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Anesthesiology

What is Anesthesiology?

aneszteziológia

Anesthesiology is a branch of medicine that deals with anesthesia and pain relief.  As the surgical techniques developed and more and more advanced methods, medicines and instruments became available requiring pain relief, anesthesia itself became an independent medical science. 

The anesthesiologist is responsible for making sure that the patient is administered the most complete and safest pain relief medication before surgery and for constantly monitoring the patient’s vital functions during surgery.  Their goal is to have the patient suffer the least amount of stress as possible during a procedure.   

Before Surgery

You will have to first undergo a thorough physical examination.  The results will be subsequently evaluated by the anesthesiologist who will then sit down with you for a detailed discussion.  You will be asked questions regarding your current and past health, any medications you are taking, past illnesses you have had, any previous surgeries and their outcome, if you have drug or other allergies, and so forth.  These provide important information that might influence the successful outcome of the surgery and help figure out the best possible personalized anesthetic plan for your needs.   

Just before surgery, you will have to undergo one more examination to see whether any change occurred in your condition during the preparation process.  You will also be given instructions about not eating or drinking before surgery and about taking your usual medications. 

Thoroughly informing the patient regarding the surgical process and the type of anesthesia to be used is an integral part of the pre-operation preparation process since the patient who knows what steps will be taken and why and what happens to him or her during the intervention will have a much lower anxiety level.

How is the type of anesthesia determined?

The pain relief and anesthesia method to be used can be varied depending on the type of intervention and your condition. The most important difference between the methods is whether the anesthesia should extend to your entire body or only a specific area needs to be involved and whether you need to stay awake during the whole process or not.

During the surgical anesthesiological examination, yours entire medical history will be taken including all previous illnesses, surgeries, medications and possible drug allergies.  You will also have to undergo a general physical to check your airways, take an ECG and have laboratory blood tests and urinalysis done.  Based on these results and the amount of strain the procedure will place on you, the anesthesiologist will decide, together with you and the surgeon, the most appropriate anesthesia method for you.

What happens during anesthesia?

If general anesthesia, when you are completely put to sleep (as in abdominal or chest surgery), the anesthesia is administered either through an IV or breathed in through a mask following which you will be unconscious and feel no pain.  You may also be given muscle relaxants that will stop your breathing muscles from functioning in which case you will be put on an artificial respirator.  The anesthesiologist will monitor your vital signs – your blood pressure, heart, breathing, muscle tone, blood oxygenation, and make sure that you constantly received the right dose and keep you as comfortable as possible throughout the operation.

When the operation is over, the anesthesiologist will stop delivering the anesthesia, its effect will slowly decrease and you will soon be able to breathe on your own and regain consciousness.  If you have some pain and discomfort afterward,  the anesthesiologist can relieve these with medications.

What do I need to know about epidurals?

The most important fact about conscious analgesia or sedation is that you remain conscious.  Only the sensory nerves in the area to be operated are blocked.  Epidural anesthesia or sedation is used for operations of the limbs, abdominal surgeries and, for example, frequently, in caesarean sections.  This method prevents the possible unpleasantness or dizziness felt after waking from anesthesia and the caesarean section allows the mother to experience the birth of her child by being fully awake.  The analgesic is injected into the appropriate section of the cerebrospinal fluid through a thin needle, thus blocking the nerves running in the spinal cord and achieving the analgesic effect.

What are the local anesthesia methods?

The peripheral nerve block is another anesthesia technique wherein you remain awake.  It is used when the analgesic (such Lidocaine) would be enough to suppress the function of the nerve tissues serving the surgical area.   In cases of limb surgeries, mouth and dermatologic interventions, the doctor performing the operation usually administers the local anesthesia him or herself.