In Ontario, the following health-care professionals are qualified to administer anesthesia:

· The Anesthesiologist: In Ontario, an anesthesiologist—a medical doctor who has specialized in the field of anesthesiology, making them the expert in anesthesia—is present in the operating rooms for all major and most minor surgeries. Additionally, anesthesiologists regularly provide anesthetics to patients outside the OR including to labouring women (epidurals), and patients in critical care and the ER. In some countries, such as the UK, the term “anesthesiologist” is interchangeable with the term “anesthetist,” however the latter term is not commonly used in Canada. Learn more about anesthesiologists in Ontario here.
· The Family Practice Anesthetist (FP-A): Family physicians who have received one additional year of anesthesia education after their family practice training are known as FP-As. This extra year trains them to manage routine surgeries and procedures, including administering epidurals for routine pain relief during labour and providing anesthesia for such common procedures as caesarean sections, the removal of appendixes and gallbladders and joint replacement surgeries. FP-As are more commonly found in rural parts of the province.
· The Certified Clinical Anesthesia Assistant (CCAA): In Ontario, your anesthesia care may include a CCAA. All CCAAs work under the direct supervision of an anesthesiologist, as part of what in Ontario is called the ACT model (scroll down to learn more about that). In Canada, CCAAs are either registered respiratory therapists or registered nurses who have received additional specialised training and are regulated through the Canadian Society of Respiratory Therapists.
· Other Qualified Physicians: Depending on your situation, another type of physician may administer your anesthetic. For example, for certain minor procedures that require only light sedation, such as colonoscopy or treatment of a dislocated shoulder, an emergency physician or family physician may provide the appropriate numbing and/or sedating medications so that you may undergo the procedure comfortably.

There are three main types of anesthesia:

1. General Anesthesia: When people talk about “being put to sleep” or “put under,” they are usually referring to general anesthesia. It involves using multiple intravenous medications and sometimes anesthetic gases to render the patient deeply unconscious, preventing them from feeling or being aware of their surgery. General anesthesia also requires intubation, or a special breathing tube, which allows the anesthesiologist to take over and control the patient’s breathing during surgery.

2. Regional Anesthesia: Under regional anesthesia, a specific part of the body is deeply anesthetized using medication. This is usually done by using a “nerve block,” which “freezes” the nerves that send signals to and from that part of the body. Spinal anesthetics and epidural anesthetics are two examples of regional anesthesia. Patients undergoing regional anesthesia may be conscious but are usually given sedatives to decrease anxiety, which often results in the patient going to sleep while breathing on their own. Additional painkillers may be given to the patient to supplement the freezing.

3. Local Anesthesia: Anesthetic drugs are injected into a specific spot in the body to numb the surrounding area. The freezing you receive at the dentist’s office when you are having a cavity filled is an example of local anesthesia.

Exactly what type of anesthesia you will receive will depend on your procedure, the current state of your health and other key details. A member of your health-care team will explain to you what to expect and will answer any questions you have.

Fasting before anesthesia can be a challenge but it’s an important step to keep you safe. We require that you avoid food and liquids before your surgery to allow your stomach to completely empty itself before your procedure. When you are under anesthesia, your reflexes, including those connected to your stomach, relax, which can put you at risk of choking or aspirating on undigested food or stomach acids.

Your surgical team will provide you with the exact details of when you need to start fasting. Please don’t hesitate to ask questions.

Under the Anesthesia Care Team (ACT) model, Certified Clinical Anesthesia Assistants (CCAAs), more commonly referred to as anesthesia assistants (AAs), work under the direction, delegation and supervision of an anesthesiologist or family practice anesthetist. The anesthesiologist creates the anesthesia plan for the patient and the CCAA assists in implementing it.

The ACT model has been used in Ontario since 2007 for thousands of surgeries. It is an efficient way to optimize patient care and deliver high-quality services to patients. In Ontario, the ACT model is used for a wide variety of procedures including eye-related surgeries, hip and knee replacements, Caesarean sections and more. Indeed, most surgical procedures would benefit from the skills a CCAA brings.

For example, CCAAs can prepare anesthesia machines and drugs, assist with transferring and monitoring patients to/in post-surgical care and facilitate short breaks for anesthesiologists during longer cases. CCAAs are especially useful during critical moments or emergencies when extra hands and expertise are required to help navigate and resolve the situation. During those times, having a CCAA in the operating room may prevent the need to call in a second anesthesiologist, which can result in delays in other surgeries.

In short, employing CCAAs and the ACT model creates more anesthesia capacity, which given Ontario’s significant surgical backlog, is incredibly important. Ontario’s Anesthesiologists encourages the government of Ontario to expand the ACT model and help more patients get the care they need.

Ontario’s health-care sector is facing many challenges related to human resources and the field of anesthesiology is no exception. However, the situation is more complex than simply needing more anesthesiologists. Learn more about it here.