What Is Anesthesiology?

The duration before, during and after surgery is called the perioperative period. Given the pain and discomfort the patient may undergo during surgery, he or she is given anesthesia, which is basically a medicine that acts as a sedative. Anesthesia can be general (complete loss of consciousness), regional (loss of consciousness in one part of the body) or local (lack of sensation in the area being operated on). Anesthesia has been used for centuries, but in the context of modern medicine, anesthesiology is an evolved and sophisticated area of medicine. The specialists who manage this function are called anesthetists.

Anesthesiology is an important branch of medicine as it makes surgery safe, feasible and possible. Skills like airway management and resuscitation that form a basic part of anesthesiology training are life-saving procedures and are indispensable in any surgical procedure. In no other branch of medicine can one have better understanding and training of vital organ management as in anesthesiology.

Over time, the branch has given rise to newer sub-specialities like pediatric anesthesiology, obstetric anesthesiology, neurosurgical anesthesiology, cardiovascular anesthesiology, critical care and pain management. Most anesthesiologists have a good idea about all these specialities while some dive deep.

Why Is Anesthesiology Important?

Administration of an anesthetic causes various changes to the physiology of the patient and this includes fluctuation in their vital parameters. This implies that these parameters must be continuously monitored which is what an anesthesiologist does. Anesthesia can also induce a range of conditions in patients such as hypothermia, shivering, sore throat, nausea, vomiting, headache, delayed unconsciousness, etc.

That is why, before administering anesthesia, an anesthesiologist meets the patient to enquire about his/her medical history, allergies to certain drugs, lifestyle habits such as smoking, alcohol consumption, use of psychedelic drugs and medical history of the patient and close family members. Such information helps the anesthesiologist in preparing the right dosage of anesthesia and determining the precautions to be taken before, during and after surgery.

The practice of anesthesiology is the best example of safety in medicine. Every year, just 5.2 deaths per million occur worldwide due to improper anesthesia. This is the closest that any medical practice can come to the quality standard called Six Sigma (3.4 errors per million). In contrast, nearly 88000 deaths occur every year in the USA alone due to medical mistakes. That is why it’s said, a hospital is only as safe as its anesthesiology practice.

Surgeons have even compared anesthesiology to aircraft flying. The induction of anesthesia, maintenance of a sedated state and emergence out of it are all similar to take off, being airborne and landing! During a surgery, the operating room resembles the air traffic control. The anesthesiologist who acts like an air-traffic controller closely monitors vital parameters, gives instructions and takes action when necessary. This ensures efficiency and safety in the operating room.

Role of an Anesthesiologist

Anesthesiologists are specialists who are trained in the field after completing an undergraduate degree in medicine. Depending on the country, this training may last 8-12 years. Their training acquaints them with subjects such as pharmacokinetics, which deals with the effect of a drug on the body, and pharmacodynamics, which deals with the effect of a drug on other drugs being administered to the patient. They are also trained in mechanical ventilation, parameters used in physiological functioning, neuro-anatomy, etc.

Before surgery, the anesthesiologist evaluates the patient’s medical history, conducts interviews with him/her, and orders blood for transfusion. The anesthesia used must factor in the nature and duration of the surgery, the patient’s current health, the technical support required during surgery, etc.

During surgery, the anesthesiologist continuously administers anesthesia to keep the patient unconscious till the end of the procedure. He/she also monitors the patient’s vital parameters like a heartbeat, BP, blood sugar, and oxygen level throughout, in case there are any life-threatening developments such as excessive bleeding or a severe allergic reaction. All these ensure the best possible pain relief for the patient and comfortable working conditions for the surgeons involved.

That is why anesthesiologists are regarded as the guardian angels in the operating room and their life-saving skills are considered indispensable to medical practice. It’s a humbling and rewarding experience for most anaesthesiologists and this is what motivates them to give their best to the profession.

At the same time, being an anesthesiologist can be stressful but they overcome this by having a work-life balance and by pursuing creative interests that are rejuvenating.