What is anesthesia?
Anesthesiology is a discipline within the practice of medicine specializing in the medical management of patients who are rendered unconscious or insensible to pain and emotional stress during surgical, obstetrical and certain other medical procedures. It involves preoperative, intraoperative and postoperative evaluation and treatment. Anesthesiologists are responsible for protecting life functions and vital organs under the stress of anesthetic, surgical and other medical procedures. They also manage cardiopulmonary resuscitation, pulmonary care and critically ill patients in special intensive care units.
As the type of anesthetic you may require is varied, so are the medications used to produce the anesthetic state. Following are typical anesthetic medications used. You may receive all or only one or two, depending on what your anesthesiologist feels is required. Most are given through an intravenous line (IV) with a saline (salt) solution.
Sedation/antianxiety drugs are typically used in the preoperative holding area to decrease nervousness and anxiety. The goal is a relaxed and calm patient who is relaxed and cooperative, not "knocked out." Valium and Versed are drugs in this class that are commonly employed.
Narcotic/pain medications are used to relieve and prevent pain. Common examples are morphine, Demerol and Fentanyl. They are often used in conjunction with inhaled anesthetics.
IV induction drugs are used in the operating room to quickly produce unconsciousness and unawareness. They induce anesthesia or "put you to sleep." They are generally short acting and only begin the anesthetic. Sodium Pentothal is the traditional drug used that most people are familiar with, but it has been largely replaced by newer drugs, such as propofol, that cause fewer side effects. Sometimes induction drugs are given by continuous infusion to maintain the anesthetic.
Inhaled anesthetic drugs are used to maintain the anesthetic state. These are gases that are breathed into your lungs after you are asleep that continue to keep you asleep until they are discontinued. There are six inhaled anesthetics commonly used today; all are far superior to the original inhaled anesthetic, ether. Inhaled anesthetics are often used to induce or begin the anesthetic in young children who would struggle against a needle stick.
Muscle relaxants are sometimes given to the unconscious patient to improve operating conditions or to make it easier to put the breathing tube in place.
Many other nonanesthetic drugs are often given during an anesthetic. Examples include antinausea drugs, antibiotics, medications to control blood pressure and many infrequently-used drugs.
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What does an anesthesiologist do?
The anesthesiologist is a medical doctor who, after medical school and internship, has chosen to specialize in anesthesiology. All anesthesiologists have at least three years of training after medical school; most have four years, and a few have more.
It is the anesthesiologist's job to keep you safe and comfortable during surgery and recovery from anesthesia. Once you enter the operating room, the anesthesiologist never leaves your side until you are safe and stable in the postanesthesia care unit.
The anesthesiologist always monitors your heart rhythm, blood pressure, the amount of oxygen in your blood, temperature and your level of consciousness. When patients are completely asleep (under a general anesthetic), the anesthesiologist monitors each breath by measuring the volume of breath exhaled and the amount of carbon dioxide in each breath.In some cases, the anesthesiologist may monitor the amount of blood your heart is pumping and the blood pressure inside your lung vessels.
During a few large neurosurgical or orthopedic procedures, the anesthesiologist monitors neurological function. The anesthesiologist keeps the patient "asleep" or unconscious during surgery by administering a few or several anesthetic drugs. Some are given intravenously; others are mixed with the oxygen the patient breathes.
If the patient encounters a problem during surgery (low blood pressure, asthma, substantial blood loss, inadequate blood flow to the heart, heart arrhythmia and many others), the anesthesiologist works to correct the problem. The postanesthesia care nurse and the anesthesiologist work together in the recovery area to keep the patient safe and comfortable.
Finally, some anesthesiologists with subspecialty training and interests perform functions beyond those listed here.
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Will the anesthesiologist be in the room the whole time?
Yes, Associated Anesthesiologists of Reno will guarantee that a physician anesthesiologist will be in the operating room during the entire intraoperative anesthetic.
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Do you use nurse anesthetists?
No, all anesthesia providers in Associated Anesthesiologists of Reno are physicians (M.D.) anesthesiologists. All the anesthesiologists are Diplomates of the American Board of Anesthesiology, except for those who have been in practice for less than two years, and are in the certification process.
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What drugs will I get with general anesthesia?
General anesthesia involves the use of multiple different medications that are chosen on a case-by-case basis by the anesthesiologists. Decisions are made based on the patient characteristics, and on the length and type of surgical procedure. The majority of the time, adults receive an intravenous induction agent, such as a short-acting barbiturate or sedative-hypnotic (usually propofol). Maintenance of anesthesia is usually with a combination of inhalational anesthetic agents (i.e., gases), opioid narcotics, muscle relaxants and sedative hypnotic medications.
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