In the modern world of increasingly advanced medical technology, surgical procedures are becoming more and more complex, and painless operations and examinations are being carried out more and more widely. To understand their work!
1. What does an anesthesiologist do? The role of anesthesiologists in surgery is very important. In addition to pre-anesthesia evaluation and administration of anesthesia before surgery, while the surgeon is performing surgery, he or she must also be responsible for handling the physiological changes caused by the patient receiving anesthesia and surgery, maintaining the basic vital functions of the patient in the anesthesia state, such as heartbeat, respiration, blood circulation and oxygen delivery. In addition, we must pay attention to the appropriate depth of anesthesia for the patient, prevent and urgently deal with any abnormalities that may occur during anesthesia to avoid complications and serious sequelae. At the end of the surgery, the patient is safely and completely out of anesthesia. The anesthesiologist will also make several visits to observe the patient according to his condition and provide postoperative analgesia to patients who need it, so that the patient can recover painlessly, comfortably and safely.
Anesthesiologists have the ability to save patients’ lives in critical situations, and they are not only important in the operating room, but also in emergency care and many intensive care wards and intensive care units, taking into account the main force of emergency care. On the other hand, because anesthesiologists are well aware of the functioning of the human nervous system, they are also experts in dealing with various kinds of pain. From childbirth pain, acute pain from surgery, to various chronic pains in the body, from behind the scenes to behind-the-scenes treatment, anesthesiologists have taken on the role of a pain relief expert.
”Half of the credit for good surgery should go to anesthesiologists”, it is because of the escort of anesthesiologists that surgery has developed by leaps and bounds over the past century, surgeons have been able to perform various operations on the operating table with ease, and patients have been able to pass the most dangerous stage of surgery smoothly; it is because of the active participation of anesthesiologists in the work of analgesia that painless abortions, interventions, painless gastroscopies and other operations have been widely carried out. It is because of the active participation of anesthesiologists in analgesia that painless abortions, interventions, painless gastroscopies and other operations and examinations are widely carried out, and the great pain of countless patients in the treatment process is relieved.
2.How to cooperate with anesthesia and surgery?
Whether anesthesia and surgery can be carried out smoothly, in addition to the technical level of medical personnel and the spirit of serious and responsible work, your cooperation is also very important, from the following aspects to cooperate.
1.Build up confidence, trust the doctor, relax your whole body and eliminate tension. Excessive tension and poor sleep can cause blood pressure fluctuations on the day of surgery, which in turn can affect the surgical process.
2, to strictly follow the doctor’s instructions for preparation, to the doctor to speak the honest truth. Especially before the surgery under general anesthesia, whether you have eaten, whether you have fever, whether women have menstrual flow, you should tell the doctor first, so that the doctor can consider whether to suspend the surgery, so as not to increase the pain after the operation.
3. Before entering the operating room, empty your bowels and urine. Patients wearing movable dentures should remove them to prevent them from falling off during anesthesia intubation and accidentally entering the esophagus or respiratory tract. If you have valuables, give them to the ward matron or relatives for safekeeping before entering the operating room, and do not bring them to the operating room; when entering the operating room, change your shoes and put on the operating cap as required.
4, different surgeries, different anesthesia, the position taken is different. For lumbar anesthesia and epidural anesthesia, a sitting or lateral recumbent position is taken for the operation. The position during surgery should fully expose the surgical area and facilitate the operation of the surgeon. Once the doctor and nurse have positioned you, you should not move or change at will and tell the doctor if there is any discomfort or pain. Moving around will affect the surgical operation.
5.Some surgeries require the insertion of catheters or gastric tubes. These catheters will cause you some discomfort or pain, but you should endure them and never pull them out at will.
6, non-general anesthesia surgery, the patient is awake on the operating table, should be quiet and closed eyes to accept the operation, do not talk to the medical staff at will, and do not suspect some words of the medical staff at will, so as not to cause misunderstanding or waste burden.
3.What are the main methods of anesthesia?
There are three main anesthesia methods.
1.General anesthesia
2.Regional block anesthesia
3.Local anesthesia
Each of them has many forms and uses.
4. Can the patient request which type of anesthesia to use?
Yes, some surgeries can be done with multiple anesthesia methods. After understanding the situation, the anesthesiologist will tell you which anesthesia method to take, how to anesthetize, and how it will affect you.
5.What exactly happens to general anesthesia?
General anesthesia is divided into three processes, divided into induction, maintenance and recovery phases. Before anesthesia, intravenous access is established and the corresponding monitor is connected. Make the evaluation of vital signs before anesthesia.
Induction phase
The purpose of induction of anesthesia is the process of changing the patient from the awake state to the anesthetized state. Usually intravenous general anesthetics, analgesics, inotropes, etc. are used, and the patient undergoes the following changes within a few minutes: from a conscious state to loss of consciousness; respiration 16-20 times/min to respiratory arrest, a process that requires tracheal intubation (using an endotracheal tube inserted into the lungs, replacing the patient’s breathing with a ventilator); the presence of pain to its disappearance, etc. During this period, the patient’s vital functions change considerably, requiring close monitoring and readiness to deal with what happens.
Maintenance period
After the induction period, the surgeon prepares for surgery. Anesthetics during the induction period can only be maintained for a short period of time, and anesthetic drugs are continuously applied during surgery to maintain a certain depth of anesthesia. Usually there are intravenous general anesthetics, inhalation general anesthetics, etc., and the medication is adjusted according to the depth of anesthesia and the effect of the drug on the patient. Monitoring is performed during the maintenance period, and the effect of surgical operation on the patient’s life is always observed and treated when necessary to ensure the patient’s life safety.
Recovery period
When the surgery is over, the patient enters the recovery period. The anesthetic drugs will be discontinued and some drugs will be used to reverse the effects of the anesthetic drugs. In the anesthesia recovery room your consciousness will gradually return, the patient’s vital symptoms are still continuously monitored, some medications are used to reduce your discomfort, and the tracheal tube is removed when the patient’s respiratory function returns better. When the patient feels pain, postoperative pain management is performed. The whole process is managed by anesthesiologists and nurses, and the patient is unaware of the surgical procedure when he or she regains consciousness.
6. Why does the anesthesiologist ask many questions?
Because surgery and anesthesia will largely affect the human body, the anesthesiologist wants to know as much as possible about his patient.
In addition to relieving you of pain and comfort during surgery, the anesthesiologist is overwhelmingly responsible for the maintenance of important vital functions, so it is very important to understand the patient’s medical condition, which includes past disease history, recent medications, allergy history, past anesthesia history, etc.
The anesthesiologist must be very familiar with your health condition in order to provide the best anesthesia treatment during the procedure.
A thorough knowledge of the case scenario will help the surgeon to make quick and accurate judgments and treatment of what is happening.
There are patients who undergo surgery with other medical conditions such as diabetes, asthma, bronchitis, heart disease other medical conditions.
During the anesthesiologist’s preoperative visit to the patient, you should inform the doctor of your past medical history so that the anesthesiologist is prepared to treat some diseases during the anesthesia so as not to affect the life safety.
7.Why should a patient not eat or drink before surgery?
Fasting is very important in most anesthesia patients to make the chances of vomiting and accidental aspiration greatly reduced. This is because some anesthetic drugs weaken the normal protective reflexes of the body. For example, the lungs have protective reflexes against foreign objects, such as food in the stomach, to prevent them from entering the lungs. However, after anesthesia, these reflexes disappear. And stomach acid is so irritating to the lungs that it often causes aspiration pneumonia, which can lead to respiratory failure and affect life. Therefore, for your safety, you should follow the doctor’s instructions and fast before surgery.
8.How does the anesthesiologist ensure patient safety?
Sphygmomanometer, oximeter, respiratory monitor, blood gas monitor, mean arterial pressure, central venous pressure, muscle relaxation monitor, temperature, ECG, SWANGANZ catheter and other instruments are often used for monitoring in anesthesia, providing information on patient’s changes minute by minute, and the doctor can evaluate the patient’s condition more effectively and carry out treatment. Monitor – a beneficial weapon for anesthesiologists.
9.Why should I sign the anesthesia consent form?
Due to individual differences and co-morbidities, everyone tolerates and reacts differently to anesthesia, and accidents and complications may occur during anesthesia. As patients and their families, it is necessary and right for them to fully understand the risks of anesthesia, which is why surgical patients are required to have a pre-anesthesia conversation and sign.
10.Why do I still feel anesthesia?
After anesthesia, many patients will ask the anesthesiologist this question.
In fact, except for general anesthesia, most anesthesia methods do not affect consciousness per se, the patient remains awake, and not all sensation is lost in the nerve block area (the area that has been anesthetized).
Since most patients will be nervous to varying degrees after entering the operating room, the anesthesiologist will usually give appropriate medication to sedate the patient to sleep, so there is no need to worry at all.
11.Why do I have to go into the anesthesia recovery room after surgery?
Both surgery and anesthesia can disturb the normal physiology of the human body to some extent, especially for those patients who are in poor general condition before surgery, who have undergone general anesthesia or major surgery. Patients who require continuous monitoring after surgery, such as those who have not awakened from anesthesia or whose respiratory and circulatory functions are unstable, will be admitted to the anesthesia recovery room.
The anesthesia recovery room is equipped with full-time medical staff and complete equipment, which can implement timely and effective monitoring and resuscitation, so that patients can successfully pass the unstable period after surgery and anesthesia and further ensure patient safety.
12.Does postoperative analgesia affect wound healing?
After surgery, the anesthesiologist will use different analgesic methods according to the different conditions of the patients, and these analgesic methods will not increase the rate of wound infection or affect the growth of the incision margins. Effective analgesia can also improve sleep, enhance postoperative immune function, facilitate patients’ coughing and sputum removal, and get out of bed earlier, thus speeding up postoperative recovery and effectively reducing postoperative complications such as lung infection and lower limb vein embolism.
13.Why is there postoperative chills?
Postoperative chills refer to involuntary muscle contraction and twitching after surgery, the specific cause of which is still unclear. Local anesthetics, inhaled anesthetic gas, prolonged surgery, large intraoperative blood and fluid transfusion and exposure of the operating field will increase the incidence of chills.
Warmth and oxygen can relieve chills, and the anesthesiologist will give certain medication if necessary.
14.What about postoperative agitation?
Due to the residual effect of drugs, patients after general anesthesia may experience emotional fluctuations and agitation. At this time, family members should cooperate with the medical staff to fix the patient to prevent falling or bruising, and try to calm the patient, observe abnormal conditions, and accompany the patient until he/she is fully awake.
15.Does general anesthesia have any effect on intelligence?
The general anesthetics used in modern anesthesia are all drugs with minimal effects on the human body and reversible, and can be completely excreted by human metabolism after surgery.
16.Does drinking alcohol affect anesthesia?
This is a question that anesthesiologists often hear from friends of the cup when doing pre-anesthesia visits.
What exactly is the effect between alcohol and anesthesia? As the general public may think, chronic alcoholics do require a higher dose than the general population during anesthesia, but this is not exactly a rule of thumb; for anesthesiologists, the dose can always be adjusted according to the patient’s condition during surgery.
17. Is anesthesia more risky in elderly patients?
Yes! Unlike younger patients, older patients often have diabetes, hypertension, cardiovascular disease, cerebrovascular disease and other systemic diseases. These high-risk factors increase the difficulty of surgery and anesthesia, and sometimes the surgery is successful but the patient eventually dies due to other factors.
Therefore, the assessment before anesthesia should be prudent, and life safety should be the first priority, unless emergency surgery is required to save the life of the patient, otherwise the surgery should be suspended. Because of the poor physiological and physical condition, it is more important to choose the appropriate anesthesia, monitor the cardiovascular, pulmonary and respiratory, and renal functions during the operation, provide postoperative care and pain relief, and maintain the body temperature.
Postoperative complications such as respiratory failure, myocardial hypoxia, angina pectoris, myocardial infarction, stroke, etc. occur. They are even higher than preoperative and intraoperative ones.
The metabolism of anesthetic drugs is also slowed down by the aging of tissues and organs in elderly patients. Therefore, we should pay attention to the reduction of dose and the delayed effect of drugs.
18.Why should I fast before anesthesia?
Patients may ask, “Do I need to fast even for upper body anesthesia? Yes, you need to fast whether you are under general or semi-body anesthesia.
Why do I need to fast? Because loss of consciousness or unconsciousness during anesthesia can cause aspiration pneumonia due to vomiting and aspiration of vomit into the patient’s lungs. Aspiration pneumonia is a potentially life-threatening anesthetic complication. To reduce this comorbidity, fasting before anesthesia is necessary.
Isn’t the patient under semi-anesthesia conscious? In principle, yes, but during surgery, general anesthesia may be administered because of the need for surgery or because the degree of pain relief or the level of anesthesia in semi-anesthesia is insufficient. In order to avoid the additional risk of switching to general anesthesia in the aforementioned cases, fasting is also required even for patients undergoing semi-body anesthesia.
19. How long do I need to fast?
The traditional approach is to stop eating all solid or fluid foods from midnight on the day of surgery. However, this does not take into account the difference in the rate of emptying of solid foods and clear liquids in the stomach. Also, if the patient is delayed until the afternoon, he or she is likely to be anxious due to hunger and dry mouth, and some children or young women may experience hypoglycemia. Therefore, it has been changed to a more humane and safe method. As a general rule, adults and children should stop solid foods, including milk or fruit juices, 6 to 8 hours before anesthesia. Two hours before anesthesia, you can drink clear liquids such as plain water or fruit juices without grains or pomace, which can not only reduce the patient’s discomfort, but also because drinks like plain water stay in the stomach for a very short time and do not increase the risk of aspiration pneumonia due to vomiting. The infant who is fed only cow’s milk or breast milk should fast for 4-6 hours, but again, some boiled water or sugar water can be fed two hours before, which can reduce the infant’s crying.
20.Do I need to stop the medication I usually take?
Generally speaking, except for cardiovascular drugs such as anti-hypertensives, the rest are stopped during the fasting period. Of course, you can swallow with plain water when taking them. In addition, diabetic patients should be especially careful not to take hypoglycemic drugs or administer insulin during the fast to avoid hypoglycemia during the fast or during anesthesia.
By telling your anesthesiologist your medical history and medication history honestly and clearly, and by observing the fasting rule before the anesthesia, you will be able to go through the surgery happily and safely and regain your health.