Most people think of the anesthesiologist as a doctor who relieves pain through pharmacological treatment and renders the patient unconscious. However, few people realize that the task of today’s anesthesiologists in the operating room is not only to ensure patient comfort, but also to monitor, diagnose, and thus treat changes in vital functions caused by multiple factors (surgery, anesthesia, primary disease, etc.) during surgery and recovery from anesthesia, to prevent and urgently treat possible abnormalities during anesthesia and surgery, to avoid complications and serious The patient’s safety in the perioperative period is ensured. Therefore, there is an image in the industry that “surgeons treat diseases, anesthesiologists protect lives”. For patients who have experienced surgery and anesthesia, what they see and feel is just “a shot” and then “sleep”, after waking up, the surgery is over, but it is hard for them to appreciate the labor and efforts of the anesthesiologist behind the surgery. Anesthesia is not just a simple “shot”! Anesthesia does not mean sleeping, and because everyone tolerates and reacts differently to anesthetics, accidents and complications are inevitable during the anesthesia process. These accidents include: inhibition of whistle circulation, cardiac arrest, vomiting, regurgitation and aspiration, and nerve damage. This is why the anesthesiologist cannot leave the patient during the entire operation and must know every step of the operation and the next step; he or she should have a full understanding of the indications, contraindications and interactions between various anesthetic drugs and adjust the anesthetic dose and dosage according to the needs of the operation at any time. The purpose is to keep the patient’s vital function at a normal physiological level. Therefore, anesthesia is never as simple as “one shot, one sleep”. It is more important to monitor and diagnose changes in vital functions caused by various factors during surgery and recovery from anesthesia, and to provide timely treatment to ensure the safety of patients in the perioperative period. There are many people in daily life who have some prejudices against anesthesia, thinking that it is bad and that it has an effect on the body. Some people are afraid of anesthesia and have to undergo anesthesia only as a last resort, in the case of life-threatening diseases. In fact, the positive effects of anesthesia on the elimination of pain and the maintenance of the patient’s life functions far outweigh the possible adverse effects of anesthesia itself. Anesthesia is not perfect. What is the likelihood that it will be dangerous? According to the American Society of Anesthesiologists, maternal death caused by epidural anesthesia itself is 1.7 per million during cesarean anesthesia and labor analgesia. What are the risks of anesthesia? All surgeries and anesthesia carry a certain amount of risk, determined by a variety of factors including the surgical procedure, the patient’s physical condition and the presence of co-morbidities with other serious systemic diseases. During surgery, the anesthesiologist is the one who gives direct life support to the patient, and he or she has to monitor the patient’s heart rate, blood pressure, inspiration, body temperature and the balance of the internal environment and a series of other vital signs. For surgical subjects of different ages, 1 year old, 30 years old, 80 years old, as long as the same disease, there is basically no difference when the surgeon is operating; however, there is a world of difference when the anesthesiologist is considering the anesthesia plan. Regardless of any type of anesthesia, due to the inherent side effects of anesthetics, the complexity of the condition, and adverse stimuli such as surgery, unpredictability can lead to dramatic changes in a patient’s vital signs, even life-threatening, such as intraoperative hemorrhage, acute heart failure, myocardial hypoxia, myocardial infarction, severe drug allergy, whistle failure, and stroke. These emergencies require timely and correct emergency treatment by anesthesiologists to bring the patient back to life. Is the anesthesiologist important? For the patient undergoing surgery, the most urgent expectation is to be safe and pain-free. For the surgeon, it is the need for smooth and good operating conditions. The importance of the anesthesiologist is actually proportional to the size and level of the medical institution. The larger the hospital, the more critical patients there are, the more important the anesthesiology department is. Conversely, without a good anesthesiology department, the level of the hospital will not be too high, or at least in layman’s terms, a high level of critical care emergencies and surgical procedures will not be possible. A good hospital and a good anesthesiology department are inseparable. Instead of saying how important the anesthesiologist is during the surgery, it is better to say what role the anesthesiology department plays in the whole perioperative period from preoperative to postoperative. 1. Preoperative assessment and management Surgery is always a major trauma to the human body. Life is a long run, and surgery and trauma is one of the extraordinarily treacherous interludes. Whether the human body can withstand the blow. Before surgery, the patient’s cardiopulmonary reserve, underlying diseases, and abnormalities that need to be corrected all depend on the anesthesiologist’s clinical diagnosis, assessment, and treatment. 2.Intraoperative anesthesia and support For any kind of surgery, patient safety and pain relief are the basic requirements of anesthesia, while for those major surgeries and patients in poor condition, the monitoring and treatment by anesthesiologists maintain the life of patients who may be lost in every minute and second. Anesthesia maintains one of the highest nurse/patient ratios of any medical specialty. A patient’s surgery requires the constant attention of at least two anesthesiologists or nurses, because even the simplest surgery has the potential to be dangerous at any time. 3. Postoperative monitoring Today’s anesthesia has gone beyond intraoperative management to cover a series of postoperative support. Intensive care was first established around surgery and trauma, which are surgical problems led by the anesthesiology department. Of course, today’s critical care has far exceeded its original scope. The dominant position of anesthesiology 1. The anesthesiology department has professional advantages in many aspects, such as the management of the whistle tract and the treatment of trauma. Anesthesiologists are doing the management of the whistle tract every day and have rich experience in handling complex situations such as difficult intubation, late stage patients with posterior tongue drop and regurgitant misaspiration. The complexity of the human body determines the risky and challenging nature of anesthesia, however, opportunities and challenges coexist, so anesthesiologists have developed excellent skills in the rescue of critically ill patients and occupy a professional advantage. 2, anesthesia requires frequent exposure to strong narcotic analgesics, such as strong opioid analgesics, which is a double-edged sword, on the one hand, can be analgesic, but on the other hand, it is also easy to addiction. How to use the strong opioid drugs well, so that the surgical patients can be anesthetized comfortably, so that the pain patients, including oncology patients, can have pain relief without suffering from whistle suppression and addiction, these are the serious challenges faced by the anesthesia discipline. It is also because of this heavy challenge that the discipline of anesthesia sings a leading role in anesthesia and analgesia. 3. The Department of Anesthesiology is also in a dominant position in solving the problem of blood shortage. Blood for surgery accounts for most of the blood used in hospitals, and blood for surgical patients is a big problem. The conservation of blood for surgery occurs mainly in the operating room, and one of the leading actors in the operating room is the anesthesiologist. We are now greatly conserving the limited blood supply through autologous blood transfusion, controlled hypotension and hemodilution. Today, it is impossible to imagine what our lives would be like without surgery to treat disease, and equally unimaginable is what surgery would be like without anesthesia. The continuous development of theories and techniques in anesthesiology to maintain the patient’s vital functions has allowed surgery to be performed in areas such as the cardiothorax and central nervous system that were previously considered off-limits to life. At the end of this article is a very famous story in the United States: many Americans think that the job of anesthesiologists is just to give patients a shot and sleep, so simple, how to get the salary is the first (average salary) in the U.S. medical profession? Salary should be reduced. So there was a very lively TV debate. The vast majority of guests, overwhelmingly, supported a pay cut for anesthesiologists. At this point, the anesthesiologist who attended this debate famously said, “I actually got this shot for free ……” and the room immediately fell silent. He went on to say, “I give this shot for free. I charge what I charge, and I get paid, but only to watch the patient after the shot, not to let him or her die because of anesthesia or surgical bleeding, and to make sure they wake up safely after the procedure. If you think I’m getting paid too much, that’s fine, I’ll just give the shot and leave.” Since then America has stopped debating whether anesthesiologists are paid too much.