Anesthesiology in Mexico (2024)

This article pretends to give a general ideaabout the Anesthesiology in Mexico, taking advantage of theexcellent coverage that Joseph Eldor's website (CSEN) has on thepractice of this speciality.

Even before Mexico was conquered by thespaniards in 1521 the ancient cultures of America already had agreat tradition in healing medicine. This was characterized,among other things, by the great number of resources they used tocure and treat illnesses with herbs, animals, minerals, baths,etc. All these practices are illustrated in the famous aztec(nahuatl) codices such as the De La Cruz-Badiano's Codex. In thisbook there are 272 different curative plant varieties. In anotherbook the Florentino Codex there are 142 healing herbs describedand in the Matritense Codex there are 73 more.

In Mexico, Dr. Ramon Pardo Galindez, physicianfrom the state of Oaxaca was the first doctor that practicedraquianalgesia in Latin America. He realized that procedure atthe Hospital de la Caridad in the state of Oaxaca in 1900; thistook place 2 years after August Bier, German physician, at theUniversity Hospital in Kiel performed the same procedure for thefirst time.

The Mexican Society of Anesthetists was foundedin 1934 with the collaboration of the very first specialists onthis field. They were Dr. Juan White Morquecho, Dr. BenjaminBandera, Dr. Antonio Colina Barranco, and Dr. Vicente GarciaOlivera. It was this last one who in 1946, organized the firstMexican National Anesthesiology Congress. He also fought forusing the more proper name of anesthesiologist instead ofanesthetist. He was also responsible for publishing the firstJournal of Mexican Anesthesiology (Revista Mexicana deAnestesiologia), in 1951. This Journal remains the officialpublication of the Mexican Society of Anesthesiology. Dr. GarciaOlivera also founded the first Pain Clinic at the HospitalGeneral de Mexico (General Hospital of Mexico) in 1976.

From 1940 to 1946 there were differencesbetween general anesthesia and raquianalgesia. The later wasconsidered to be better than the first one. However, the numberof neurological complications associated with the raquia (spinalblockade) lead to its discredit in such a way that patients wereafraid of it. Dr. Dario Fernandez Fierro used raquianalgesiaintensively in almost any kind of surgery. He even used it foroperations of thyroid, ear and throat, and called it"general analgesia". The same technique was usedindependently by Dr. Koster in New York, but it was in fact Dr.Dario Fernandez who used it in Mexico for the very first timeever. Fortunatelly, this method due to its high risks was notpopular anymore.

Today, thanks to the great advances inanesthesiology (techniques, pharmacology, etc.) regionalanesthesia is one of the most popular types of anesthesiapracticed here in Mexico, with any of its three modalities:epidural, spinal, or combined. At the hospital I work for, 40 to50 % of the surgical procedures are performed with regionalanesthesia. Among these, the 90 % are lumbar epidural blockade, 7% are spinal blockade, and 3 % are combined technique.

In order to obtain the specialty ofAnesthesiology in Mexico, a person must first complete 4 years ofmedical studies, then continue with one year of internship andthen one more year of Social Service. After all this, he or shemust complete four more years of anesthesiology specialtystudies. It is also possible to continue studying after thisspecialty to obtain a subspecialty on Neuroanesthesiology,anesthesia for cardiovascular surgery, pediatrics anesthesia,gynecobstetric anesthesia, and pain clinic. In contrast to othercountries, it is not necessary to have the specialty of CriticalCare Medicine and/or Internal Medicine, to become ananesthesiologist.

Mexico has organizations that regulate thepractice of anesthesiolgy in the country. They are: theUniversity of Mexico (Universidad Nacional Autonoma de Mexico),the Federation of Anesthesiology Societies of the MexicanRepublic, the Mexican Society of Anesthesiology, theAnesthesiologists College, and the Mexican Council ofAnesthesiology. There are also other minor organizations thatregulate in part the practice of anesthesiology in this country,but the ones mentioned above are the most important.

Actually, (September 1997), the minimum numberof legal documents required for the practicing of Anesthesiologyin any Mexican hospital is: Medical doctor diploma, given by amajor University, Professional License, Department of HealthLicence, Diploma of the specialty (in this case anesthesiology),and to be registered at the Mexican Counsil of Anesthesiology.

Fees an anesthesiologist receives in Mexico forhis work vary a lot, depending if the person works at a privateor public institution, or both. However, in general they are low.An anesthesiologist working full time for a public institutionmakes an average wage of US$7,500.00 to US$15,000.00 a year. Inaverage, at a public hospital, an anesthesiologist performs twoto six anesthetic procedures per day. This means about 40 to 120procedures per month. So, for a single anesthetic procedure, heor she makes US$10.40.

Anesthesiologists' wages from banks andinsurance companies are also low. For example, the amount ofmoney he or she receives for anesthesia for a cesarean section issomething between US$35.00 and US$100.00, cholecystectomy betweenUS$100.00 to US$187.00. Wages for an anesthesiologist at aprivate institution are a little higher, but unfortunatelly, formost of our Mexican colleagues this type of job is "animpossible dream". This is mainly because the majority ofthe Mexican people are unable to pay for private medicalservices. Insurance companies to cover for these expenses are notan option because premiums are just too high for the averageperson to pay. In private practice a cesarian section runs aboutUS$187.50 to US$375.00, and a cholecystectomy for about US$250.00to US$500.00.

To finish I just would like to make known thefact that in Mexico the big deficiencies due to the lack ofresources we experience, is efficiently overcome thanks to theexcellent work and dedication of the Mexican anesthesiologists.

Luis Federico Higgins Guerra, MD

Anesthesiologist

Mexico City

e-mail: higgins@data.net.mx