical care and research, our ability to effectively treat pain has grown rapidly," said Dr. Clark. "New techniques enable us to provide more effective relief for a wider variety of patients who have more kinds of pain than ever before."
NorthShore University HealthSystem’s strength in cardiac care and heart surgery demands the expertise of anesthesiologists with specialized skill in caring for heart patients. In addition to specialists in cardiac anesthesia, the department includes six internationally recognized physicians exam-qualified in transesophageal echocardiography (TEE), a diagnostic procedure in which an ultrasound probe is inserted down the esophagus to provide images of cardiac function to help assess valvular problems, blood clots, and congenital and other types of heart disease.
"The use of echocardiography, especially in the operating room, is becoming a standard of care for many top-level cardiac institutions," said Jesse H. Marymont, MD, who is exam-qualified in TEE. "Since we are hospital-based specialists, we are available to quickly provide these diagnostic capabilities during surgery or for critically ill patients in the ICU."
As the individual needs of patients continuously expand, they can be assured their anesthesiologist is at the forefront of those changes.