WHAT IS ANESTHESIOLOGY?

Anesthesiology is the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery, as defined by the American Society of Anesthesiologists (ASA). A physician called an anesthesiologist is responsible for the patient’s wellbeing throughtout the duration of the surgery. There are different types of anesthesia. The type of anesthesia you get depends on factors such as, how much you weight, your age, as well as the type of surgery you are having, your medical history, and your overall health as a whole.

METHODS OF ANESTHESIA

• General anesthesia: The type of anesthesia familiar to most people is general anesthesia. During general anesthesia the patient is unconscious and cannot be aroused, or made alert. Examples of surgery that are usually done under general anesthesia are open heart surgery, lung surgery, brain surgery and operations in the abdomen.
• Sedation techniques: For smaller operations or less invasive procedures general anesthesia may not be needed, and different levels of sedation, ranging from "light" to "moderate" to "deep" sedation can be provided instead. During light sedation, patients are easily aroused, are able to breathe without help, and there is little effect on heart function or blood pressure. At deeper levels of sedation, patients can be aroused only with stimulation and may need assistance with breathing.
• Regional anesthesia: Techniques in which nerves are blocked using so-called "local anesthetic" medications are called regional anesthesia. Regional anesthesia is used for a variety of major and minor surgeries. It is frequently used for orthopedic surgical procedures such as knee or hip replacements, and for cesarean sections.
• Epidural anesthesia: is a form of regional anesthesia in which a narrow tube, (also called a catheter) is placed in the epidural space in your back. The epidural space is a part of the spine that is in close contact with nerves. By injecting anesthetic medication into this space, the spinal nerves are numbed. An epidural requires the insertion of a special needle into the back. The epidural needle can be inserted with very little discomfort by an experienced practitioner, using local anesthesia to numb up the skin and tissues of the back. When the needle is in place, the epidural catheter is threaded through the needle and the needle is then removed.
• "Spinal" anesthetic: An alternative to the epidural technique is a "spinal" anesthetic. This technique is similar to an epidural. With a spinal anesthetic, a special needle is inserted in the lower part of the back, and anesthetic medication is injected through the needle directly into the fluid that bathes the spinal nerves. The needle is then removed.

The effects of spinal and epidural anesthesia, and of other regional anesthesia techniques, are very similar - they temporarily block nerves, so that pain is not felt. As well as blocking sensation, these anesthesia techniques also decrease the ability to move the affected part of the body. As the medication wears off, the affected parts will recover both sensation and movement.

RISKS INVOLVED

The advancements in both technology and medicine have made the practice of anesthesia safe. Even though it is safe however, there can still be some risks and complications. These risks depend on the type of operation and what type of condition you are in. Ask your doctor about specific risks that are associated with your operation. There are some steps you can take to reduce the risks.

Things to tell your anesthesiologist:

• Your health conditions (including high blood pressure, heart, lung or liver disease or diabetes) 
• Whether or not you have had a previous blood transfusion 
• Whether you have had depression or other psychiatric disorders 
• About recent surgeries or hospital visits 
• Your previous experiences with anesthesia and your reaction 
• Your dental history (loose teeth, crowns or bridges) 
• About all medications you are on (prescription, over the counter or herbal) 
• About drug and food allergies 
• Whether you smoke, drink alcohol or use any recreational drugs 
• About family members’ histories with anesthesia

MEET WITH YOUR ANESTHESIOLOGIST

In order to provide you with safe anesthesia and an optimal recovery from the surgery, the anesthesiologist needs to know your medical history in detail. This includes information about allergies, medications (including herbal and over-the-counter medicines), and previous anesthetics and surgeries, especially if there were any problems or complications. It is helpful to bring a list of your medications and their dosages. The anesthesiologist will also do a physical examination that focuses on the airway, heart and lungs, so it is wise to wear comfortable loose clothing.

Certain tests may need to be completed before your surgery to define problems that can affect the anesthetic and the safe conduct of the surgical procedure. Hospital records, notes from your doctor, and the results of previous tests, especially those involving the heart and lungs, may be of special value to the anesthesiologist. The anesthesiologist will inform you of the different options for anesthesia, their risks and benefits, so that you can understand, and participate in the decision-making process.