The word anaesthesia is derived from the Greek language, meaning "without sensation". Modern anaesthesia is safe. In countries that have extensive anaesthetic resources, the risk of dying is one in 100,000 to 500,000. The risk of death has decreased to one-tenth of what it was thirty years ago. Safety has improved with better knowledge of pharmacology and physiology, and advances in drugs, investigations, monitoring and education. The complexity and expense of providing anaesthesia has escalated.

When resources (personnel, equipment, drugs and funding) are limited, an anaesthetist with good clinical skills and a thorough knowledge of physiology, pharmacology, equipment and how disease will affect the patient, can provide safe and effective anaesthesia.

All anaesthetists must pay careful attention to detail. There must be thorough preoperative assessment and planning for anaesthesia. The anaesthetist should anticipate problems and have a secondary anaesthetic plan to deal with these problems. They must also be well trained in treating unanticipated emergencies.

Good clinical skills of history taking and examination can approximate the accuracy of complex investigations. There are simple "bedside tests" of respiratory and cardiovascular function that can predict intraoperative problems and post operative recovery.

All appropriate anaesthetic monitoring should be used when available. Increasing complexity of monitoring can improve patient safety but continuous close observation of the patient and basic monitoring will provide a safe anaesthetic and detect adverse events.

With advances in drugs and equipment the intricacy of delivering anaesthesia has increased, but when resources are limited an anaesthetist who is thoroughly familiar with an appropriate anaesthetic technique can provide a safe and effective anaesthetic service.

This site aims to provide clinical guidance for anaesthetic trainees and anaesthetists who are providing anaesthesia with limited resources. We also hope to offer a forum for discussion.

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