Journal of Anesthesia

, Volume 25, Issue 5, pp 734–740 | Cite as

The role of Certified Registered Nurse Anesthetists in the United States

  • Takashi Matsusaki
  • Tetsuro Sakai
Review Article


Certified Registered Nurse Anesthetists (CRNAs) have been providing anesthesia care in the United States (US) for nearly 150 years. Historically, anesthesia care for surgical patients was mainly provided by trained nurses under the supervision of surgeons until the establishment of anesthesiology as a medical specialty in the US. Currently, all 50 US states utilize CRNAs to perform various kinds of anesthesia care, either under the medical supervision of anesthesiologists in most states, or independently without medical supervision in 16 states; the latter has become an on-going source of conflict between anesthesiologists and CRNAs. Understanding the history and current conditions of anesthesia practice in the US is crucial for countries in which the shortage of anesthesia care providers has become a national issue.


Nurse anesthetists United States Anesthesia practice 



The authors thank Christine M. Heiner, BA (Scientific Writer, Department of Anesthesiology/Department of Surgery, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA) for her editorial assistance with the manuscript. The authors also thank Richard Henker, Ph.D., CRNA, FAAN (Professor and Interim Chairman, Acute/Tertiary Care Department, University of Pittsburgh School of Nursing, Pittsburgh, PA, USA) for his review of the manuscript.


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Copyright information

© Japanese Society of Anesthesiologists 2011

Authors and Affiliations

  1. 1.Department of AnesthesiologyUniversity of Pittsburgh School of Medicine, UPMC MontefiorePittsburghUSA

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