The Naperville Sun
Health Matters
Someone to watch over you
September 22, 2009
When surgery is scheduled for you or a family member, there's someone you should know: the anesthesiologist.
If your experience with this type of specialist is limited to television hospital shows, your sole impression may be of a mysterious masked person who eases the patient into unconsciousness by having him count backwards.
In the real world, the anesthesiologist does a lot more than that. While the surgeon is busy fixing the problem that brought you to surgery, the anesthesiologist monitors, and often controls, those functions that keep you alive and well, such as heart rate and rhythm, breathing, blood pressure, body temperature and body fluid balance.
Four years of training beyond medical school also prepares anesthesiologists to deal with any underlying conditions that could be affected by surgery or anesthesia, such as heart disease or diabetes.
After reviewing your medical record and consulting with other doctors, the anesthesiologist develops a personalized anesthesia plan taking into account the type of surgery involved, your overall health and any underlying medical conditions.
"Just as a cook may choose from 20 or more ingredients to make a dish, the anesthesiologist chooses the right combination from a broad array of anesthesia medications and techniques," said anesthesiologist Frank Gentile of DuPage Valley Anesthesiologists and chairman of Edward Hospital's department of anesthesiology.
Anesthesiologists provide three categories of anesthesia: general, regional and sedation (also called monitored anesthesia care).
In general anesthesia, you're unconscious and unaware of sensations. With regional anesthesia, such as the epidurals used in childbirth, nerves are blocked to numb an area of your body. Sedation, which is usually provided via an IV, relaxes the patient and often causes him or her to fall asleep during a procedure. This may be done in conjunction with a regional or local anesthesia to numb a small part of the body, such as the foot.
Before your surgery the anesthesiologist will meet with you to discuss your recommended anesthesia plan, as well as what you can expect when you wake up regarding pain control and possible post-anesthesia effects.
Once anesthesia is properly induced in the operating room, the anesthesiologist will begin to track your functions on various monitoring devices and give you additional drugs and fluids as needed.
When the surgery is over, the anesthesiologist reverses the anesthesia and you're transferred to the post-anesthesia care unit for recovery, including administration of drugs to relieve pain and control blood pressure. Your anesthesiologist also determines when you can be transferred to a hospital room or discharged, if it's same-day surgery.
It's estimated that almost 40 million anesthetics are administered each year in this country.
"Only 50 years ago a death related to anesthesia occurred in 1 in 10,000 cases involving otherwise healthy people," said Gentile. "Today, the mortality rates is less than one in 250,000."
Why the drop?
Anesthesiologists today follow more than 30 standards of safe practice developed by the American Society of Anesthesiologists. These guidelines, together with today's sophisticated monitoring technology and better drugs, have made anesthesia safer than ever.
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