Every day, thousands of people elect to undergo surgery for a variety of health concerns. Sometimes, it's for the removal of a tumor or other growth that is putting your health at risk; at other times, it's to repair or even replace a body part that isn't functioning properly. A team of medical professionals is needed to ensure the success of each operation, and each member of that team brings a unique but critical skill set to the operating room. One key team member is the anesthesiologist, the doctor responsible for ensuring that you feel no pain during a procedure.

The Science of Anesthesiology

Besides ensuring the absence of pain, the anesthesiologist also monitors your vital signs, such as breathing and heart rate, before, during and after a procedure. Several factors have an impact on how each anesthetic drug will affect your body, and the doctor must consider all of them when determining which drugs to use that will be right for you in any given situation. 

Patient Concerns

The anesthesiologist factors in your size and weight to determine the volume of anesthetic they give. If you have certain health issues, such as an impaired breathing system or a heart condition, the doctor will pay particular attention and make sure the anesthetic drugs don't worsen these existing problems. Additionally, some patients are unable to tolerate certain types of anesthetic drugs.

Anesthesiologists are responsible for being aware of your medical history, including possible allergies or health concerns, and ensuring that any drugs used will not adversely affect you. The anesthesiologist will discuss the possible drug options, their likely effects during the procedure, and possible side effects after the surgery with you before the operation begins.

Drug Selection

For minor, minimally invasive surgeries, the anesthesiologists may elect to numb just the skin and tissue around the surgery site, using what is called a "local" anesthetic. These drugs have a low risk for complication and are usually cheaper. "Regional" anesthetics are used to numb larger, but still limited, areas of the body. If the doctor used this type of anesthetic, you will remain conscious but receive a dose of additional medication to help you relax.

For more invasive surgeries, those that delve deeply into the body, the anesthesiologist uses "general" anesthesia, which will make you unconscious. A combination of different drugs fulfills the responsibilities of the anesthesiologist: putting the patient to sleep, keeping them asleep and immobile throughout the procedure, and blocking their sensation of pain. The anesthesiologist must balance the effectiveness of each medicine with their possible side effects to ensure the process goes smoothly.

There are usually several drug options that can perform the anesthetic function in any given surgery, and each uses a different chemistry to accomplish that goal. Almost all anesthetics cause some side effects; some patients experience lapses in physical or mental functioning as a result of general anesthesia. Accordingly, the anesthesiologist must select the appropriate combination of anesthetic drugs for each particular patient and type of surgery to keep negative effects to an absolute minimum.

Delivery Methods of Anaesthetic Drugs 

The delivery method differs from anesthetic to anesthetic as well. Drugs for local or regional procedures may come in fluid form and the anesthesiologist injects them directly into your bloodstream. The anesthetic properties of local and regional drugs will wear off gradually over time and usually have no long-lasting side effects. General anesthetics, however, are gaseous and are administered through a mask placed over your nose and mouth. The anesthesiologist sits with the patient during the surgery and controls the amount of anesthetic you receive.

What to Expect During Surgery

The doctor must evaluate which drugs will protect the health and welfare of each patient. These medicines affect not just your consciousness, but also your breathing capacity. Too much of the drug can suppress breathing altogether which could cause a brain injury or even death. The anesthesiologist must monitor the breath at all times during the procedure to ensure you are getting only the level of general anesthesia you need to get through the surgery.

Choosing Your Anesthesiologist

There are usually several anesthesiologists available for any particular surgery, and the primary doctor or surgeon will often make a referral to their preferred anesthesiologists. Certification in Anesthesiology is required, which entails additional training and education after completion of the medical degree. Board-certified anesthesiologists must pass tests specifically designed to measure the capacity and competence of each anesthetist. You do not have to let your primary doctor choose anesthesiologist for your procedure, as may wish to speak with several possible specialists before making a final selection.

Asking Questions

After choosing an anesthesiologist, you may want to prepare a list of questions to ask at your first official doctor/patient meeting, to ensure you are fully informed about the procedure and its impact on your body and health.

About the Anesthetic

Common questions about the medicine concern drug selection by asking the following questions: 

  • What are the possible drug options?
  • What does each drug do individually?
  • How do the drugs interact with one another?
  • What are the most common side effects, and how common are they?
  •  How can you expect to feel after the anesthetic wears off?

You should also alert the anesthesiologist about all other medications you are taking to make sure that they will not interact negatively with the anesthetic.

About the Process

The instructions for most anesthetics involve limiting eating or drinking in the 12 to 24 hours before administration of the drug, so you should make sure you understand the restrictions that come with the medicine you will receive.

  • Ask whether you will be able to safely drive to or from the surgery. Recovery from general anesthetics or relaxation-inducing drugs often leaves people mentally foggy, so you probably shouldn't expect to drive yourself home.
  • Ask how long it takes for your anesthetic to wear off. Different drugs wear off at different paces, so find out how long and to what extent you will remain affected by the particular medicine after the surgery is over. 

Receiving any form of surgery can be nerve-racking. It's important to make sure you stay prepared for and informed about all aspects of any planned medical procedure. Check out these additional articles for further information you may need before going under the knife:

5 Questions You Need to Ask Before Getting Surgery