Anesthesiologists are physicians who focus on surgical patients and pain relief. They administer anesthetics, which are medicines to prevent patients from feeling pain and sensations; closely monitor patients' vital signs during surgery and adjust anesthetics accordingly; monitor patients through the first recovery stages after an operation; and administer appropriate medications during recovery. More than 90% of the anesthetics used in health care are administered by or under the direct supervision of an anesthesiologist.
An anesthesiologist's first contact with a surgical patient is usually during a "preoperative interview." At that time the anesthesiologist reviews the patient's medical history and medications, discusses the upcoming surgery, and reviews the options for anesthesia and pain-killing drugs. The anesthesiologist also becomes familiar with the patient's pre-existing medical conditions, such as diabetes or heart disease, and plans how to manage those conditions during surgery. A specialized nurse called a CRNA or nurse anesthetist may also visit with the patient in the preoperative period. They will assist the anesthesiologist in taking care of the patient in the operating room.
The anesthesiologist is responsible for a patient's life functions as the surgeon and other members of the medical team operate. During surgery, the anesthesiologist uses sophisticated electronic equipment to carefully monitor the patient's vital signs, including heart rate and rhythm, blood pressure, breathing and brain and kidney functions. As the surgical procedure progresses, the anesthesiologist may have to adjust the patient's anesthesia to compensate for changes in the patient's physical state.
When surgery is finished, the recovery phase begins. The anesthesiologist administers medications to reverse the effects of the anesthetic, returning the patient to consciousness if a general anesthetic has been used. After surgery, patients are moved to a recovery room, where the anesthesiologist is still responsible for the patient's vital functions. In the recovery room, nurses and other specially trained staff closely monitor the patient under the supervision of the anesthesiologist. Eventually, the anesthesiologist determines when the patient has recovered sufficiently to leave the recovery room.
There are three main types of anesthesia administered during surgery: general, regional and local. General anesthesia renders the patient unconscious and unable to feel pain or any other sensation. Many general anesthetics are gases or vapors administered through a mask or breathing tube, whereas others are liquid medicines introduced through a vein. Regional anesthesia numbs an entire area of the body requiring surgery. Local anesthesia is used to numb a specific part of the body (such as the foot or hand). Both regional and local anesthetics are administered via injections. In addition to anesthetics, patients requiring regional and local anesthetics often are given sedatives to help them relax during surgery and put them to sleep.