THE CHANGING PROFILE OF ANESTHETIC PRACTICE - AN UPDATE FOR INTERNISTS

BACKGROUND Internists are commonly consulted to ''clear'' patients for anesthesia and surgery. Newer anesthetic agents and techniques now ex tend limits and possibilities beyond what many internists were taught. OBJECTIVE To update internists on recent changes in anesthetic manage ment and how they affect the preoperative evaluation. SUMMARY Recent a dvances in anesthetic management include new monitoring standards, bal anced anesthetic technique, new agents, equipment changes, better unde rstanding of human factors, and expanded pain management techniques. C ONCLUSIONS Postoperative care will likely assume increasing importance in determining anesthesia-related morbidity and mortality. For this r eason, increased interaction and cooperation between surgeons, interni sts, and anesthesiologists are needed.