We provide anesthesia for all types of general surgery cases including laparoscopic cholecystectomy and hernia repairs. A significant number of our cases are of an outpatient nature. Therefore, our choice of anesthetic techniques and postoperative analgesics, provide our patients optimum patient comfort, with same day discharge . In addition, we aggressively attempt to prevent and treat post operative nausea and vomiting. Our nursing colleagues in the recovery room also rapidly address post operative nausea and vomiting, making same day discharge possible in almost all outpatients. We also provide anesthesia for more complex inpatient procedures such as exploratory laparotomy, colectomy, and Whipple procedures, often necessitating additional monitors such as arterial and central venous catheter placement. In addition, if requested by your surgeon, we are able to place epidural catheters for your postoperative pain management.
Located at BMC Jacksonville (downtown) at the Baptist Neuroscience Center in the new Weaver Tower, our Neuroanesthesia coverage consists of anesthesia for both spinal and intracranial procedures including neuro-oncology and Neuroendovascular. We work closely with highly trained Lyerly Neurosurgeons and appropriately monitor our patients during these complex surgical procedures. We also provide arterial and central venous cannulation and monitoring for these surgeries when needed. In addition, pain relief and prevention of nausea and vomiting is a high priority in these patients. Sometimes our surgeons perform often complex and lengthy spinal fusion procedures in the prone (face down) position entailing their own additional risks. These risks, although rare, can be quite serious and require special considerations in anesthetic technique to minimize their occurrence.
Our anesthesiologists also provide all anesthesia services, including 24/7 call coverage, for the Baptist Stroke and Cerebrovascular Center at BMC Jacksonville. We work closely with Lyerly Cerebrovascular Surgeons who provide advanced diagnoses and treatments for all types of cerebrovascular disorders from stroke and brain aneurysms to arteriovenous malformations.
Cardiothoracic and Vascular Surgery
Our team of Cardiac Anesthesiologists provide anesthesia for all open heart procedures at the Baptist Heart Hospital, located at Baptist Downtown, such as coronary artery bypass and valvular repairs done most often under cardiopulmonary bypass (using the heart-lung machine). Our surgeons also perform minimally invasive valve repairs, TAVRs (Transcatheter Aortic Valve Replacements), and also utilize the Da Vinci robot for minimally invasive thoracic procedures. In addition, our expertise in intraoperative transesophageal echocardiography (including 3D TEE) helps guide our surgical colleagues in their clinical decision making, and with valvular repairs and replacements allows us evaluate the function of the new valve prior to leaving the operating room. In addition to routine monitoring, we place arterial catheters and Swan-Ganz Cardiac catheters for intensive monitoring of your cardiovascular system during these complex open heart procedures. We also provide anesthesia for all vascular cases such as aortic aneurysm repair (open and endovascular) and carotid endarterectomy. Examples of thoracic cases done include open thoracotomy with lung resections and VATS (video assisted with smaller incisions) procedures. In addition, if requested by your surgeon, we are able to place epidural catheters for your postoperative pain management in these thoracic cases.
At both Baptist Jacksonville and South, our busy orthopedic anesthesia practice includes both general anesthesia, regional anesthetic techniques including neuraxial (spinal and epidural anesthesia) and peripheral nerve blocks (including interscalene, supaclavicular, axillary, fascia iliaca, adductor canal and popliteal nerve blockade) for postoperative pain management. If a block is requested by your surgeon, we will utilize the latest technology including ultrasonography and nerve stimulation to ensure that your block is safely and efficiently placed. Peripheral nerve blocks provide superior postoperative pain control, allowing lower doses of narcotic medication, with less side effects. Nerve blocks are useful for both inpatient procedures such as total knee replacements and outpatient procedures such as rotator cuff repairs of the shoulder. If requested by your surgeon, we are also able to place peripheral catheters for continuous peripheral nerve blockade.
Some of our orthopedic surgeons also specialize in spine surgery from outpatient minimally invasive discectomy to complex fusion surgery. These cases are done under general anesthesia and the lengthy fusion surgeries may necessitate the placement of additional monitors such as arterial and central venous catheters to more closely monitor your cardiovascular system. There are specific risks related to your prone (face down) position for lengthy spinal fusion procedures, which although rare, can be quite serious and require special considerations in anesthetic technique to minimize their occurrence.
Highly skilled ENT surgeons operate at both Baptist South and Baptist Pavillion Outpatient Center, Downtown, performing largely outpatient procedures such as tonsillectomy and endoscopic sinus surgery. We provide our patients with appropriate analgesics (pain medication) and antiemetics (anti nausea medications) making it possible for most patients to return home on the day of surgery. In addition, we also provide anesthesia for more complex inpatient procedures such as tracheostomy and radical neck dissection for cancer often requiring more specialized anesthetic techniques.
Anesthesia for urologic cases includes routine cystoscopy to radical prostatectomy both with and without the Da Vinci Robotic system at both Baptist downtown and Baptist South. The use of this specialized robot entails placing you in a steep trendelenberg (head down) position for your robotic surgery. There are additional position related risks associated with this position, and whilst rare, can be quite serious and require special considerations in anesthetic technique to minimize their occurrence. In addition we provide general, regional and IV general anesthesia for all other urologic procedures from nephrectomy to ureterocystoscopy.
Highly trained plastic surgeons operate at both Baptist Downtown and Baptist South and mainly perform breast reconstructive procedures. These predominantly include breast reconstructive surgery following mastectomy for breast cancer including complex flap reconstructive procedures requiring vascular anastomosis (stitching minute blood vessels together) such as the DIEP procedure. For these complex lengthy procedures, sometimes taking 10-12 hours, your anesthesiologist may place arterial and central venous catheters to provide more intense monitoring.
We provide anesthesia for our surgical colleagues at the Baptist Bariatric Center, Baptist Downtown. These cases are often more complex than other general surgical cases and pose a higher risk of postoperative complications. Patients having these procedures are morbidly obese and have additional risks associated with this condition. They may have a "difficult airway" or in layman's terms the anesthesiologist may have difficulty in providing oxygen and/or placing your breathing tube into your trachea (windpipe). At Baptist, we take difficult intubation seriously and routinely use advanced fiber optic equipment, allowing us to quickly and safely place your endotracheal tube (breathing tube) into your trachea after you are asleep. On the rare occasion, your anesthesiologist may deem that your airway warrants an "awake intubation" where the tube is placed with you sedated but not completely asleep. Most patients do not remember this and we reiterate that this awake intubation, when occasionally done, is done for your own safety and will be performed as comfortably as possible.
Our busy Obstetric services at both Baptist Downtown labor and delivery (L & D) and at Baptist South LDRP include providing Epidural analgesia for labor, as well as spinal and epidural (regional) anesthesia for both elective and emergency Caesarian sections (c-section), including high risk deliveries. On the rare occasion we do have to administer general anesthesia for c-sections, but most often our safer regional anesthesia techniques allow our patients to be pain free and awake for the birth of their children. In addition, regional techniques will also allow your partner to be with you in the operating room for your c-section.
We use an anesthesia care team model on L & D and work closely with a CRNA (Certified Registered Nurse Anesthetist) who helps to provide care under the close medical direction of an Anesthesiologist. This gives us more flexibility in our Obstetric service minimizing wait times for your labor epidural. At Baptist, although our highly qualified CRNAs assist in managing your epidural, the actual placement of your labor epidural catheter will always be performed by one of our experienced board certified Anesthesiologists.
Gynecology, Gynecological Oncology, and Urogynecology
We provide anesthesia for a large number of our gynecology, gynecological oncology and urogynecology colleagues who perform open, laparoscopic, and laparoscopic robotic procedures (Robotic procedures are performed by gynecologists at both Baptist Downtown and at Baptist South using the latest Da Vinci Surgical Robotic System). These patients mainly have general anesthesia or IV general anesthesia for shorter procedures such as hysteroscopy. Because gynecologic procedures are more likely to cause nausea and vomiting, we aggressively try and prevent postoperative nausea in addition to providing adequate pain relief prior to leaving the operating room.
Oral and Maxillofacial Surgery
We provide anesthesia for all oral surgery procedures from teeth extractions to complex maxillofacial reconstructive procedures. These case are almost performed under general anesthesia. Occasionally arterial and/or central venous monitoring may be indicated.
Our ophthalmology procedures are performed at the Baptist Eye Institute, part of the Baptist Outpatient Center. Anesthesia for these procedures is mainly MAC sedation and local anesthesia for routine cataract surgery or TIVA (IV general or deep sedation) and eye blocks for more complex and lengthy retinal surgery. On the rare occasion, general anesthesia may be required. The benefit of performing these cases under light sedation or IV general is that these anesthetic techniques allow rapid awakening, and rarely cause nausea and vomiting. In addition, these techniques avoid the need to administer stronger analgesics (pain killers) such as opiates (drugs such as morphine which can cause sleepiness and nausea), allowing patients to be quickly and comfortably discharged home.
Cardiology-diagnostic, interventional and electrophysiology/ Structural Heart
We administer mainly general anesthesia for cardiac electrophysiology (EP) procedures such as EP Ablations on a daily basis working with our colleagues from Baptist Heart Specialists. In addition to routine monitoring we often place arterial catheters for these complex ablation procedures. Even though this procedure is performed through the groin, rare complications such as damage to the heart can occur rapidly, with the resultant blood around the heart causing compression of the heart and cardiac arrest. Your anesthesiologist will be carefully monitoring you throughout the procedure and will be prepared to rapidly begin resuscitation should the need arise. In addition we also provide IV general anesthesia for diagnostic cardiac procedures such as TEE (Transesophageal Echocardiography). This allows rapid sedation, wake up, and discharge from the unit. Our cardiac anesthesiologists also provide anesthesia for our Structural Heart Program including TAVR, Watchman and Mitraclip procedures.
Our gastroenterology procedures are performed at the Center for Endoscopy, Baptist Downtown and in the Endoscopy Suite, Baptist South. Anesthesia for these procedures, which include upper endoscopy, colonoscopy, as well more complex procedures such as endoscopic ultrasound, and ERCP, are mainly performed under IV general anesthesia with the drug Propofol. This allows patients to be rapidly sedated, awakened, and discharged. In addition, patients rarely experience nausea from this anesthetic technique. Occasionally for ERCP, or upper double balloon enteroscopy procedures, general anesthesia will be required.
We also provide general anesthesia for complex bronchoscopy procedures for our pulmonology colleagues, when needed, in the endoscopy lab.
We work with our psychiatry colleagues at Baptist Downtown to provide anesthesia for ECT (Electro Convulsive Therapy) in our downtown Recovery Room. Patients are given and IV general anesthetic with a sedative hypnotic medication and a small dose of paralytic agent in order to provide amnesia and muscle relaxation, obtunding the effects of the induced seizure activity.
We provide general and IV general anesthesia for both diagnostic (ex. MRI) and interventional radiology procedures which take place in the Radiology department. Radiation therapy procedures are also performed under either general or IV general anesthesia and take place at the Baptist Cancer Center (part of the new Baptist Outpatient Center).