Patients’ Corner

You’re scheduled to have a surgical procedure but you’re not too worried. You’ve met with the surgeon, who is skilled and experienced in this type of procedure. But what do you know about the anesthesiologist?

Most people think that the anesthesiologist ‘puts you to sleep’ and then leaves, but in reality, he or she is present during the entire surgical procedure. Most of the anesthesiologist’s time is spent keeping your heart rate, blood pressure, and other vital functions normal. “With general anethesia, it’s less a matter of keeping patients unaware and pain free as it is maintaining vital functions and keeping them healthy”, Todd says.

Because anesthesia is a controlled drug-induced coma and has nothing to do with sleeping, it can pose a greater risk than the surgical procedure itself. “Most people worry about not waking up after surgery, which isn’t a surgical concern, it’s an anesthetic concern”, Todd notes. Surgeons carry out the technical aspects of an operation and cannot pay attention to monitoring blood pressure and heart rate, he adds.

Although you won’t be selecting the anesthesiologist yourself, it is important to speak to the anesthesiologist before the procedure. Ask how long the anesthesiologist has been at that hospital and if he or she is certified by the American Board of Anesthesiology. A practitioner should be certified or in the process of completing certification if he or she is in the first year or two of practice.

Ask what experience the person has with procedures like the one you will be undergoing, particularly for complex operations. Usually hospitals assign anesthesiologists to cases in their area of special expertise, but with some simple procedures, any competent anesthesiologist can do the job, he says.

Ideally, the anesthesiologist will come to see you in the hospital the night before your procedure, explain what will happen, and get an idea of your general health. With the trend in admitting patients the morning of surgery, however, this is becoming less common. “You might only meet the anesthesiologist just before your surgery”, he says.

Depending upon your general health and the type of surgery that will be performed, you may have a choice between receiving general anesthesia so you are fully unaware, and regional anesthesia, where you are awake, but the area of the body to be operated upon is anesthetized. Most doctors prefer regional anesthesia whenever possible, Todd says. “Many patients are afraid of having regional anesthesia. It’s common to have patients who want to be fully ‘asleep’ even if it’s not the best way to do it.” The regional method can be better because it leaves the patient in control of breathing and other vital functions, which is not the case with general anesthesia. The post-operative period is often shorter and smoother as well, he adds.

Before undergoing surgery try to discuss all your options with the surgeon and the anesthesiologist.

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