Anesthesiology Assignment Help

WHAT IS ANESTHESIOLOGY?

Anesthesiology is the discipline of medicine that deals with the loss of sensation and pain relief with total care of the surgical patient throughout and even after the surgery. Anesthesiology is a branch of medicine that causes the patient to become unconscious during the surgery so that he or she feels no pain. A person who practices anesthesia is known as Anesthesiologist. They are also known as Anesthetist.

ANESTHESIOLOGIST

They are the physician who makes anesthesia-related medical decisions and is responsible for the safety and well being of the patient during the surgery. They are trained and licensed medical doctors who perform anesthesia techniques before the commencement of the surgery. In simple terms, he is a medical doctor who administers anesthesia and cares for a patient before, during and immediately after a surgical procedure.

ROLE OF ANESTHESIOLOGIST

Anesthesiologists are the very important person on the surgical team. No surgery can be performed in their absence. They administer a drug that eliminates the pain a patient might feel during the surgical procedure.

  • They are the one who put you to sleep during surgery by administering the anesthesia. They also help patients through surgery and in some cases may also treat patients with conditions that cause chronic pain.
  • They are trained in the care of patients with cardiac or respiratory problems, like the patients who need artificial ventilation. They also supervise the post-anesthesia recovery of the patients.
  • Role of the anesthesiologist extends beyond the operating room. They first meet the patient before the surgical patient which is known as the 'preoperative interview'. The anesthesiologist has to make the preoperative assessment of the patient regarding the medical history medical history and medications he might be allergic to. He also briefly discusses the upcoming surgery with the patient.
  • After the session, he plans the best anesthetic method for that individual based on the current health of the patient. The anesthesiologist takes care of the patient postoperatively when the person is emerging from the effects of the anesthesia. Anesthesiologists calculate the proper drug dose for the patient according to the age, sex and weight.
  • He administers anesthesia and monitors the vital signs throughout the surgical procedure so that no mishap takes place. The various vital signs are heart rate and rhythm, blood pressure, breathing, body temperature, and functions of brain and kidney.

WORKING SCHEDULE

Anesthesiologists usually have long and irregular working hours. Working hours are not and hence the job can be stressful. During operations, they have to stand for long periods of time. They have to be on call at any hour, whether it is a day or night. Therefore, they may have to drop everything at any given point of time and have to rush to the hospital for an emergency case that needs to be operated immediately.

USES OF ANESTHESIOLOGY

1. DURING SURGERY-

Anesthesiologists are needed in almost all the types of surgery. In the operating room, as mentioned above, they are responsible for the anesthetic care of the patient throughout the duration of the surgery or the medical procedure. The anesthesiologist has to carefully access the anesthetic needs of the patient with the medical condition, his or her responses to anesthesia and the other requirements during the surgery.

2. POST-OPERATIVE CARE-

This is the room where the patient is transferred after surgery so that they can emerge fully from the effects of the anesthesia. In this room, they are under the supervision of the nursing personnel with an anesthesiologist. Safety is the foremost priority during the surgery and it is also of the utmost concern when the patient is being monitored and assessed while he or she is fully regaining consciousness. It is the duty of the anesthesiologist to decide when the patient has recovered enough so that he can be sent home after the outpatient surgery. If the patient has not stabilized he can be moved to a regular room or ward which has all the basic medical facility until the time he is perfectly normal.

3. PAIN MANAGEMENT AFTER TE SURGERY-

The anesthesia blocks the receptors which carry pain sensation. In addition to the relief of the pain during the surgical procedure, it is equally important that the adequate pain relief is present even after the procedure is over. The anesthesiologist has to prescribe the pain-relieving medications to the patient so that a level of comfort can be maintained. That is why the anesthesiologists are qualified to prescribe the drugs that can relieve acute, chronic, and childbirth pain. The anesthesiologist has to take care of two people and also provides them with pain relief with epidural or spinal blocks for the mother. He manages the life functions of both the mother and the baby.

4. EMERGENCY CASES AND CRITICAL UNIT-

Critical care units are now found in all major medical hospitals and institutes. The major role of the anesthesiologist is to provide medical assessment and diagnosis. They also provide respiratory and cardiovascular support to the patients along with infection control. Anesthesiologists receive training to deal with all kinds of emergency situations. They can airway management, cardiac and pulmonary resuscitation, advanced life support and pain control to the patients at the time of emergency.

TYPES OF ANESTHESIA

As discussed above, anesthesia is the drug that causes the loss of sensation over a period of time. There are mainly three categories of anesthesia and they are:

  • General
  • Regional
  • Local

General anesthesia-

The patient is fully unconscious and has no awareness and sensations. Under general anesthesia, the patient is fully sedated and will wake up after the surgery. There are many general anesthetic drugs –

  • Gases or vapors inhaled that can be through a breathing mask
  • Medications that can be administered through the vein.

Advantages

  • Reduces the patient awareness during procedure and recall
  • Allows proper muscle relaxation for long period of time
  • Provide complete control of the airway, breathing, and circulation
  • Can be used in sensitivity cases with local anesthetic agent
  • Can be administered in the supine position
  • Can be adapted for the procedures of long duration
  • Can be administered rapidly and the state is reversible

Disadvantages

  • Increased complexity of the procedure
  • Preoperative patient preparation is required
  • Physiologic fluctuations may be caused that require active intervention
  • Nausea or vomiting, sore throat, headache, and delayed return to normal mental functioning are few symptoms most commonly seen
  • Can be associated with malignant hyperthermia. It is a rare, inherited muscular condition in which when the patient is exposed to some general anesthetic agent results in acute and potentially lethal temperature rise. The patient also suffers from hypercarbia, metabolic acidosis, and hyperkalemia.

Stages of Anesthesia

STAGE OF ANALGESIA- This stage starts as soon as the patient is administered with the anesthesia and lasts till the patient loses the consciousness. Pain is progressively abolished and some minor surgeries can be performed at this stage.

STAGE OF DELIRIUM- The stage starts from loss of consciousness to the beginning of the regular respiration. No procedures can be carried out at this stage. This stage may be associated with jerky breathing, excitement and struggling. During this stage, the patient can make the eyelash reflex and swallowing movements.

SURGICAL ANESTHESIA- From the onset of regular respiration to the cessation of the spontaneous breathing. This stage is further divided into four planes. The surgical and dental procedures are carried out at this stage at the plane 1 and 2. This stage is the main stage in which the surgical procedures can be carried so that the patient feels no pain.

MEDULLARY PARALYSIS- From the cessation of breathing to the failure in the circulation. The patient should never reach this stage. This stage might lead to the death of the patient if the patient is not recovered in time by using antagonist.

Regional anesthesia-

In this technique, an injection is given near a cluster of nerves to numb the area of your body where the surgery will be performed.

The patient might be awake or maybe sedated so that he or she cannot feel the actual surgery taking place. The most common kinds of anesthetics are Spinal anesthesia and Epidural anesthesia and Nerve blocks.

  • Spinal – This technique is used for lower abdominal, pelvic, rectal, or lower extremity surgery. The procedure involves injecting a single dose of the anesthetic drug into the spinal cord in the lower back. The injection causes the numbness in the lower body.
  • Epidural and caudal anesthesia - This anesthetic technique is similar to a spinal anesthetic and is used for surgery of the lower limb, or during labor and childbirth. This type involves continually infusing drugs with help of a thin catheter placed into the space surrounding the spinal cord in the lower back region.
  • Nerve blocks - A local anesthetic is injected over a specific nerve or group of nerves to block pain from the area of the body supplied by the particular nerve. The nerve block is used for procedures on the face, hands, arms, feet, and legs.

Local anesthesia-

An anesthetic drug is injected into the tissue so that there is a loss of sensation over that particular area. The patient is not sedated and is fully awake but he cannot feel the pain from the surgery due to the loss of sensations.

Lignocaine, prilocaine, tetracaine, bupivacaine, benzocaine is the most commonly used local anesthetic agents. These agents can be used alone or can be combined with adrenaline to increase their potency and the duration. These agents are quite helpful in small dental and medical procedures so that the patient doesn’t have to feel the pain.