Scars That Mark More Than Just the Skin

A scar always tells a story: a fall, a surgical procedure, a burn, or a skin disease. It is estimated that over 30% of the population has some visible scar, and although effective treatments exist today to improve their appearance, complete removal is not always possible.

Beyond the Skin

However, when we talk about scars, we cannot limit ourselves to the physical aspect. The skin is our calling card, and when a mark is visible, it can deeply affect self-esteem and self-confidence. In fact, numerous studies on patients with burns or acne show that those with scars in exposed areas often experience shame, insecurity, social isolation, difficulties in intimate relationships, and even depression due to challenges in social interactions.

A particularly significant example is hidradenitis suppurativa, a chronic inflammatory disease that causes painful outbreaks of abscesses and extensive scarring in the armpits, groin, or other intimate areas. Beyond the physical pain, patients often carry the emotional burden of permanent marks, which act as a constant reminder of the disease and, in many cases, affect their emotional life, generating anxiety, depression, or feelings of stigmatization that profoundly impact their quality of life.

Current Treatment Options

Today, there are multiple therapeutic options to treat scars, with two main objectives: improving their appearance and restoring skin function. The most notable include:

Since there is no single definitive treatment for every scar, the most effective approach usually combines several of these therapies, tailored to the patient’s skin characteristics and needs.

Tattooing: A New Therapeutic Option

There is an alternative therapy that has gained prominence over the years and is now a complementary tool in the comprehensive approach to scars: therapeutic or paramedical tattooing.

It has long been recognized for its fundamental role in aesthetic reconstruction after oncological surgeries, such as breast cancer, where the areola and nipple can be redrawn in 3D with highly realistic results.


It is also used to restore color and uniformity to skin affected by stretch marks or scars, camouflaging them with pigments that match the natural skin tone (cloaking), or even transforming the scar into an artistic design, integrating the mark into the tattoo and making it visually imperceptible.

Although this procedure does not cure the scar, it helps restore body appearance, improving self-esteem and supporting emotional recovery.

A Comprehensive Approach

When we talk about scars, focusing on the skin alone is not enough. It is essential to understand that each scar carries a personal experience and an emotional impact. Therefore, treatment should be comprehensive: combining the most suitable medical and/or aesthetic options with psychological support to help patients regain not only their appearance but also their confidence and overall emotional well-being.

CAN TIME HEAL WOUNDS?

The human mind remains one of the greatest mysteries for scientists. Although we are beginning to understand many aspects of its functioning, concepts such as consciousness or its effects on our health are still far from being fully understood.

An innovative study conducted by psychologists at Harvard University revealed that the way we perceive the passage of time can directly affect the speed of healing of our physical wounds. This finding, published in Nature Scientific Reports, challenges traditional notions about the mind-body connection.

The Experiment


In the study, minor wounds were inflicted on a group of healthy volunteers, and their perception of time was manipulated using modified clocks. Participants were divided into three groups: one that perceived time as slower, another that perceived it as normal, and a third that perceived it as faster. Surprisingly, the results showed that those with a faster perception of time experienced significantly faster healing compared to those who perceived time as slower, even though the actual time elapsed was the same in all cases. Thus, physical healing was directly influenced by each subject's psychological experience of time, regardless of the real elapsed time.

Implications for Medicine


Although the influence of the mind on health is usually framed within the field of emotions—such as the effect stress has on inflammation and immune function, how chronic pain affects mental health, or the placebo effect of certain medications—this finding underscores the connection between mind and body, suggesting that our subjective perception of time can influence physiological processes such as wound healing. Researchers believe these findings open the door to new studies that consider how psychological factors (or abstract elements like time) directly affect physical health.

Tattooing and Anesthesia


Research like this, on wound healing, is particularly relevant in the context of tattooing, where there is skin injury followed by a repair process—the so-called tattoo healing process, which occurs in multiple phases.

At Sedalux, where we have extensive experience in tattoo anesthesia, we have observed that all our projects show an accelerated healing process, with scab formation occurring around day 4, peeling completed before day 10, and full healing not exceeding 2 weeks. These times—significantly shorter than expected for a traditional tattoo—are likely linked to all the therapeutic maneuvers and pain prevention and control strategies (Preemptive & Preventive Analgesia) that we apply in a protocolized manner during the pre-procedure phase, which help us:

  1. reduce skin damage or injury (allowing it to respond better to tattooing), and
  2. prevent peripheral sensitization.

But if Harvard researchers believe that the perception of time influences wound healing speed, what if tattoo sedation itself, which alters the state of consciousness and modifies our perception of the passage of time, is an additional factor responsible for the beneficial accelerated healing process experienced by all our patients?

New lines of research into the mind-body connection are opening up before our eyes.

HOW DOES TATTOO PAIN FEEL LIKE?

Pain is an inseparable part of getting a tattoo. The art of embedding designs into human skin through repeated needle punctures that deposit pigments beneath the epidermis causes continuous stimulation of the pain receptors (nociceptors) located in the superficial dermis. As a result, this process triggers painful sensations whose intensity each person may tolerate differently.

The intensity of pain is influenced by a wide variety of factors: biological (age, sex, illness, fatigue, sleep issues…), psychological (mood, expectations, coping strategies, attention…), and social (beliefs, environment, culture…). These factors interact and shape how someone perceives and experiences pain. For instance, a person suffering from depression might be more sensitive to pain and have a harder time coping with it, leading to a higher perceived intensity.

The problem with tattoo-related pain is that many people try to minimize it through unsafe and unproven means, often following advice from sources with questionable scientific backing. Some turn to unregulated products or "alternative therapies", non-approved drugs, psychiatric medications obtained from friends or family, or even narcotics or psychoactive substances—anything to deliberately alter their mental state and reduce pain perception. These attempts often fail to provide a truly effective and safe solution and carry underestimated health risks.

Tattoo anesthesia was born as a professional response to this growing demand, aiming to provide a safe and effective solution. Not only does it eliminate pain, turning the experience into something more enjoyable, but the benefits go much further: it also helps reduce burning, swelling, and oozing at the end of the session and improves skin recovery, preventing complications. Additionally, it optimizes time by reducing the need for multiple sessions and enhances the tattoo’s quality, as the artist can work more quickly, precisely, and efficiently—benefiting both the artist and the client.

It is the perfect alternative for those who have suffered in previous experiences, have unfinished tattoos, or want to tackle highly sensitive areas such as the neck, chest, ribs, or abdomen. It is also ideal for people with limited time who want to complete a large project as quickly as possible.

Peace of mind before the session, the absence of pain during the tattoo, and improved healing afterward make choosing the anesthetic services of Sedalux—Spain’s pioneering company in tattoo anesthesia—a guarantee for enjoying a tattoo without fear of pain. With this innovative solution, artistic expression merges with comfort, allowing everyone to enjoy a masterpiece without facing a painful experience.

TATTOOS WITH GENERAL ANESTHESIA: OUR COLLABORATION ON JORDI WILD’S TATTOO

Impressive. That’s how we could describe the tattoo that successful YouTuber and podcaster Jordi Wild has been proudly wearing on his back since January. Behind this meaningful masterpiece, two teams of professionals combined their expertise in their respective fields to create a collaboration that’s revolutionizing the tattoo industry: tattoo anesthesia.

To complete this piece in a single session, the Murcian artist Joaquín Ganga, supported by his team, partnered with the medical team of anesthesiologists from Sedalux. Their intervention made it possible to carry out the process comfortably and safely, over eight uninterrupted hours.

This story, which was picked up by media outlets like RTVE’s L’Altaveu or EuropaSur, has reignited the debate over whether pain should be an inherent part of getting a tattoo. While some believe that suffering adds emotional value to the final result, others emphasize the advantages of using anesthesia—not only reducing discomfort such as inflammation and burning, but also allowing the design to be completed in fewer sessions.

What is tattoo anesthesia, and how was it used in Jordi Wild’s tattoo?


Tattoo anesthesia is the method that allows you to enjoy a pain-free experience while multiple artists work on your tattoo simultaneously. This service can only be performed by a licensed anesthesiologist experienced in tattoo anesthesia, who tailors the anesthetic technique to the patient’s conditions and the complexity of the tattoo.

They may use any anesthetic technique, alone or in combination, but the goal is to numb the skin and apply a sedation that provides immobility and comfort, without needing general anesthesia—as in Jordi Wild’s case, where the tattoo covered a very large area and was an ambitious, symbolic project.

Jordi Wild’s experience with tattoo anesthesia


"You fall asleep, several tattoo artists do all the work, and when you wake up, it’s done," confessed the YouTuber.

Jordi Wild spent 8 hours completely unaware of the work being done. Several artists worked at the same time with no limitations: relaxed muscles, no involuntary movements in the tattoo area, and total comfort throughout the creative process. All of this made it possible to complete a piece of such magnitude—which would normally require several sessions—in a single, uninterrupted session.

Some argue that pain is an essential part of the experience. Others, like Jordi Wild, admit: “A back like mine, filled the way I wanted, would take six, seven, eight, nine sessions. That means nine full days with their respective recoveries, and honestly, I don’t have that kind of time and it’s a complete and total pain in the ass.”

Sedalux: pioneers of tattoo anesthesia in Spain

Sedalux is not just another brand. It’s a Valencia-based company specializing in anesthetic services that has reimagined the uses and benefits of anesthesia—leading the revolution in pain-free experiences with its pioneering outpatient anesthesia service, redefining what’s possible.

What began as a dream to change the world over drinks on a Valencia terrace has become a true benchmark for those looking to transform procedures once associated with discomfort or suffering.

Their pioneering approach has earned national media recognition, including a feature on Onda Cero that highlighted their revolutionary role in the pain-free tattoo sector. This innovation has not only caught the attention of the media, but also the trust of renowned artists.

In this regard, Joaquín Ganga—one of the world’s most acclaimed tattoo artists and a key figure in spreading the Painless Tattoo concept in the U.S.—didn’t hesitate to trust Sedalux’s team to tattoo one of the most prominent Spanish-speaking content creators.

WHICH AREAS OF THE BODY CAN I GET TATTOOED WITH ANESTHESIA?

The pain of getting a tattoo isn't the same across the entire body. There are areas with more nerve endings or less subcutaneous fat that are particularly sensitive. The ribs, neck, inner arm, wrists, or ankles tend to be areas where pain intensifies. Places like the armpits, chest, face, fingers, or genital area are especially hard to endure. On the other hand, areas like the thighs, glutes, or outer arm tend to be more tolerable for most people.

Any part of the body can be tattooed with anesthesia, but people generally use it to better tolerate those more sensitive areas or to withstand longer sessions.

In recent years, its use has increased because the tattoo world has become more professional, and the work is now more complex and demanding. We've moved from tattooing a tribal or an anchor to creating full-limb projects with true works of art full of detail and ink. As a result, longer sessions have also become more exhausting. In fact, thanks to professional tattoo anesthesia services like Sedalux, unimaginable pieces of 7 to 10 sessions are now being completed in just 8 hours—completely pain-free.

Where can I get tattooed with general anesthesia?


If you're looking to get tattooed with "professional tattoo anesthesia", we recommend that you don't trust just anyone and that you do thorough research beforehand. Ask several providers, verify their credentials, and only take advice from certified medical professionals. Because having a “professional anesthetist with over 20 years of experience” is not enough—they must be a licensed anesthesiologist with extensive experience in tattoo-specific anesthesia who can tailor their anesthetic technique to the patient's condition, the type of tattoo, and the body area.

Recommended areas for tattoos with anesthesia

Chest tattoos with anesthesia

The chest is one of the most delicate areas to tattoo, especially near the sternum and collarbones, where the skin is close to the bone and highly sensitive. That's why using anesthesia can make a huge difference, especially for large or detailed projects requiring multiple hours or sessions. Topical anesthesia may help for smaller areas, but for longer sessions and sensitive areas of the chest, local or professional anesthesia is the safest and most effective way to ensure you’re comfortable and pain-free during the process.

Back tattoos with anesthesia

 The back is a large canvas with areas that vary in sensitivity. The regions near the spine, ribs, or shoulder blades tend to be quite painful, while the lower back, which has more muscle and fat, is easier to tolerate. For large tattoos, like full-back pieces or murals, professional anesthesia is highly recommended to avoid fatigue and intense pain during long sessions.

Full-arm tattoos (sleeves) with anesthesia

Sleeves are ambitious projects that can last many hours and often require multiple sessions. The arm has areas with varying pain levels: the outer side is more tolerable, but the inner side—especially near the elbow and armpit—is very sensitive. Local or professional anesthesia is ideal for these long sessions, as it allows pain to be controlled across the entire arm and helps the artist work without compromising quality.

Full-leg tattoos with anesthesia

 Just like arms, full-leg tattoos are major projects requiring many hours of work. Pain levels vary: the front of the thigh and calf are more tolerable, but the inner thigh, knee, or ankle are quite painful. For long sessions or highly detailed tattoos in these areas, professional anesthesia ensures you can handle the process without pain.

Does anesthesia affect tattoo quality?


Depending on the type of anesthesia used, the quality of the tattoo can be affected. This is especially true with topical anesthetic creams—once absorbed, they can harden the skin’s surface or make it slippery if overapplied. This can compromise line precision, make ink injection more difficult, force the tattoo artist to apply more pressure, and ultimately increase work time or affect the final quality of the tattoo.

With local anesthesia, similar issues might occur, especially if it’s administered by unqualified personnel, and it's not without the risk of serious complications.

With general anesthesia or "professional tattoo anesthesia", this never happens. The drugs used to ensure a pain-free experience are not applied directly to the skin, which means everyone benefits: the tattoo artist gets a perfectly prepared canvas to work on, and the client feels no pain during the session. Additionally, the expert anesthesiologist will apply specific treatments to eliminate burning, swelling, and oozing at the end of the session—facilitating skin recovery, avoiding complications, and improving overall healing results.

WHAT TYPE OF ANESTHESIA CAN BE USED FOR A TATTOO?

When it comes to tattoo anesthesia, broadly speaking, there are 3 types of anesthesia that can be used to numb the skin and allow for pain-free tattooing: topical anesthesia, local (or infiltrative) anesthesia, and general anesthesia.

Is it possible to get a tattoo with anesthesia?

Yes, it is possible to get a tattoo with anesthesia, but not just any way or with any product. There are different anesthetic options — topical, local, or even professional tattoo anesthesia — that can reduce or eliminate pain during a session. However, not all are equally safe or suitable for every case, and their application must follow specific medical guidelines.

Types of anesthesia for tattoos

Topical anesthetic creams

Topical anesthesia is generally applied in the form of anesthetic creams to the area of skin to be tattooed before starting to inject ink. It helps numb or slightly desensitize the skin and reduce the intensity of pain for a certain period of time.

The duration of this anesthesia will depend on the type of cream and the amount applied, but generally speaking, its peak effect lasts around 45 minutes; after that, the area begins to regain sensation and the pain gradually increases.

These creams contain varying concentrations of local anesthetics such as lidocaine, prilocaine, or benzocaine and, like any medication, are not free of side effects or adverse reactions due to improper application, misuse, or local allergic reactions. They can also alter the skin’s texture, potentially affecting the final result of the tattoo — which is why many tattoo artists are reluctant to use them.

This type of anesthesia is ideal for relatively small tattoos and less sensitive areas of the body.

Local anesthesia for tattoos

Local anesthesia is administered via small subcutaneous injections (under the skin) of local anesthetics such as lidocaine in the area to be tattooed.

This is a much more powerful and effective option than topical anesthesia but also considerably more painful (due to repeated injections) and riskier. Great care must be taken with this type of anesthesia: knowing where to inject and controlling the total dose administered is crucial because its use is not free of serious complications. That’s why tattoo artists can never use this method (despite what some websites claim); it must be applied by licensed medical professionals who have the appropriate training and legal authorization to administer these medications safely.

This type of anesthesia is suitable for small tattoos in sensitive areas of the body, provided they don’t exceed the size of the palm of your hand and require longer sessions due to detail.

General anesthesia for tattoos

People often mistakenly refer to general anesthesia for tattoos when they should be talking about professional tattoo anesthesia. This type of anesthesia can only be administered by a professional anesthesiologist, who will tailor the anesthetic technique to the patient's condition and the tattoo project. Any anesthetic technique may be used, but the goal is to desensitize the skin and combine it with sedation to ensure immobility and comfort. General anesthesia can be considered, but it's typically excessive — like "using a cannon to kill a fly."

This type of anesthesia is ideal for large-scale projects, collaborations with multiple artists, and very sensitive or hard-to-reach areas that typically involve long sessions.

Does a tattoo hurt after the anesthesia wears off?

Depending on the type of anesthesia used, your tattoo may or may not hurt afterward. If topical or local anesthesia is used, it’s very likely that once the effect wears off, your skin will awaken with strong pain or a burning sensation. On the other hand, with professional tattoo anesthesia, there is no pain after tattooing. Why? Because in this case, your anesthesiologist will also treat the skin to eliminate inflammation, burning, and oozing. So, by the end of the session, the tattooed area is dry, nearly inflammation-free, and pain-free.

What’s the best option for a pain-free tattoo?

If you're considering getting a tattoo with anesthesia, have doubts, and want more information... your tattoo studio can inform you about inks, styles, and processing times, but any information related to anesthesia is likely to be inaccurate. We recommend that you only take advice from medical experts on this matter. In this case, at Sedalux — a benchmark in anesthetic services and a pioneer in the tattoo world — they can explain how the process works and what recommendations you should follow.

BULLYING: AN INVISIBLE PAIN THAT CAN SHAPE YOUR FUTURE

Every May 2nd marks World Anti-Bullying Day, a date that invites us to reflect on one of the most persistent issues in schools around the world. Bullying is a phenomenon that not only affects victims in the present but can have profound long-term consequences on their emotional and physical well-being. Especially in teenagers, whose minds and bodies are still developing, and where the impact of bullying goes far beyond short-term humiliation and psychological pain.

The teenage brain is in a critical stage of development. During adolescence, neural connections are being formed and reorganized — a process that is essential for emotional, cognitive, and social maturity. In this context, bullying can significantly disrupt this developmental phase.

The emotional pain caused by bullying — the result of constant exposure to psychological violence — can generate deep anguish with long-term psychological consequences. It can also lead to behavioral changes such as social isolation, eating disorders, or even substance abuse as a way to cope with suffering.

What many don’t realize is that the impact of bullying is not always confined to emotional damage. Multiple studies have shown that chronic stress caused by bullying can trigger physical disorders that affect teens throughout their lives. Prolonged stress constantly activates the body’s stress response system, which can disrupt hormonal balance, increase inflammation, and alter immune function. All of this creates the perfect breeding ground for the development of chronic diseases in adulthood.

One of the most common consequences of chronic stress is chronic physical pain — a condition that bullied adolescents may become more prone to in the future. Chronic pain can manifest in many forms, such as headaches, musculoskeletal disorders, gastrointestinal issues, and other conditions that often lack a clear physical cause.

Recent research suggests that a person’s emotions can influence their likelihood of developing chronic pain. Emotional distress and chronic emotional stress can affect both the perception of pain (intensifying it or altering its nature) and its duration, potentially prolonging suffering and hindering recovery.

At Sedalux, we want to raise awareness about pain and make it matter“MAKE PAIN VISIBLE AND MAKE PAIN MATTER.” The well-being of young people should never be taken lightly. It's crucial to understand that the pain experienced by bullied adolescents isn't always visible, but its long-term effects can be devastating. Parents, educators, and society as a whole must work together to create safe, inclusive, and respectful environments that prevent bullying and support those who have suffered it.

CAN YOU IMAGINE A WORLD WITHOUT ANESTHESIA?

Talking about ANESTHESIA is talking about PROGRESS.

Before, surgery was a terrifying last resort in a final attempt to save a life. Few procedures were possible. Superficial surgery, amputation, removal of fungus from cancers, and "cutting for the stone" (the extraction of bladder stones) were truly the only areas where surgeons could operate. The interior of the abdomen, chest, and skull were forbidden zones. Speed was the only factor determining a surgeon’s success. Most patients were restrained or tied down, some passed out from the agony, and many died on the table or immediately after the operation. The suffering was intense.
The introduction of anesthesia changed all of this. Today, it's hard to understand the importance of this breakthrough, but this is what allowed surgery to slow down, become more precise, and enter the “forbidden zones.”
Anesthesia revolutionized medicine, making safer and more humane interventions possible. In this way, the evolution of surgical practice has always gone hand in hand with progress in anesthesia; and today, thanks to it, millions of people can undergo surgery without pain or suffering.

At Sedalux, we believe that progress means changing processes and always seeking improvement — being open to evolution and not fearing change — because “excessive respect for the past can be the worst enemy of the future.”
Next time you walk into an operating room, remember what surgery used to mean — and appreciate the incredible progress that brought us here.

Can you imagine a world without anesthesia? Neither can we 😉

EMOTIONAL PAIN: BEYOND THE PHYSICAL WOUND

Pain, according to the International Association for the Study of Pain (IASP), is an unpleasant sensory and emotional experience associated (or similar to that associated) with actual or potential tissue damage. However, not all pain experiences have a physical origin; pain has other dimensions or components that play a fundamental role in how pain is perceived and experienced. Based on this, we classify pain into 3 types: physical pain, emotional pain, and psychological pain.

Difference between emotional pain and psychological pain


Emotional pain is a subjective experience in which the person has a wound that no one can see. The causes can be different: unrequited love, a breakup, a change of city, being fired from a job... Regardless of the cause, it originates from not knowing how to manage life changes and not having the necessary resources to cope with the new situation.

Psychic, psychological, or psychogenic pain may seem like emotional pain, but it is not exactly the same. Psychological pain is known as the somatization of pain (or "persistent somatoform pain disorder"), which originates from an emotional state (stress, anxiety, sadness, etc.) and manifests physically or in the form of illness.

Emotional pain of unrequited love


Unrequited love is a clear example of emotional pain, an experience that, although not manifesting in a visible wound, can be just as intense as physical pain. Rejection, loss, and disappointment can activate the same brain regions involved in physical pain, showing that emotional suffering is a legitimate form of pain.

It is important to differentiate between pain and suffering. While pain is a natural response of the body to an assault or threat, suffering is the interpretation we make of that experience. Suffering arises from our resistance to pain, from fighting against what we feel, or from the difficulty in accepting reality as it is. In this sense, while we may not always be able to avoid pain, we can learn to manage suffering, transforming it into an opportunity for growth and resilience.

"Pain is inevitable, suffering is optional" (Siddhartha Gautama)

Facing emotional pain requires recognizing it. It is not a sign of weakness but part of the complex human experience. Learning to deal with emotional pain is key to mental health and well-being, reminding us that, just like physical pain, it can heal over time, with proper support and self-care.

LEGAL FRAMEWORK AND CURRENT SITUATION OF ANESTHESIA NURSING IN SPAIN

In Spain there is no specific regulation regarding the roles and responsibilities of nursing in the field of Anesthesiology, and the lack of regulation makes it difficult to conceptualize these advanced practice nursing (APN) roles in the same way as in other countries, which is why, at present, they are framed in a paradigm of variable competencies. This is due to the lack of postgraduate specialty content (except for already recognized specialties (e.g., midwifery, mental health nursing...)), budgetary reasons and because the polyvalence of nursing has been promoted to the detriment of its specific training.

A FIGURE THAT HAS BEEN “MATURING”

However, although over the years there has been no normative evolution and we find ourselves in the same situation, progress has been made in improving the visibility and empowerment of the important role of nursing in society:

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  1. In the early 2000s, and coinciding with an increase in healthcare demand and the super-specialization and scope of anesthesiology, postgraduate training programs in anesthesia for nurses began to emerge and, at present, different Spanish universities offer postgraduate training with a master's degree in the field of Anesthesia, Resuscitation and Pain Therapeutics. We at Sedalux, aware of the importance of formal training, also created our own Expert Course in Nurse Anesthesia.
  1. As of 2012, the competencies and functions in Spain of anesthesia nurses were defined by the Spanish Association of Anesthesia, Resuscitation and Pain Therapy Nursing (ASEEDAR-TD), in tune with those defined by the International Federation of Nurse Anesthetists (IFNA) because there are a large number of nurses working in the field of anesthesia coinciding with the role of a specialist nurse or EPA.
  1. The conceptual change from Anesthesiology to Perioperative Medicine has led to the emergence of new opportunities for anesthesia nursing in Spain, which not only represent an aid to the anesthesiologist, but also entail an advanced practice of the profession that allows differentiating these roles from those of surgical nursing.
  2. Morbidity and mortality, the aging of the population, the increase in life expectancy, the increase in the demand for care, as well as the development of technology and the expansion of the areas of work of anesthesiologists, among other factors, have resulted in an increase in the demand for anesthetic procedures and have led to an overload of work for the medical specialist. With training in line with existing needs and aimed at complementing the role of the anesthesiologist, the nurse anesthetist becomes an integral part of a team that manages to improve patient safety. The Minessota study in the USA compared outcomes and costs between anesthesia performed by nurse anesthetists alone or by anesthesiologists. This study found higher mortality when anesthesia was performed by nurses, but the best results were obtained when anesthesiologists worked as a team with nurses. These data were later confirmed and have encouraged the use of the term Anesthesia Team, a way of working that is being implemented in the USA and has advocates in Europe, based on the fact that “four eyes see more than two”, a popular saying that alludes to the fact that teamwork between doctor and EPA provides safer care and optimizes assistance by providing greater effectiveness in the diagnosis of irregular situations, adverse events or complications during anesthesia and thus providing greater safety to the patient.

SPECIALTY WITHOUT RECOGNITION, BUT WITH LEGAL COVERAGE

However, the nurse anesthetist, a role that has existed in our country for years but lacks legal recognition and accredited training, provides collaborative assistance in different areas to the anesthesiologist, which is not exempt from legal coverage.

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According to the Law for the Regulation of Health Professions (LOPS) (BOE Law 44/2003 of November 21), in its article 9 “Interprofessional Relations and Teamwork” comes to give legal coverage to the “anesthesia team” and says in its points 3 and 4: 

3.- CWhen a healthcare action is carried out by a team of professionals, it shall be articulated in a hierarchical or collegiate manner, as the case may be, taking into account the criteria of knowledge and competence, and where appropriate the qualifications, of the professionals that make up the team, depending on the specific activity to be performed, the trust and reciprocal knowledge of the capabilities of its members and the principles of accessibility and continuity of care for the persons being attended

4.- Within a team of professionals, it will be possible to delegate actions, provided that the conditions under which such delegation or distribution of actions may take place are previously established within the team. A necessary condition for the delegation is the capacity to carry it out on the part of the person receiving the delegation, a capacity that must be objectifiable, whenever possible, with the appropriate accreditation.

Therefore, in accordance with the provisions of the aforementioned LOPS, it can be deduced that the performance of nurses in the field of anesthesiology should be governed by the following principles: 


  1. Its performance will never be autonomous, always working under the delegation and supervision of functions by an anesthesiologist.
  2. They should have specific training for the tasks entrusted to them, which should be objectifiable and with the consequent accreditation. This training should provide knowledge and training in airway management (the main cause of complications in sedation outside the operating room), in respiratory and cardiovascular physiology, in monitoring and in pharmacology, without entering into the disquisitions of which drugs should be used and which should not, as long as the staff is trained in their use. The debate should be limited to guaranteeing safety, regardless of the drug and who uses it.

Thus, there is an adequate legal framework to promote the change towards standardization and empowerment of multidisciplinary work teams, essential to develop the “new anesthesia” called Perioperative Medicine, at the same time that we have the positive experience in other countries that endorse the operation of this duality.

It is up to us to strive to further define competencies, to work every day for adequate training and to develop a plan to share tasks, creating a situation of mutual interest between nurse and anesthesiologist in order to take anesthesia to the next level.