What is anesthesiology?

Anesthesiology is the practice of medicine dedicated to:

  • The comprehensive care of patients before, during, and after surgery and childbirth;
  • Critical care medicine, and;
  • The treatment of acute and chronic pain.

Advancements in medicine have made the practice of anesthesia very safe; a healthy person’s risk of death related to anesthesia is 1 in 200,000.

Several types of anesthesia are available, including general anesthesia, sedation anesthesia, and regional anesthesia. The type of anesthesia that is chosen is based on the patient’s medical history, the planned operation or procedure, and the patient’s preferences.

What does an anesthesiologist do?

A physician anesthesiologist is responsible for the patient’s well-being before, during, and after surgery. An anesthesiologist will do the following:

  • Determine if it is safe to proceed with the anesthetic and surgery or procedure.
  • Devise an anesthetic plan with the patient. This is typically general anesthesia, sedation anesthesia, or regional anesthesia such as a spinal, epidural, or regional nerve block (usually accompanied by intravenous sedation).
  • Ensure unconsciousness with general anesthesia, or the appropriate level of sedation with sedation anesthesia.
  • Monitor and maintain normal vital signs, including respirations (breaths), pulse, blood pressure, and temperature.
  • Monitor and maintain normal levels of oxygen in the bloodstream and carbon dioxide gas in the lungs.
  • Identify and treat any problem or emergency that may occur before, during, and after the procedure, such as an unexpected or allergic reaction to a medication, bleeding, or an unexpected change in vital signs.
  • Minimize the stress response to the operation or procedure to allow the patient to make the best recovery.
  • Control pain after surgery.
  • Provide ongoing care after the surgery in the anesthesia care unit or intensive care unit.

The anesthesiologist may work with a certified registered nurse anesthetist (CRNA), resident physician, or a student nurse anesthetist. All of these caregivers will be supervised by the anesthesiologist, who retains overall responsibility for the patient’s safety.

What happens when anesthesia is given?

Before the operation, the anesthesiologist will ask you about your medical and surgical history and discuss options for anesthesia. Answer all questions the doctor asks honestly, and follow all directions the doctor gives you to prepare for the surgery. You will be asked to not eat or drink before the operation, and told what to do if you are taking certain medications or supplements.

Share any questions or concerns that you have about anesthesia with your doctor. Knowing about the process will relieve anxiety and help you to stay calm before and after the operation.

You will receive anesthesia (local, regional, or general) before the surgery begins. You may be awake or sedated or completely asleep, depending on the type of surgery. If you are awake or sedated, you should expect to have no pain and limited sensation (feeling) in the surgical area. Doctors, nurses, and the anesthesia team will monitor you closely.

After the operation is completed, you will go to a recovery room or intensive care unit, depending on the type of operation and anesthetic you received. The doctor may prescribe other pain medications to make sure you are comfortable. Tell your caregiver or doctor if you have any new symptoms after the surgery.

Local anesthesia

With local anesthesia, only the surgical area is numb. Local anesthesia may be given by injection or spray, or as an ointment. You will be awake or moderately sedated. Local anesthesia is often used for outpatient procedures such as foot or hand surgery. Dentist and doctor’s offices usually use this method.

You will go home that same day. You may continue to feel numbness in the surgical area afterwards.

Regional anesthesia

This form of anesthesia numbs a portion of the body, such as the lower body, with spinal or epidural anesthesia, or an extremity (arm or leg) with nerve block anesthesia. Examples of how regional anesthesia is often used include spinal anesthesia for knee and hip replacement surgery, epidural anesthesia for childbirth, and nerve block anesthesia for shoulder or wrist surgery.

General anesthesia

General anesthesia allows your surgery or procedure to be performed safely while you are deeply asleep or unconscious. Your vital organ functions and your vital signs will be monitored and maintained while you are under a general anesthetic. You will also receive pain medication, and your body’s stress response to surgery will be reduced as much as possible. These measures will speed up your recovery after surgery.

You will wake up (typically in the operating room) after your operation is completed, and then you will be transferred to the recovery room. If you are having major surgery such as heart surgery, you will likely wake up gradually in an intensive care unit. You will have no later memory or recall of your operation.

What are the risks of anesthesia?

Thanks to technology and advanced medical training, anesthesia is very safe. However, risks do exist and complications can occur. Risk depends on your planned surgery or procedure and your surgical diagnosis, other medical conditions, overall health status, and age. Ask your doctor about specific risks associated with your operation or procedure.

You can reduce your risks of having anesthesia by discussing the following with your surgeon and anesthesiologist beforehand:

  • Your health conditions (such as high blood pressure, heart, lung, or liver disease, or diabetes)
  • Your blood transfusion history
  • Any history you have of depression or other psychiatric disorders
  • Your recent surgeries and hospitalizations
  • Previous difficulties you have had with anesthesia
  • Your dental history (loose teeth, crowns, or bridges)
  • Medications you take (prescription, over-the-counter, or herbal)
  • Your medication and food allergy history
  • Your tobacco, alcohol, and recreational drug use history
  • Blood relatives who have had difficulties with anesthesia
References

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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition. This document was last reviewed on: 4/27/2017…#15286