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Pain-free surgery: New equipment helps CRNA do job

Staff reporter

It's not as easy as it looks.

Education and specialized training are required to find the perfect balance of anesthesia, and to monitor vital signs during surgeries.

Bruce Skiles has been a Certified Registered Nurse Anesthetist at St. Luke Hospital, Marion, for the past 13 years.

He has assisted with thousands of surgeries and procedures since he completed schooling in 1980 to become an anesthetist.

Skiles first received training as a registered nurse. After completion of education and training as a anesthetist, he worked 10 years at St. Joseph Hospital of Wichita.

He returned to school and earned a doctorate of chiropracty.

Being in a smaller community, the two professions have worked out well.

"It makes a good mix," Skiles said.

Anesthetists can be two types of professionals.

"Some anesthetists are medical doctors and some are registered nurses," Skiles explained.

Rural health care providers typically are CNRAs, said Skiles.

Skiles is pleased to be at St. Luke Hospital and is excited about a new anesthesia machine recently purchased by Marion County Hospital District #1.

"This is a state-of-the-art machine," Skiles said, with updated electronics to provide more accurate readings.

"The ventilator setup is more precise," said Skiles.

The old machine was good, he continued, but couldn't be repaired because of its age.

The cost of the equipment was approximately $60,000.

One piece of equipment that was taken from the old and installed on the new is a monitor that provides readings of patients' brain activity.

Brain wave monitoring keeps the CRNA aware of the patient's comfort level.

The reading goes from 1 to 100 — with the highest reading indicating the patient is awake.

When a patient is prepared for surgery, monitoring devices are connected to the patient.

Blood pressure, oxygen intake and output, heart rhythm, and brain wave activity are monitored.

"Many people think we just give a person Sodium Pentothal to put them to sleep and that's it," Skiles said.

Sodium Pentothal, a trademark for sodium thiopental, is a short-acting barbiturate used during general anesthetic.

"All it does is put a patient to sleep," Skiles said. "Narcotics and muscle relaxants also are used for pain and to keep the patient still."

During surgery, the CRNA monitors the patient to keep him/her comfortable, and dispenses doses of drugs to adjust vital signs — raise or lower blood pressure and speed up or slow down heart rate.

When surgery is finished, a drug is administered to reverse the muscle relaxant so the patient can breath and move on his/her own.

The CRNA accompanies the patient to recovery to make sure the comfort level is maintained.

Skiles plans to become more educated with chronic pain management, which is a natural fit for CRNAs.

"In the future, that's going to be the next 'big' profession," he said.

For now, he will continue to serve patients at St. Luke Hospital and is grateful for modern equipment.

"I appreciate how the hospital district is committed to providing new equipment for its patients," Skiles said, "and the best for our community."

Skiles and wife Belinda reside in rural Marion and have two adult children.

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