What do we (Anesthesiologists) do?
Anesthesiologists are Specialist Physicians whose primary responsibility is to provide for your medical care before (preoperatively), during (intraoperatively), and after (postoperatively) your surgery and certain other medical procedures.
Before your surgery, your anesthesiologist will consult with your surgical team and medically evaluate you, preparing you to more safely undergo your planned procedure. On occasion, your evaluation may elicit a new medical problem or determine that your current medical problems require further investigation and treatment prior to surgery. We want you to undergo your surgery safely and it is important for you to be forthcoming about your medical history, and complete any required testing prior to your procedure.
Another important preoperative requirement is to strictly follow any fasting directives. These have been put in place for your own safety. Eating a full breakfast for example and not informing your anesthesiologist will put you at grave risk for “aspiration pneumonitis,” in which any food in your stomach can come up your esophagus and travel into your lungs, potentially causing serious lung damage. Remember, your anesthesiologist wants you to get through your surgery safely. Please diligently follow all of your preoperative instructions including the use of only authorized medications and supplements prior to your surgery.
During surgery, your anesthesiologist will be present by your side for the entire time you are under anesthesia. He or she will continuously monitor your vital functions, including your pulse, blood pressure, oxygen level, ventilation (breathing) and level of anesthesia. On occasion your anesthesiologist will perform additional procedures to more closely monitor your blood pressure or your heart function depending on your medical condition and type of surgery. In addition, your anesthesiologist keeps a close eye on your fluid status and administers any necessary intravenous fluids or blood and blood products during your surgery. We will also administer any required pain medication and anti-nausea medication before you leave the operating room.
Some patients are concerned about “waking up” during their surgery. Your anesthesiologist will continuously monitor not only your vital signs, but your “depth” of anesthesia to prevent any intraoperative awareness. In addition we frequently utilize a special device that monitors your EEG, or brain function, confirming that you are indeed asleep.
After your surgery, your anesthesiologist will personally transport you to one of our PACUs, or post anesthesia care units, which are specialized recovery rooms where registered nurses with extensive training or ICU (intensive care unit) experience will closely monitor your vital signs. You may be somewhat drowsy and confused when you first wake up and your PACU nurse, under the direction of your anesthesiologist, will administer any pain and anti-nausea medication you may still need. When you meet certain discharge criteria your anesthesiologist will medically discharge you to your own room or, if you are an outpatient, to the day stay area prior to your discharge home.
If you experience any pain or nausea after waking up, it is important to quickly inform your R.N. We take post-operative nausea and vomiting seriously and do our best to prevent this concerning side effect of surgery, anesthesia and narcotic pain medications. On occasion, despite our best efforts, some patients who are more prone to nausea will still get nauseated after surgery. If this happens we will aggressively treat your symptoms with the help of our PACU nurses.
Sometimes, we may have to keep you on a breathing machine or ventilator after your procedure due to the type of surgery (e.g. after open heart surgery) or due to your medical condition (e.g. severe lung disease). In that situation, your anesthesiologist will transport you to the PACU or ICU sedated and order medication for your comfort as you awaken. At some institutions Anesthesiologists will also medically manage you in the ICU. At Baptist, this role falls to our Pulmonary Critical Care colleagues, who will remove your ventilator in a timely manner when you are medically stable and breathing adequately on your own.