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Medications Used in General Anesthesia:
Propofol, Vecuronium bromide, pancuronium, Halothane, Enflurane, Isoflurane, Midazolam, Ketamine, Nitrous Oxide, Thiopental, Etomidate, Atracurium

Regional Anesthesia:
Mepivacaine, Chloroprocaine, Lidocaine

Local Anesthesia:
Procaine, Lidocaine, Tetracaine, Bupivacaine

Topical Anesthesia:
Benzocaine, Lidocaine, Dibucaine, Pramoxine, Butamben, Tetracaine (Sprays, Ointments, Creams, Gels)

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Anesthesia Medications ::: A wide variety of drugs are used in modern anesthetic practice. Many are rarely used outside of anesthesia, although others are used commonly by all disciplines. Anesthetics are categorized in to two classes: general anesthetics , which cause a reversible loss of consciousness, and local anesthetics , which cause a reversible loss of sensation for a limited region of the body while maintaining consciousness. Combinations of anesthetics are sometimes used for their synergistic and additive therapeutic effects, however, adverse effects may also be increased. **See Below For A Quick Look At Anesthesia Medications

Although not considered core members of the Anesthesia Care Team, other health care professionals make important contributions to the perianesthetic care of the patient (see Addendum A).


ANESTHESIA CARE TEAM - Anesthesiologists supervising resident physicians in training and/or directing qualified nonphysician anesthesia providers in the provision of anesthesia care wherein the physician may delegate monitoring and appropriate tasks while retaining overall responsibility for the patient.
QUALIFIED ANESTHESIA PERSONNEL/PRACTITIONER - Anesthesiologists, anesthesiology fellows, anesthesiology residents, oral surgery residents, anesthesiologist assistants and nurse anesthetists. An exception is made by some clinical training sites for non-physician anesthetist students (see "Non-physician Anesthetist Students" below).

SUPERVISION AND DIRECTION - Terms used to describe the physician work required to oversee, manage and guide both residents and nonphysician anesthesia providers in the Anesthesia Care Team. For the purposes of this statement, supervision and direction are interchangeable and have no relation to the billing, payment or regulatory definitions that provide distinctions between these two terms (see Addendum B).
Safe Conduct of the Anesthesia Care Team

In order to achieve optimum patient safety, the anesthesiologist who directs the Anesthesia Care Team is responsible for the following:

1. Management of personnel - Anesthesiologists should assure the assignment of appropriately skilled physician and/or nonphysician personnel for each patient and procedure.

2. Preanesthetic evaluation of the patient - A preanesthetic evaluation allows for the development of an anesthetic plan that considers all conditions and diseases of the patient that may influence the safe outcome of the anesthetic. Although nonphysicians may contribute to the preoperative collection and documentation of patient data, the anesthesiologist is responsible for the overall evaluation of each patient.
3. Prescribing the anesthetic plan - The anesthesiologist is responsible for prescribing an anesthesia plan aimed at the greatest safety and highest quality for each patient. The anesthesiologist discusses with the patient (when appropriate), the anesthetic risks, benefits and alternatives, and obtains informed consent. When a portion of the anesthetic care will be performed by another qualified anesthesia provider, the anesthesiologist should inform the patient that delegation of anesthetic duties is included in care provided by the Anesthesia Care Team.

4. Management of the anesthetic - The management of an anesthetic is dependent on many factors including the unique medical conditions of individual patients and the procedures being performed. Anesthesiologists should determine which perioperative tasks, if any, may be delegated. The anesthesiologist may delegate specific tasks to qualified nonanesthesiologist members of the ACT providing that quality of care and patient safety are not compromised, but should participate in critical parts of the anesthetic and remain immediately physically available for management of emergencies regardless of the type of anesthetic (see Addendum B).
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