ABSTRACT
Anesthesiology is a specialty, which emerged and has evolved to serve primarily the needs of surgical patients in the operating theater environment. Until not that long ago, anesthesia for out-of-OR remote locations had been often viewed by many anesthesiologist as a mere diversion from their primary responsibilities in the main OR. Indirect evidence of this somewhat disdainful attitude can be found in many classical textbooks of anesthesia where provision of anesthesia care for a wide variety of non-surgical procedures in remote locations would be covered in one small chapter. Whereas anesthesia for each subspecialty of surgery would have its own chapter, such radically different disciplines as interventional neuroradiology, endoscopy, and cardiac electrophysiology were lumped together under some vague and euphemistic moniker like, “Anesthesia at remote locations” (1-6). It would be incomplete to neglect mentioning that the practitioners in those non-surgical specialties often reciprocated in this attitude by making little effort to accommodate unique requirements of anesthetized patients in their practice, treating “anesthesia” as no more but a pesky necessity otherwise of little consequence to their routines. Unlike surgery, however, until recently very few non-surgical professions had perceived or wanted anesthesia to become an essential component to progress in their specialties. Symbolically, the previous 2006 edition of this very textbook had no chapter on anesthesia. This kind of unawareness among non-surgical professions is most likely due to the relatively minor fraction of these patients who required anesthesia care in the past, which in turn provided relatively insignificant occupation and income opportunities for most anesthesia providers. However, with advances in procedural complexity and increasing severity of patient illness, this reality has been undergoing rapid and dramatic transformation in recent years.
