“Once you have anaesthetised the kid, you must leave the room?”

This is a question I frequently encounter.

What does an anaesthesiologist do? This question intrigues a lot of laypersons, in fact some doctors too, who aren’t too familiar with the OT environment.

Let me answer this question as plainly as I can, so that even laypersons can understand.

The anaesthesiologists work begins before the patient is taken up for surgery.

We make sure that before the surgery the patient is optimally prepared for surgery.

We ask for and check whether all relevant workup has been done.

We do a physical examination of the patient, particularly the “airway”, because general anesthesia often paralyses the patient, so that the patient is no longer able to breathe on his own. We must make arrangements for breathing for the patient.

We usually make the patient fast for a few hours before surgery so that when the patient loses consciousness, food doesn’t come up from the stomach and choke the patient. ( can happen when the patient is unconscious )

We usually give something to allay the patient’s anxiety, because everyone is somewhat scared and apprehensive about the surgery. And a calm patient often translates into a good outcome.

After everything is ready, and checking all the drugs and equipment in the OR, it is the anaesthesiologist who wheels the patient  into the OR, and after connecting the relevant monitors, we make the patient go to sleep.

It is the anaesthesiologists responsibility to monitor each and every vital sign of the patient, during all the time the patient is in the OR. This includes ECG, BP, temperature, urine output, among other things.

These things are monitored continuously.

We use optimum drugs, based on the  patient’s weight and age, and type of surgery, for pain relief, to keep the patient asleep, and make sure that the patient doesn’t remember anything about the surgery, and wakes up comfortable and happy.

After the surgery is over, and if conditions permit, we stop and “reverse” the anesthesia at the end of the procedure, the patient wakes up, breathing on their own, and we make sure that their is maximal pain relief.

If the surgery is such that the patient needs to kept sedated for some time after surgery, as happens in cardiac surgery, we continue the anesthesia after the surgery, and transfer the patient to the ICU.

Note that it is the anaesthesiologists who wheel the patient in, and also wheel them out, when the surgery is over.

And are continuously responsible for their care (including administering drugs, etc ) during all parts of the surgery.

The anaesthesiologists care doesn’t end here, we are also actively involved in patient care in the ICU, though the primary care giver there is the intensivist ( who may or may not be an anaesthesiologist by training )