Anesthesiology and Perioperative Medicine
Welcome to the Department of Anesthesiology and Perioperative Medicine at Denver Health Medical Center. Our team of physician anesthesiologists, certified registered nurse anesthetists, nurse practitioners, and anesthesia technicians are dedicated in providing care to the highest standard throughout the perioperative period.
The perioperative period spans the spectrum of care for a patient throughout their surgical operation and can be divided into three stages: 1) Preoperative Care, 2) Intraoperative Care, and 3) Postoperative Care. This spectrum of care can range from several weeks to months before surgery through our Preanesthesia Clinic (PAC), immediately after surgery in the Post Anesthesia Care Unit (PACU), and to several days after surgery while in the hospital. Conceptually, our goal is similar to that of a primary care provider specializing within the perioperative domain of medicine where we will evaluate and help manage your medical problems while you safely transition from one stage of perioperative care to the next. For example, while you may be scheduled for a foot operation, our team will also focus and help care for any additional medical needs such asthma, heart problems, and pain problems to ensure you make it safely through surgery. Throughout each stage of care our goal is one and the same:
Maximize Your Safety and Minimize Your Surgical Pain.
While the majority of our services pertain to adults and children undergoing a surgical operation, our scope of practice also extends in caring for pregnant patients during labor and delivery and for patients undergoing cardiac, radiological, or gastroenterology related procedures and diagnostic studies.
Preanesthesia Clinic (PAC)
Once a decision has been made that a patient requires surgery (or gastrointestinal, radiological or cardiac procedures that involve anesthesia), patients are often referred to the Denver Health Preanesthesia Clinic (PAC). There patients undergo a “preanesthesia evaluation” which may involve a physical exam as well as various laboratory and other diagnostic tests to ensure they are well prepared for their surgery or procedure. Patients will also receive additional education about their day of surgery, such as which medications to take and how long to go without consuming food or liquid prior to surgery. Not all patients require appointments in the PAC, so if your surgeon does not feel you require one, please ensure you have been given all necessary instructions regarding your medications, etc. prior to leaving the surgical clinic.
The Denver Health Preanesthesia Clinic is located at A1233, across from the
Adult Urgent Care Clinic (AUCC) on the first floor of Pavilion A on the Denver Health Main Campus. Please note that the small but efficient PAC staff sees over 3000 patients each year, playing a vital role in ensuring the safety of our pre-surgical patients. PAC appointments are usually brief (less than an hour), and the schedule fills very rapidly. Please arrive early. Patient who miss their PAC appointments often must have their surgery cancelled or postponed.
Patients scheduled for surgery at Denver Health may be assigned to have their procedure in our Ambulatory Surgery Center. This center is designed to provide a relaxed and pleasant experience for our patients and their families on the day of their operation.
At Denver Health, our obstetric Anesthesia Care Team works closely with our
Maternity and Pregnancy team. Our main priority is your safety and to help manage your pain by tailoring each patient’s individual care to facilitate a memorable and comfortable experience. Our scope of practice includes managing blood pressure problems, bleeding problems related to delivery or surgery, and breathing problems in addition to managing pain during labor and caesarean section (C-section).
Regional anesthesia is the most common method in managing pain from labor or during a caesarean section and is commonly done with an “epidural” or a “spinal.” An “epidural” is generally offered in managing pain during labor with the advantage that it can also be used if a caesarean section is later deemed necessary. Alternatively, if you are undergoing a scheduled caesarean section, we will commonly offer a “spinal” anesthetic. However, during an emergency a “general anesthetic” will more likely be offered or given if you are unable to consent to anesthesia.
Our Anesthesia Care Team consists of both male and female providers. Although we strive to honor specific cultural beliefs and customs, unfortunately, provider gender requests cannot always be accommodated.
Denver Health functions under the Anesthesia Care Team model which includes Physician Anesthesiologist (MD or DO) and a Certified Registered Nurse Anesthetist (CRNA). Denver Health is a teaching hospital closely affiliated with the University of Colorado School of Medicine and all of our physician anesthesiologist serve as faculty at the medical school. Since one of the primary goals of Denver Health is to train the next generation of health care providers, your care team may also include an anesthesiology resident physician or a Student Registered Nurse Anesthetist (SRNA).
Howard J. Miller, MD
Director of Service
Denver Health Medical Center
Associate Professor of Anesthesiology
University of Colorado School of Medicine
Dr. Miller graduated from the University of Colorado School of Medicine in 1991 with honors (AOA) and also completed his residency in Anesthesiology at the University of Colorado. He has been a Diplomate of the American Board of Anesthesiology since 1992 and a practicing anesthesiologist at Denver Health with a faculty appointment at the University of Colorado for over 20 years. He has actively been involved with medical education throughout his career and has over 12 publications, presented at over 40 lectures and workshops, and has mentored several residents throughout his career. He has been listed in “Best Doctors in America” on several occasions and has received multiple awards as an “Outstanding Teacher.” Prior to being appointed Director of Anesthesiology at Denver Health, he served as former Associate Director at Denver Health for over 3 years.
Doug Warnecke, CRNA
Denver Health Medical Center
Doug Warnecke is a practicing Certified Registered Nurse Anesthetist (CRNA) and Chief Anesthetist at Denver Health. CRNAs are experienced critical care nurses who return to graduate school for 2 to 3 years and study anesthesia at the Master’s or Doctorate level, then pass a national certifying board exam. He has practiced at Denver Health for approximately 30 years and served as Chief Anesthetist for over 20 years overseeing a staff of over 30 CRNAs. Doug has actively been involved in the Administrative work of Denver Health, sitting on various committees including the Medical Staff Executive Committee and the Allied Health Credentialing Committee. He is a former recipient of the prestigious Florence Nightingale Award given by the Colorado Nurse’s Foundation and former President of the Colorado Association of Nurse Anesthetists.
View a complete list of Denver Health
Anesthesia and Perioperative Medicine Providers.