Anesthesia ......

Anesthesiologist : the unsung hero of the surgical team.

In the recent developments at Bangalore where in two people lost their life during and postoperatively brings the Anesthesiologist to the lime light for the other reason, the Surgeon, hospital management, relatives, and finally media, have judged the anesthetist as a criminal who has killed the patients by overdose of drugs ! The mentioned team except the surgeon, do not know the ABCD of anaesthesia,its methods, drug effects ,complications  etc .without going in to the fact, what went wrong  during the conduct of anesthesia at  the Operation theatre, they  came to the conclusion that it was anesthesia  problem. It's really ridiculous that the poor anesthetist is targeted for no fault of his. This practice of blaming anesthetist for the operation room mishap has been  running  since ages... The Surgeon grabs the credit of the successful operation and for the catastrophes he holds the anesthesia and the anesthetist responsible. Pity the  hapless  Anesthesiologist who is at his mercy.

Anesthesiologist for the most of the time remains behind the scene of surgery. He is not exposed to the patients most of the time. He is called to give anesthesia, where in the patients is already on the operation table. Rarely  will he be asked to see the patients pre operatively although it should be insisted in every case in the interest of the  of the patient's safety and successful outcome of surgery.

Anesthesiologist is the one, who prepares the patients for the proposed surgery, no doubt the Physicians and Cardiologist would have done their job of clearing  the patient fit for the surgery by  routine ECG and Echocardiograms and other investigations, but the final say is from the anesthesiologist as he is the one who faces the music in the Operating Room when patients end up with problems during anesthesia,  No Physician and Cardiologist who had vouched fit, will come to the rescue of the anesthesiologist and the ailing patient.

Normally the Anesthesiologist will examine the patient along with all his investigations to find out whether this patient will tolerate the  proposed surgery and anesthesia. He clinically examines the patient's respiratory, cardiac, GI, metabolic systems, enquires about the diseases the patient suffering, the drugs he is on for the ailments, finally orders and reviews some of the investigations before declaring him fit for surgery.

 After this pre anesthetic checkup  the anesthesiologist will plan the procedure of  anesthesia and  he will explain the details to the patient. He will decide about the procedures such as GA, regional, epidural, spinal etc .Normally a six hours of fasting is ordered to keep the stomach empty to prevent aspiration of stomach juice in to the lungs causing the pneumonia, infection and sometimes even the death.

Once the patient is wheeled in the OT the Anesthesiologist takes charge of the patient in Toto. He starts and IV line ,connects the patient to the multimonitors such as, ECG,SPO2.ETCO2,HR,BP .These

gadgets will  always reflect the physiology of the patient undergoing the surgery, where in the surgeon is busy correcting the anatomical abnormality of the patient who has come for corrective surgery.

Anesthesiologist puts the patients to sleep, takes control of the airway ,sees that the patient does not move a bit during the operation by using relaxant drugs, he sees that the patient does not feel any pain of the surgery and blunts the  recall of events during the surgery, he infuses required IV fluids and blood that patients needs during the surgery and lastly has a look at the kidney function by looking at the  urine output of the patient.

At the end of the surgery ascertaining everything is fine, he will reverse the patient back to life from anesthesia induced sleep. He  then orders shifting of the patient to the ICU or the recovery room for the further monitoring and provides sufficient pain relief medicines to keep the patient comfortable in the post operative period.

Patients preexisting disease condition may worsen during surgery, patient may respond in a different ways  than expected, surgical bleeding may be too much to cope up with, irregular rhythm of the heart causing the cardiac arrest and so on so forth, these will land the patient to the complications during the procedure.

The eternal vigilant  anesthesiologist identifies the problems and takes corrective steps  to bring the patient to the normal physiology. Most of the time he is successful in doing so, which will be never noticed and appreciated. But at times when he fails to revive the patient, the entire world looks him down, and  begin all sort of mudslinging ,treats him as a criminal who took away the life of the patient. People often forget that he is the only person in the operation room who goes all out to save the patient, tries all his methods, in saving the life of the patient. But how many people come to know about his efforts ?

Normally the lay public are not aware of the job anesthetist  does in the operation room it is  presumed that the anesthesia doctor will either give one injection to the back or through the IV line and put a mask over the face of the patient and that's all !!! no matter how complicated and long the surgical procedure be.

Anesthesiologist is the real friend and not a foe of the patient, who sees that the patient is through his surgery without any complications .Every patient who undergoes surgery should be indebted to the anesthesiologist for the safe journey through the painful surgery otherwise.

Lastly the Anesthesiologist is stepping  out of the operating room to aid  pain relief in chronic and cancer patients  provide the  painless labor child birth and  helps to  man  the critically ill patients in the Intensive Care Unit and Cardiac care unit.