Subspecialties
Structured primers across the major fields of anesthesia practice. Each covers core concepts, monitoring, common drugs, and the clinical pearls that distinguish veteran clinicians.
Cardiac Anesthesia
Hemodynamics, CPB, and the perioperative ICU mindset.
Cardiac anesthesia covers anesthetic management for open-heart surgery, structural interventions, and high-risk cardiac patients. The hallmarks are invasive monitoring, deliberate manipulation of preload/afterload/contractility, comfort with TEE, and seamless coordination with perfusion during cardiopulmonary bypass.
Pre-bypass goalsOn bypassSeparation from CPB
Neuroanesthesia
ICP, CPP, and protecting the brain.
Neuroanesthesia balances surgical exposure with neuronal protection. Central concepts include cerebral perfusion pressure (CPP = MAP − ICP), autoregulation, the BBB, and avoiding secondary injury from hypoxia, hyper/hypocapnia, hyper/hypoglycemia, and hyperthermia.
CPP & ICPChoice of agentsAwake craniotomy
Obstetric Anesthesia
Two patients, one anesthetic, zero margin.
OB anesthesia is high-volume, time-sensitive, and unforgiving. Maternal physiology (decreased FRC, increased oxygen consumption, aspiration risk, edematous airway) means failed intubation can become failed oxygenation within minutes.
Neuraxial analgesia for laborSpinal for C-sectionAortocaval compression
Pediatric Anesthesia
Tiny patients, vast physiology.
Children are not small adults. Pediatric anesthesia requires familiarity with weight-based dosing, age-related airway anatomy (large occiput, anterior larynx, narrowest at cricoid in <8 yo), brisk vagal tone, rapid desaturation, and developmental considerations.
ETT sizingMaintenance fluids — 4-2-1 ruleInhalational induction
Regional Anesthesia
Precise anatomy, profound analgesia.
Regional anesthesia provides targeted analgesia, reduces opioid exposure, and enables ambulatory surgery. Modern ultrasound guidance has dramatically improved efficacy and safety, but LAST and nerve injury remain ever-present concerns.
LASTCommon upper extremity blocksCommon lower extremity blocks
Critical Care Medicine
Resuscitation, ventilation, and multi-organ support.
Anesthesiologists practicing critical care manage the sickest patients — septic shock, ARDS, multi-organ failure, post-cardiac arrest. Familiarity with ventilator modes, vasoactive choices, hemodynamic targets, and end-of-life conversations is essential.
Sepsis bundleARDS ventilationShock classification
Pain Medicine
Acute, chronic, cancer, and interventional.
Pain medicine spans acute postoperative pain management, chronic pain syndromes, cancer pain, and interventional procedures (epidural steroid injections, facet blocks, spinal cord stimulators). Multimodal, opioid-sparing approaches dominate modern practice.
Multimodal analgesiaAcute on chronicCommon chronic syndromes
Ambulatory Anesthesia
Fast, safe, same-day discharge.
Ambulatory anesthesia prioritizes rapid emergence, minimal PONV, effective analgesia, and quick discharge readiness. Patient selection, multimodal opioid-sparing analgesia, and PONV prophylaxis are the pillars.
Patient selectionDrug selectionPONV prophylaxis
Trauma Anesthesia
Hemorrhage control, damage control resuscitation.
Trauma anesthesia demands rapid assessment, parallel processing, and damage-control resuscitation. Permissive hypotension, balanced transfusion (1:1:1), early TXA, and avoiding the lethal triad (acidosis, hypothermia, coagulopathy) save lives.
Massive transfusion protocolDamage-control resuscitationHypothermia
Transplant Anesthesia
Complex physiology, complex coordination.
Solid-organ transplant anesthesia (liver, kidney, lung, heart) is a niche of high acuity and prolonged cases. Liver transplant in particular tests every domain — massive transfusion, coagulopathy, hemodynamic upheaval during reperfusion.
Liver transplant — phasesReperfusion managementKidney transplant