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What do anesthesiologists do?

What do anesthesiologists do?

You may think of ‘anesthesia’ merely as a convenient drug that induces sleep and suppresses pain during surgery, allowing doctors to treat diseased regions without causing pain while you are unconscious.  But, please stop and think about how anesthesiologists help patients sleep and feel no pain.  Let’s take abdominal surgery as an example.

Anesthesia is given before surgery. This is the work of anesthesiologists, as you know, but before giving anesthesia, the anesthesiologist selects the most suitable anesthetic application method for each individual patient. The patient is examined from several days before surgery, and sometimes, additional tests may be needed.

After the anesthetic takes effect, surgery starts with an incision of the abdominal skin, and then muscles are separated or opened to access the diseased region. It is not possible to proceed with surgery when the muscle is tense, so anesthesiologists are responsible for administering a muscle-softening drug, called a muscle relaxant.  Such drugs reduce the action of muscles used for breathing making it impossible for the patient to breathe by him/herself.  Accordingly, artificial respiration becomes necessary, and the anesthesiologist inserts a tube into the patient’s trachea (called tracheal intubation), and performs artificial respiration.  Such procedures are called respiratory management.

The degree of pain varies among patients, even for the same surgery.  Surgery can sometimes be very painful, but not always.  Patients respond to such changes in the degree of pain, even though they are sleeping, and various unfavorable responses appear in their condition. For example, blood pressure and heart rate increase with increased pain.  Inversely, continuous bleeding can reduce blood pressure.  Anesthesiologists constantly observe the physiological condition of the patient, noting blood pressure and heart rate. When an abnormality is seen, they give appropriate treatment without delay.  This is called circulatory management.

Anesthesiologists administer anesthetics and analgesics at high doses to help patients during and after surgery when the pain is critical, but they reduce doses to avoid excess anesthetic administration when the pain is not so marked.  This is called pain control.

Anesthesiologists remain at the side of the patient, not leaving even for a moment while the patient is under anesthesia. It is their job to protect the patient by using their specialized knowledge and techniques to ensure a successful conclusion to surgery.  They also confirm the stability of breathing, blood pressure, heart rate, and the recovery of consciousness after the completion of surgery.

Now you can see the different types of skills anesthesiologists need. Their responsibilities do not simply revolve around giving anesthesia for surgery alone. They concentrate their efforts to make sure surgery is carried out safely and patients are kept comfortable before, during and after.