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Since ancient times, medicine has sought to make surgical intervention painless for patients, and almost until the middle of the XIX century, many of those who found themselves on the operating table, died of pain ... Today anesthesia specialists deal with the anesthesia of operations.
The goal of general anesthesia is to provide the most favorable conditions for the operation. This means that the patient should not feel pain, and his muscles should be in a state of relaxation (muscle relaxation). In modern anesthesiology, the fundamental principle is accepted: anesthesia can not threaten the life of the patient and reduce the defenses of the body so that after the operation they help him to recover.
It is these tasks and the anesthesiologist decides - a qualified specialist with a higher medical education and a corresponding medical specialization.
Who is an anesthesiologist?
An anesthesiologist, as well as a surgeon, has a huge responsibility for the successful outcome of any operation conducted under general anesthesia. In fact while the surgeon does the business, the anaesthesiologist does the - is engaged in coordination of the vital functions of an organism of the person, immersed in anesthesia. Therefore, the anesthesiologist (or anesthesiologist-resuscitator) should know well not only the fundamental principles of medicine, anatomy and physiology, but also the pharmacodynamics of drugs used in anesthesia - to be able to correctly determine the slightest deviation in the work of organs during surgical interventions and to take adequate measures in a timely manner.
It should be noted that general anesthesia and regional anesthesia by spinal and epidural anesthesia (in which the pain at the surgical site is completely blocked) can only be performed by an anesthesiologist. Local anesthesia by all other methods is carried out by doctors on the profile of the disease - dentists, otolaryngologists, orthopedists, ophthalmologists, etc.
When should I go to an anesthesiologist?
For advice to a good anesthesiologist, you should contact if you have an operation that involves general anesthesia, and you have any concerns about this.
For example, certain difficulties in conducting anesthesia can be found in people with allergies. And in order to minimize the risk of potential allergies, it is advisable to turn to an anesthetist who will perform anesthesia to find out the list of drugs for anesthesia. Then you can contact an allergist to conduct allergy tests for these drugs. Although, as the experienced experts say, these tests of a 100% guarantee of the absence of allergy during anesthesia do not give ...
An anesthesiologist should also be consulted when after a general anesthesia a person is disturbed by headaches, nausea, weakness, confusion, partial paralysis (after epidural anesthesia). The explanatory doctor-anaesthesiologist will give you recommendations and will advise, to what narrow expert to address for the help.
What does an anesthesiologist do?
What does an anesthesiologist do when performing a surgical treatment for a particular disease? At planned operations - before getting on the operating table - patients meet not only with the surgeon, but also with the anesthesiologist.
Having a diagnosis and knowing the features of the operation prescribed to the patient, the anesthesiologist assesses his physical condition and finds out what kind of chronic illnesses a person has, what operations he has already suffered and how he reacted to anesthesia (anesthesia history), what injuries he had, recently took and there is not at it or him an allergy on any preparations.
Based on this information, taking into account the nature of the forthcoming surgery and its duration, the anesthetist chooses the optimal method of anesthesia, as well as the type and dosage of the medication anesthetic.
By the way, questions like "what kind of illnesses does an anesthesiologist cure?" Or "what tests should I take when I contact an anesthesiologist?" In this case are meaningless, because, as you understand, anesthesiologists do not deal with treatment as such. But in the case of some complications in the course of the operation - for example, heart rhythm disorders - an anesthesiologist-resuscitator resorts to urgent measures, for example, carries out cardiac stimulation. And with bleeding, it is up to him to choose the remedy necessary to replenish the volume of circulating blood.
As for the tests, before the operation, the anesthetist needs data on the blood group (and its rhesus) of the patient, the general blood test, the general urine test, the results of the ECG.
Then an anesthesia plan is drawn up. As a rule, extensive intracavitary operations are performed using combined endotracheal anesthesia: after anesthesia, anesthesiologist performs direct laryngoscopy and intubation of the trachea or bronchi, and an anesthesia and respiratory apparatus (with artificial ventilation of the lungs) connects to the intubation tube. And out-of-cavity operations of a small volume (lasting no more than one and a half hours) are administered under inhalation general anesthesia through the mask of the anesthesia device - with independent breathing of the operated patient.
In addition, medication is prepared for anesthesia - premedication. Considering such factors as the patient's condition, age, body weight, nature of operation and the selected method of anesthesia, the anesthetist prescribes the administration of a number of medications. These drugs are designed to relieve mental stress on the eve of surgery, to provide a normal patient sleep and facilitate the introduction of anesthesia. Also certain drugs prescribed by an anesthetist help prevent possible unwanted reactions of the body to anesthesia and reduce the risk of side effects of the anesthetics used.
What does an anesthesiologist do during and after surgery?
After the patient is admitted to the state of anesthesia, the anesthetist is constantly at the patient's side throughout the operation and monitors his condition. To do this, the equipment is used that provides objective information about the work of the heart and lungs, monitors blood pressure, central venous pressure, blood filling of tissues, the gas composition of the inhaled and exhaled mixture (or the concentration in the blood of drugs administered intravenously), monitors the gas and acid- alkaline composition of blood.
The anesthesiologist also controls the color and moisture of the skin of the person being operated, the size of his pupils and their reaction to light.
After the operation is completed, the anesthetist stops the supply of anesthetics, but his work does not end there. In the postoperative period, with the help of special equipment, he monitors the patient's condition: depending on the type of general anesthesia, the duration of the outflow is different, and the anesthesiologist, together with the attending physician, observes how the process proceeds - in time to prevent complications. After all, absolutely harmless methods of general anesthesia do not exist, and all drugs-anesthetics somehow act on the liver, which removes them from the blood.
Advice of an anesthesiologist
When diabetes and coronary heart disease before surgery, you must continue to take medication prescribed by your doctor.
Before any operation, you can not take aspirin (it can increase bleeding) and at least a week should not drink alcohol (extra load on the liver will prevent the removal of toxic substances from the body).
Do not eat animal fats, it is better to eat chicken, fish and sour-milk products.
In elderly patients, as a result of surgery under general anesthesia, bronchitis or even pneumonia may occur.
By the way, every year - October 16 - International Day of anesthesiologist is celebrated. It was on this day in 1846 that John Collins Warren, a professor at Harvard University, applied a general etheric anesthesia for an operation to remove a tumor in the submaxillary region to a patient at the Boston Hospital, the 20-year-old artist Edward Abbott. An anesthesia was conducted by the dentist William Morton.