Patients are completely ignorant of the efforts and skills involved in giving prudent anaesthesia as usually the patients sleep when the anaesthesiologist do their job.
Whenever introduced to people as an anaesthesiologist I am often confronted with the question “what is it that I exactly do in the operation theatre?” 15 years of rigorous clinical work flash in front of my eyes. However, an informed patient and an experienced surgeon will be able to tell you what difference an able anaesthesiologist can make to your surgical experience. Sometimes in the most critical patients it can be amounting to the difference between life and death.
Meg Ryan rightfully quoted that the best thing about living in modern times is Anaesthesia. Before the advent of anaesthesia surgery was a gruesome experience with the patient tied with ropes or having the assistants grab the patient tightly during surgery. No heed was paid to the dreadful pain and imminent death following surgery.
Alcohol, opium and cannabis were the earliest compounds used to produce a state of euphoria during surgery. Technique of compressing an artery running in our neck known as the carotid artery to produce a temporary state of unconsciousness has been described in the Egyptian Scriptures. Other non-drug techniques involved hypnosis, nerve compression, using cold conditions and causing brain concussions to produce a relative state of unmindfullness.
There are many reasons why people are oblivious to this magical medical expertise which can put an alert person to sleep in seconds. For one in a healthcare setting the surgeon is the first point of contact for any patient scheduled for surgery. Interaction with the anaesthesiologist before surgery is often limited to a single visit for preoperative check-up.
Patients are completely ignorant of the efforts and skills involved in giving prudent anaesthesia as usually the patients sleep when the anaesthesiologist do their job. They wake up completely unaware and comfortable at the end of the surgical procedure.
An anaesthesiologist is a physician involved in patient care before, during and after surgery. Before surgery the he makes sure that all investigations are done and assesses if the surgery can be performed safely. Also, he allays the anxiety of the patient by counselling and preparing the patient for the course after surgery.
The anaesthesiologist is by the side of the unaware patient during the surgery constantly giving titrated doses of anaesthetic gases, intermittent injections of medicines and pushing intravenous fluids. The anaesthesiologist is responsible for providing favourable conditions for the surgeon to perform a successful surgery. The responsibility of providing adequate pain relief after surgery too lies mainly on the anaesthesiologist.
Pain management starts before surgery by proper counselling of the patient and planning of meth
ods for pain relief during and after surgery. After surgery, the anaesthetist and the surgeon collectively give instructions ensuring the patients smooth recovery and a timely discharge without any complications.
In COVID times because of the ability to intubate a patient required to be put on ventilator anaesthesiologist -the unsung heroes have come into limelight. Due to the skill set that they possess anaesthesiologist often work as intensivist in the ICU and independently as pain physicians. Moreover, in times of crisis the anaesthetist takes the lead in the operation theatre while the surgeon continues to quickly complete the surgery. Anaesthesia as a medical speciality essentially revolves around ensuring patient safety despite all odds.
Anaesthesia in my view is one of the greatest gift of man to mankind. If you ever need to lie down on the operation table, take a close look at the doctor at the head end responsible to take you through a remarkable journey of lost time.
--Dr Ichha Kaur/Gurugram
(The author is a guest contributor and Former Senior Consultant at Max Gurgaon. Presently working as a free lancing anaesthesiologist at Gurugram)