An anesthesiologist is not only a doctor who safely puts you to sleep
16 kwietnia 2021
Most of us think of an anesthesiologist only in the context of an operating room and general anesthesia. Meanwhile, the scope of his work and role in the treatment process is much more serious. Any person getting ready for surgery or needing pain therapy should know this. Today we are discovering the importance of an anesthesiologist’s work - during pandemic, when anesthesiologists are worth their weight in gold: without them it is impossible to imagine effective respiratory therapy.
Common facts and myths about the work of anesthesiologists are commented on by doctor Piotr Zydroń - an anesthesiologist, head of the Department of Anesthesiology at the Carolina Medical Center.
An anesthesiologist only works in the operating room – MYTH
There are many more places where an anesthesiologist is needed. The acquired qualifications and skills also enable work in the intensive care unit and in the pain treatment clinic. Resuscitation in hospital wards is also carried out by anesthesiologists - they belong to hospital resuscitation teams and they are called in cases of cardiac arrest or when immediate help is needed..
The anesthesiologist’s task is only to administer anesthesia during surgery – MYTH
Anesthesia is a complex process, adapted to the changing conditions of surgery and "tailored individually" to the patient. The role of the anesthesiologist is to ensure that the patient goes safely through the perioperative period: before, during and immediately after surgery. One of the components of anesthesia is pain treatment, while the others are aimed at creating comfort for the patient (which is why the patient sleeps during the procedure) and for the doctor who performs the surgery (e.g. the anesthesiologist deliberately induces muscle relaxation, to create optimal conditions for the doctor who operates the patient. Such action requires further action of the anesthesiologist - supporting the patient with a ventilator).
The anesthesiologist gives consent to perform a surgery – FACT
The anesthesiologist is responsible for deciding whether the patient can undergo a surgery, taking into account his health condition and the specificity of the procedure - he analyzes, among others, operational stress, tissue trauma, bleeding, body position, pain stimulation and predicts how the body will behave all through the surgery. During the evaluation, the doctor also focuses on the history of previous diseases and treatments, medications taken, laboratory test results and other consultations’ outcomes. The information gathered in the interview also enables him to properly prepare to monitor the patient during the procedure and to evaluate what procedures he may require after surgery.
It is the attending physican or the operating doctor who decides on the type of anesthesia – MYTH
It is the anesthesiologist who selects the appropriate anesthesia, taking into account patient's health condition, the type of the surgery, and the course of the postoperative period (e.g. the need for early painful rehabilitation). In our clinic, patients are previously examined and qualified for anesthesia during a specialist anesthesia consultation. After such qualification, if there are no contraindications, the patient is admitted to the hospital for surgery. The most appropriate types of anesthesia are also discussed during the consultation.
In our clinic, most of surgeries are performed under regional anesthesia, which allow to turn off the pain in the operated area, e.g. we block the brachial plexus for hand surgery, we block individual nerves (e.g. femoral or sciatic) in lower limb procedures or we perform special anesthesia (i.e. subarachnoid), which turn off feeling in the lower body (colloquially "from the waist down"). Another type of anesthesia is the epidural anesthesia, which makes it possible to effectively treat post-operative pain, because anesthetic drugs can be administered through a thin catheter left in the epidural space for many hours after the surgery. In addition, we offer patients general intravenous anesthesia, which causes the patient to fall asleep while maintaining his own breathing (without the need for intubation or using a respirator), which eliminates the discomfort associated with the sounds of surgery and forced body position during the procedure. We perform all anesthesia under minimal sedation, i.e. under the influence of drugs that make the patient comfortable, reducing stress and pain associated with the anesthesia itself.
An anesthesiologist treats pain that also occurs as a result of surgery or cancer – FACT
Improving the quality of life of patients and reducing suffering are the main assumptions in the philosophy of chronic pain therapy. Pain therapy is tailored individually depending on the causes and severity of pain. It also requires constant monitoring of the patient's well-being and supervision by a physician in order to assess the effectiveness of the treatment. In the treatment of chronic pain, one can use the forms of regional anesthesia - blockades of particular nerves and nerves’ ganglia, and pharmacotherapy. In chronic pain, nerves are often damaged (neuropathy), so standard painkillers are added to other drugs, such as antidepressants and antiepileptic drugs, which have been proven effective in this type of disease. The highest standards in the field of pain treatment are indicated by the "Hospital without pain" certificate awarded by the Polish Society for the Study of Pain . Our clinic also obtained this certification. Today we monitor pain intensity and pain treatment in all postoperative patients. Additionally, each patient is informed about the applied pain relief methods.
An anesthesiologist takes care of the patient’s psychological comfort – FACT
In addition to assessing the physical condition, the anesthesiologist also cares about patient's mental condition. He supports the patient at every stage: before the procedure, during and after waking up. Therefore, empathy, understanding and patience are extremely important features in this profession. The doctor helps the patient recover, tries to provide him with maximum comfort by reducing pain. It is also very important to support the patient and his relatives through conversations, providing relevant information or dispelling fears related to the treatment process.
An article was prepared by doctor Piotr Zydroń - specialist anesthesiologist, Head of the Department of Anesthesiology at the Carolina Medical Center. He has been working at the clinic since 2019. He practices both in Warsaw and London, where he works in the intensive care unit at BMI London Independent Hospital. His main area of interest is the use of ultrasound in regional anesthesia. At work, he adheres to the principle of patient-centered care. He graduated from the Medical University of Warsaw. He completed numerous courses, trainings and internships - in Poland and abroad. He is a member of the European Resuscitation Council.