Surgeons may be able to answer some of your questions, but when you are worried about anesthesia, it is best to speak with your anesthesiologist. Unfortunately, there are many misconceptions and mistaken ideas about anesthesia care and your anesthesiologist.
May this article help enhance your understanding of anesthesia and our role in your care. Should you have any further questions or need clarifications, feel free to communicate with your anesthesiologists when you meet them.
Anesthesia is defined as the loss of feeling or sensation with or without a loss of consciousness. This loss of consciousness is reversible, that is, at the end of surgery and when anesthesia is discontinued, you would gradually regain consciousness and would once again be fully aware of yourself and the environment.
Anesthesia may be classified as follows:
Only that part of the body that needs surgery is made numb from pain; You shall remain conscious during the procedure.
The entire area of the body affected by surgery is made numb to pain and cannot be moved; you may be fully conscious or have some sedation.
The two most common types of regional anesthesia for procedures of the lower abdomen and lower extremities are spinal anesthesia and epidural anesthesia; upper and lower extremity blocks can also be performed.
You are unconscious and your whole body shall be numb to pain. This may begin with an intravenous or intramuscular injection, or by breathing in anesthetic gases mixed with oxygen.
Monitored Anesthesia Care
Monitored Anesthesia Care (MAC) is commonly called “stand-by” anesthesia. It is a specific anesthesia service in which an anesthesiologist has been requested to participate in the care of the patient undergoing a diagnostic or therapeutic procedure. During MAC, the anesthesiologist monitors the vital signs, ensures good airway and treats any medical problems that may occur. At times, sedatives and analgesics or other medications are given to ensure patient safety and comfort.
Anesthesia technique may involve one or any combination of the above-mentioned procedures. The decision made is based on which shall be most safe for the patient, what can facilitate your surgery, and what shall be most cost-effective for you.
Anesthesiologists are highly trained physicians who have done residency training in the specialty of anesthesiology after completing MBBS.
The anesthesiologists are medical specialists who will immediately diagnose and treat any medical problems that might arise during your surgery or recovery period.
The role of anesthesiologists extend beyond the operating room and post-anesthesia care units. Anesthesiologists also work in the intensive care units, to co-manage critically ill patients. In obstetrics, the anesthesiologist can help ease down labor pains until the time of delivery of the baby, during which he takes care of both the mother and the baby. He can also be involved in the diagnosis and treatment of acute and chronic pain problems.
You, as the patient, have a choice as to who our anesthesiologist will be. Based on the training and credentials of the anesthesiologist or from personal recommendations, you may suggest to your surgeon your anesthesiologist of choice. However, make your choice known to the surgeon so that arrangements may be made. Traditionally the surgeons will refer you to an anesthesiologist he regularly works with.
The anesthesiologist will see you prior to your surgery to carefully evaluate you and your entire medical history. It is important that your anesthesiologist get to know as much about you as possible. He will inquire about your recent and current medications, about your previous surgery experience, especially if there have been problems so that these can be avoided. In this regard, full disclosure by you regarding your medical history is of outmost importance.
During this preoperative visit, he shall discuss with you the anesthesia plan, its benefits, and risks, and make known to you if there are other appropriate tests that should be done to ensure your safety.
The anesthesiologists shall also prescribe medications, if needed, to prepare you optimally for your surgery. It would be best that you speak with your anesthesiologist sincerely and ask him whatever information you would like to know about anesthesia.
If you have not met your anesthesiologist during a preoperative visit, you will meet immediately before surgery. He will review your medical condition and evaluate your needs at this time.
Frequently, people requiring surgery may have other medical conditions, such as diabetes, asthma, high blood pressure, arthritis or heart problems. Because of your preoperative evaluation, your anesthesiologist will be alert to these conditions and well-prepared to treat them during your surgery and immediately afterward. Your continued medical management during surgery is necessary to help you have a speedy recovery. As doctors, anesthesiologists are uniquely qualified to treat not only sudden medical problems related to surgery itself, but also your chronic conditions that may need special attention during your procedure. This is because their medical training provides a strong background in the principles of internal medicine and critical care.
In the operating room…
As soon as you are in the operating room, the anesthesiologist shall give you his full attention. He shall prepare you for surgery, relieve your anxiety and make you as comfortable as you can.
He shall direct your anesthesia and maintain your vital functions.
Your safety will be further ensured with the use of monitoring devices to measure your blood pressure, heart rate, and breathing whenever available. These shall support the anesthesiologist who keeps vigilant watch of your vital signs.
The anesthesiologist is also responsible for fluid and blood replacement, when necessary. He shall regulate the anesthesia so that you will be comfortable until your anesthetic care is completed. Most of the time, you shall not have a vivid recall of any of the proceedings inside the operating room because of the premedications and anesthetics administered to you.
Regarding your medical problems during surgery, the anesthesiologist shall make sure these are promptly attended to. The anesthesiologists are uniquely qualified to manage these acute medical problems during surgery because of their strong background in the principles of internal medicine and critical care.
In the post-anesthesia care unit…
This is the place where you shall be recovering from anesthesia. It is also called the recovery room, where highly trained nurses under close supervision and in coordination with your anesthesiologists, will personally take care of you and your needs. Oxygen inhalation may be continued as needed, and pain medications shall be started to make you feel comfortable and maintain your well-being. It is your anesthesiologist who will determine when you can safely leave the post-anesthesia care unit.