ANESTHESIA: KNOW YOUR ANESTHESIOLOGIST

Before your surgery, you will meet an important physician specialist – your anesthesiologist. A vital member of the surgical team, your anesthesiologist has the critical responsibility for your welfare when you undergo anesthesia. The anesthesiologist is your advocate in the operating room.

Today's anesthesiologists are physicians who complete a four-year college program, four years of graduate doctoral training and four more years of anesthesiology residency. They apply their knowledge of medicine to fulfill their primary role in the operating room, which is not only to ensure your comfort during surgery, but also to make informed medical judgments to protect you. These include treating and regulating changes in your critical life functions – breathing, heart rate, blood pressure – as they are affected by the surgery being performed. These medical specialists are the doctors who will immediately diagnose and treat any medical problems that might arise during your surgery or recovery period.

The role of an anesthesiologist extends beyond the operating room and recovery room. Anesthesiologists work in intensive care units to help restore critically ill patients to stable condition. In childbirth, anesthesiologists manage the care of two persons; they provide pain relief for the mother, while managing the life functions of both the mother and the baby. Anesthesiologists also are involved in pain management, including diagnosis and treatment of acute and chronic problems.

You usually have a choice as to who your anesthesiologist will be. Your surgeon may refer you to an anesthesiologist ,or you may select one based on a personal recommendation or based on your own previous experience. However, you must make that choice known in advance so that arrangements may be made to honor your request. Since your anesthesiologist is responsible for your comfort, safety and medical care during surgery, it is important that you meet before entering the operating room.

Anesthesia and surgery affect your entire system, so it is important for your anesthesiologist to know as much about you as possible. During a preoperative visit, an anesthesiologist will carefully evaluate you and your medical history and will inquire about your recent medications. In addition, this physician will inform you about the procedures associated with your surgery; discuss the anesthetic choices, including their risks and benefits; order appropriate laboratory tests; and prescribe medication for you, if needed, before your operation. If you have not met your anesthesiologist during a preoperative interview, you will meet immediately before your surgery. At this time, your anesthesiologist will review your entire medical chart for a clear understanding of your needs and medical condition.

There are three main categories of anesthesia: general, regional and local. With general anesthesia, you are unconscious and have no awareness of the surgical procedure or other sensations. If you have regional anesthesia, your anesthesiologist injects medication near a cluster of nerves to numb only the area of your body that requires surgery. You may remain awake or you may be given a sedative. For some surgical procedures, a local anesthetic may be injected into the skin and tissues to numb a specific location. Your anesthesiologist, in consultation with your surgeon, will determine the best type of anesthesia for you, taking your desires into consideration whenever possible. These options will be discussed during your preoperative interview with the anesthesiologist.

Your anesthesiologist is personally responsible for your comfort and well-being before, during and after your surgical procedure. In the operating room, the anesthesiologist will direct your anesthesia and manage vital functions, including heart rate, blood pressure, heart rhythm, body temperature and breathing. The anesthesiologist also is responsible for fluid and blood replacement, when necessary. He or she will regulate the anesthesia so that you will be comfortable until your anesthetic care is completed.

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.

After Surgery, What Can I Expect?

Your anesthesiologist continues to be responsible for your care in the recovery room, often called the post-anesthesia care unit. Here, the anesthesiologist directs specially trained staff members who monitor your condition and vital signs as the effects of the anesthesia wear off. Your anesthesiologist will determine when you are able to leave the recovery room.

Your anesthesiologist is a physician specialist like your surgeon or internist, and you probably will receive a bill for your anesthesiologist's professional service, as you would from your other physicians. If you have any financial concerns, your anesthesiologist or an office staff member will answer your questions. You will note that your hospital charges separately for the medications and equipment used for your anesthetic.

Many people are apprehensive about surgery or anesthesia. If you are well-informed and know what to expect, you will be better prepared and more relaxed. Talk with your anesthesiologist. Ask questions. Discuss any concerns you might have about your planned anesthetic care. Your anesthesiologist is not only your advocate but also the physician uniquely qualified and experienced to make your surgery and recovery as safe and comfortable as possible.