Anesthesiologist

Since ancient times, medicine has sought to make surgical interventions painless for patients, and almost until the middle of the 19th century, many of those who found themselves on the operating table died from pain shock... Today, pain relief during operations is provided by special doctors - anesthesiologists.

The purpose of general anesthesia is to provide the most favorable conditions for the operation. This means that the patient should not feel pain, and his muscles should be in a state of relaxation (myorelaxation). At the same time, modern anesthesiology has adopted the fundamental principle: pain relief cannot threaten the patient's life and reduce the body's defenses so that after the operation they help him recover.

These are the tasks that an anesthesiologist solves – a qualified specialist with higher medical education and the appropriate medical specialization.

Who is an anesthesiologist?

The anesthesiologist, like the surgeon, bears a huge responsibility for the successful outcome of any operation performed under general anesthesia. After all, while the surgeon does his job, the anesthesiologist does his – coordinates the vital functions of the human body under anesthesia. Therefore, the anesthesiologist (or anesthesiologist-resuscitator) must have an excellent knowledge of not only the fundamental principles of medicine, anatomy and physiology, but also the pharmacodynamics of the drugs used in anesthesia – in order to be able to correctly identify the slightest deviation in the functioning of organs during surgical interventions and take timely adequate measures.

It should be noted that general anesthesia and regional anesthesia by means of spinal and epidural anesthesia (in which pain sensations at the site of the operation are completely blocked) can only be performed by an anesthesiologist. Local anesthesia by all other methods is performed by doctors according to the profile of the disease - dentists, otolaryngologists, orthopedists, ophthalmologists, etc.

When should you see an anesthesiologist?

You should seek advice from a good anaesthetist if you are about to have an operation that requires general anaesthesia and you have any concerns about it.

For example, people with allergies may have certain difficulties in administering anesthesia. And in order to minimize the risk of potential allergies, it would be advisable to contact the anesthesiologist who will administer the anesthesia to find out the list of drugs for anesthesia. Then you can contact an allergist to conduct allergy tests for these drugs. Although, as experienced specialists say, these tests do not provide a 100% guarantee of the absence of allergies during anesthesia...

You should also contact an anesthesiologist if, after general anesthesia, a person experiences headaches, nausea, weakness, confusion, partial paralysis (after epidural anesthesia). A competent anesthesiologist will give you recommendations and advise you on which specialist to contact for help.

What does an anesthesiologist do?

What does an anesthesiologist do during surgical treatment of a particular disease? During planned operations - before going to the operating table - patients meet not only with the surgeon, but also with the anesthesiologist.

Having a diagnosis in hand and knowing the specifics of the operation prescribed for the patient, the anesthesiologist evaluates his physical condition and finds out: what chronic diseases the person has, what operations he has already undergone and how he reacted to anesthesia (anesthesia history), what injuries he has had, what medications he has recently taken and whether he has any allergies to any drugs.

Based on this information, taking into account the nature of the upcoming surgical intervention and its duration, the anesthesiologist selects the optimal method of pain relief, as well as the type and dosage of medicinal anesthetic.

By the way, questions like "what diseases does an anesthesiologist treat?" or "what tests should I take when visiting an anesthesiologist?" are meaningless in this case, since, as you understand, anesthesiologists do not deal with treatment as such. But if any complications develop during the operation - for example, heart rhythm disorders - the anesthesiologist-resuscitator resorts to emergency measures, for example, conducts cardiac stimulation. And in case of bleeding, he faces the task of choosing the means necessary to replenish the volume of circulating blood.

As for the tests, before performing the operation, the anesthesiologist needs information about the patient’s blood type (and Rh factor), a complete blood count, a complete urine test, and ECG results.

Then an anesthesia plan is drawn up. As a rule, extensive intracavitary operations are performed using combined endotracheal anesthesia: after induction of anesthesia, the anesthesiologist performs direct laryngoscopy and intubation of the trachea or bronchi, and connects an anesthesia-respiratory apparatus (with artificial ventilation of the lungs) to the intubation tube. And small-scale extracavitary operations (lasting no more than an hour and a half) are performed under inhalation general anesthesia through the mask of the anesthesia apparatus - with spontaneous breathing of the patient being operated on.

In addition, drug preparation for anesthesia is carried out - premedication. Taking into account such factors as the patient's condition, age, body weight, nature of the operation and the chosen method of anesthesia, the anesthesiologist prescribes a number of medications. These drugs are designed to relieve mental stress on the eve of the operation, ensure normal patient sleep and facilitate the introduction of anesthesia. Also, certain drugs prescribed by the anesthesiologist help prevent possible adverse reactions of the body to anesthesia and reduce the risk of side effects of the anesthetics used.

What does an anesthesiologist do during and after surgery?

After the patient is put under anesthesia, the anesthesiologist is constantly near the patient throughout the operation and monitors his condition. For this purpose, equipment is used that provides objective information about the work of the heart and lungs, monitors arterial pressure, central venous pressure, tissue blood filling, gas composition of the inhaled and exhaled mixture (or the concentration of drugs in the blood administered intravenously), and monitors the gas and acid-base composition of the blood.

The anesthesiologist also monitors the color and moisture of the patient's skin, the size of his pupils and their reaction to light.

After the operation is completed, the anesthesiologist stops administering anesthetic agents, but his work does not end there. In the postoperative period, he monitors the patient's condition with the help of special equipment: depending on the type of general anesthesia, the duration of recovery from it varies, and the anesthesiologist, together with the attending physician, monitors how the process proceeds - in order to prevent complications in time. After all, there are no absolutely harmless methods of general anesthesia, and all anesthetic drugs in one way or another affect the liver, which removes them from the blood.

Advice from an anesthesiologist

If you have diabetes or coronary heart disease, you must continue taking the medications prescribed by your doctor before surgery.

Before any surgery, you should not take aspirin (it can increase bleeding) and you should not drink alcohol for at least a week (additional stress on the liver will prevent the removal of toxic substances from the body).

You should not eat animal fats; it is better to eat chicken, fish and fermented milk products.

In elderly patients, bronchitis or even pneumonia may occur as a result of surgery under general anesthesia.

By the way, International Anesthesiologist Day is celebrated annually on October 16. It was on this day in 1846 that Harvard University professor John Collins Warren used general ether anesthesia during an operation to remove a tumor in the submandibular region of a patient at Boston Hospital, 20-year-old artist Edward Abbott. The anesthesia was performed by dentist William Morton.

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