Introduction
The field of anesthesia is very complex, and it requires highly specialized and trained doctors to handle it. The American Society of Anesthesiologists defines the role of an anesthesiologist as ‘the practice of medicine dedicated to the relief of pain and total care of surgical patients before, during, and after surgery.’ A highly skilled healthcare professional is required to provide continuous medical care before, during, and after a surgical procedure. They administer drugs called ‘anesthetic agents’ that prevent the patient from feeling pain.
Who Is an Anesthesiologist?
A medical doctor who specializes in administering anesthesia, pain management, and other factors related to care before, during, and after a surgical procedure is termed an anesthesiologist. They undergo anesthesia education and have a thorough knowledge of the human body. They are specialists in perioperative care, the development of an anesthetic plan, and the administration of anesthetic agents during a surgical procedure. There is constant research in the field of anesthesia, which has enabled a reduction in anesthesia-related mortality and morbidity. However, challenging surgical procedures in children, adults, geriatric, and sick populations still do exist.
What Does an Anesthesiologist Do?
An anesthesiologist not only takes care of pain management during a surgical procedure but also helps in reducing the comorbid conditions of the patient for a safe and speedy recovery during the perioperative period. In short, they adopt the role of a physician as well. Hence, they can be rightly termed ‘physician anesthesiologists or perioperative physicians.’ The duties of an anesthesiologist include:
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Pre-operative Evaluation: The risk factors that may have an adverse effect on the administration of anesthesia are evaluated by the anesthesiologist. Hence, an anesthesiologist must be provided with an accurate history, diagnosis, and test reports. The pre-operative evaluation also provides the anesthesiologist an opportunity to interact with the patient, discuss the options for treatments, make the patient aware of the potential risks, and properly optimize and manage these risks. The patient is requested to sign an ‘informed consent’ containing all the relevant information, which is not just a ‘formality’ before surgery.
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Intraoperative Management of Patient: An anesthesiologist uses advanced technology to monitor the functions of the body, determine what is best for the proper functioning of the vitals, and treat any unexpected events during the surgery. The vitals include heart rate and rhythm, breathing, blood pressure, body temperature, fluid, and electrolyte balance. The anesthesiologist assistant also maintains a record of all the vitals during the procedure. However, in developing countries, where there can be a shortage of anesthesiologist assistants, all these duties are performed by an anesthesiologist. Other duties include maintaining intravenous lines at the appropriate site, depending on the type of surgery, preparation of the pre-anesthetic medication, and labeling them. Preparing and labeling emergency drugs, getting the intubation cart ready, etc. are other tasks done by them. Only an anesthesiologist can administer a regional anesthetic drug, as it requires high skills and expertise, which might be lacking by the others. In most cases, the patient might not even be aware of the administration of anesthesia, which presses on the skills of an anesthesiologist.
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Post-anesthesia Care Unit: The role of the anesthesiologist is even more important as the patient is moved to the recovery room, as the patient is still under the effect of the anesthetic drugs. The patient's activity level, adequacy of breath, circulation, level of consciousness, and oxygen saturation are monitored by an anesthesiologist. Another important duty of the anesthesiologist is optimizing pain before the patient is moved to their rooms or to the intensive care unit, where the outcome is not favorable. In most cases, the care of the patient is transferred to paramedical nurses in the recovery room, which can result in casualties. Hence, the role of an anesthesiologist in the recovery room is very crucial to the recovery of the patient.
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Pain Clinic: One of the main roles of an anesthesiologist is to relieve pain. Pain control is not only in surgical procedures but also in intractable pain of cancer, burns, herpetic neuralgias (a common complication of varicella-zoster virus reinfection), low back pain, and diabetic neuropathies (nerve damage that occurs due to elevated blood sugar levels).
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Critical Care Unit: The extensive training they receive in extensive training in clinical physiology, pathology, pharmacology, and resuscitation makes an anesthesiologist eligible to give critical care services. Some anesthesiologists pursue advanced training in critical care services and opt for careers as ICU intensivists. The complete medical care of patients in the ICU is their direct responsibility. They provide medical and diagnostic services, care for intubated patients, and infection control, in addition to other medical duties as a leader.
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Trauma and Disaster Management: Disaster management is a new field of study that is being managed by an anesthesiologist. The team of doctors that take care of disaster management is usually headed by an anesthesiologist. This is mainly because they are well-trained and experts in resuscitative measures. This is considered a separate specialization in developed countries.
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Obstetric Analgesia and Anesthesia: The role of the anesthesiologist in the maternity department is to facilitate painless delivery and to administer anesthesia in obstetric surgical procedures like cesarean section. In most cases, labor and deliveries advance uneventfully. However, in some cases, there can be some complications. The anesthesia doctors become heroes in this scenario. The life of the mother and the baby lies in the skill of an anesthesiologist. They work to resuscitate the baby in the absence of a pediatrician.
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Burns: This is another area where an anesthesiologist becomes functional. They take care of everything, from maintaining airway, circulation, fluid, and electrolyte balance to controlling pain. In some cases where it is difficult to find intravenous lines, the anesthesiologist accesses the intravenous lines by putting in a central venous line.
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Basic Sciences and Clinical Research: Research in anesthesia is ongoing and extensive, aiming to improve patient care and safety. Active research is going on in pediatric, geriatric, obstetric, critical care, cardiovascular, neurosurgical, and ambulatory anesthesia. Other areas of research where an anesthesiologist could be actively involved can be transfusion therapies (blood transfusion and fluid therapy), infection control, and organ transplantation.
Conclusion
The role of an anesthesia doctor is so important that it can not be replaced. It is a branch of medicine that provides high levels of job satisfaction, challenges, commitment to work, and empowerment. However, the lack of control over the work environment and unpredictability of work lead to high levels of anxiety and overextension of work. Hence, an anesthesiologist is a highly skilled medical specialist who plays a very important role in patient safety and care.
