This service is responsible for practicing anesthesia in all surgical, diagnostic or therapeutic procedures that are potentially painful or that require sedation or immobilization of the patient.

The process begins with the pre-anesthetic assessment of the patients, continues with the performance of the procedures in different areas of the hospital, continues with the recovery in Reanimation or hospitalization, and ends at the patient's home, where pain control is maintained efficient

In the first step, the pre-anesthetic assessment is carried out through:

• Virtual visit to the patient's home by telephone
• Face-to-face visit to external consultations, hospitalized patients and Emergency Departments

Anesthetic procedures are performed in the following areas:

• External Consultations
• Surgical Area
• Hospitalization
• Day Hospital
• Emergencies
• Delivery room
• Imaging Diagnostic Rooms
• Hyperbaric Therapeutics Unit

External consultations

It is where the face-to-face pre-operative visits are carried out. Two anesthesiologists and a specialist nurse are usually available. The nurse is part of the nursing team of the Walk-in Surgery Unit (UCSI) or the Post-Surgical Resuscitation Unit (URP) and this allows continuity of care for patients who are later admitted to this unit. The same nurses specialized in anesthesia make the phone calls that select those patients who do not need to repeat their pre-operative visit and thus make the virtual visit.

Surgical area
They are the areas where the most complex anesthetic procedures are performed and depend on the patient's comorbidity and the type of intervention to which he is subjected.

Hospitalization
In the hospitalization area, the Anesthesiology Service provides continuity of care to all surgical patients in order to ensure an adequate level of pain control, in addition to detecting and providing solutions to possible complications that may arise occur after the stay in the resuscitation area.
In this area, pre-operative visits are also carried out for admitted patients who have not been visited previously.
Anesthetic procedures can be performed in surgical programs with hospitalization or in surgical programs without admission (UCSI). The latter imply that after the intervention the patient can follow the recovery at home without the need for hospital admission.

Day hospital
Anesthesia for electrical cardioversions is performed in this area together with the Cardiology service. Lumbar punctures are also performed in collaboration with the Oncology and Neurology services.

Emergencies
The Anesthesiology team collaborates in the care of patients with cardiac arrest and polytrauma.
Likewise, sedation is performed on all those patients who require it.

Delivery room
The Anesthesia Service attends to the patient in labor by providing her with analgesia and monitoring her vital status.
Assists in basic newborn resuscitation.
Care for the patient in case of a postpartum complication (for example, uterine atony).
Attends to urgent obstetric surgery (caesarean section, scrapings or cerclage).

Imaging diagnostic rooms
The Anesthesia Service performs general anesthesia in patients undergoing interventional radiology, placement of prostheses in the digestive system and endoscopic retrograde cholangiopancreatography (ERCP). He also performs sedation on those patients who require it for diagnostic tests such as magnetic resonance imaging (MRI) or computerized axial tomography (CT).

Hyperbaric Therapeutics Unit
The Anesthesia Service collaborates and provides assistance to pediatric patients who require anesthesia or sedation in the hyperbaric chamber.

In the resuscitation area, patients are closely monitored and watched to be able to detect and treat possible alterations. Part of the area is dedicated to applying critical care and, if necessary, life support techniques to patients who require it due to the complexity of their case.

• Sant Joan Despí Hospital has an 18-bed mixed resuscitation room that is divided into two flexible areas: one for treating patients recovering from anesthesia and another for patients requiring critical care. Two of the beds are equipped with controlled ventilation and insulation capacity. This Reanimation Unit is attended continuously and permanently by an Anesthesiology assistant, 24 hours a day, 365 days a year. It also has a post-anesthetic recovery area equipped with 6 stretchers, attached to the testing room.

• Hospital General de l'Hospitalet has a resuscitation room with capacity for 10 beds. This Reanimation Unit is served, according to needs, by the team of anesthesiologists assigned to the surgical block.

• Dos de Maig Hospital in Barcelona has a resuscitation room with capacity for 6 beds. This Reanimation Unit is served, according to needs, by the team of anesthesiologists assigned to the surgical block. It also has a semi-critical area attended by a special unit of the Anesthesiology Service made up of two intensivist doctors and two anesthesiologists who work together to provide care support to critical patients.

Peritoneal Oncological Surgery Unit (UCOP)
The service has a specialized team made up of 6 anesthesiologists who collaborate with the Peritoneal Carcinomatosis Program of Catalonia (PCPC), a national benchmark in the radical treatment of peritoneal carcinomatosis.

Complex Surgical Patient Unit (UPQC)
The service has a team made up of 4 anesthesiologists who collaborate with the Complex Surgical Patient Unit, optimizing the health status of patients with multiple comorbidities.

Semicritical Unit (USC)
The service has a team made up of two intensivist doctors and two anesthesiologists who attend to patients who require intensive care at the Hospital Dos de Maig in Barcelona.

Test Cabinet Unit
The service has a team made up of 4 multi-purpose nurses specialized in anesthesia and coordinated by a doctor anesthesiologist who support 4 test rooms plus an anesthetic recovery room.

Its main goal is to improve the quality of life of people with chronic pain and to recover their physical, social and emotional well-being. To achieve this, it has a group of multidisciplinary professionals with extensive experience in the treatment of pain, updated treatment protocols for the different techniques and procedures, and the latest technologies and therapeutic advances in this field.

Anesthetic procedures are performed in the following areas:
• Virtual visit to the patient's home by telephone
• External consultations
• Operating theatres
• Day hospital
• Imaging diagnostic rooms
• Hospitalization
• Emergencies

The care actions carried out on chronic pain processes depend on the severity of the symptoms, are multimodal and interconnected, so that different actions are carried out at the same time.

Generalized and localized chronic pain procedures are performed through:
• Pharmacotherapy
• Nerve blocks: plexuses, trunks and peripheral nerves
• Intravenous blockages
• Trigger point infiltration
• Iontophoresis
• Sympathetic nervous system blockades: ganglia and sympathetic chain
• Radiofrequency techniques: facets, posterior ramus, intradiscal ganglia, sympathetic chain and peripheral nerves
• Placement of implanted reservoirs
• Treatments with botulinum toxin
• Neuromodulation (spinal cord stimulators)