Anesthesiology: Definition, Specializations, Types of Anesthesia, Pain Management and Tips

Anesthesia allows the performance of surgical interventions and other painful interventional procedures producing analgesia quickly.

Also in a safe and pleasant way, with pain control , absence of anxiety or lack of consciousness with general anesthesia and adequate muscle relaxation.

A critically important aspect of perioperative anesthetic care is the maintenance of physiological homeostasis such as hemodynamic stability, oxygenation, ventilation, temperature.

Anesthesiologists select and administer general, neuraxial, or regional intraoperative anesthesia such as peripheral nerve blocks or sedation with supervised anesthesia.

Other anesthesia services include preoperative evaluation, postoperative management in the postanesthetic care unit or intensive care unit, and management of acute and chronic perioperative pain.

Anesthesiology is a very common practice in today’s medicine and is dedicated to pain relief and care before, during and after a patient’s surgery.

Before an operation, the patient will meet with the anesthesiologist for an evaluation.

The anesthesiologist will develop a plan for the operation that takes into account the individual needs of each patient.

On the day of the operation, the anesthesiologist supervises the administration of the medication so that the patient does not experience pain.

During the procedure, the surgeon carries out the surgical work, but the anesthesiologist will remain responsible for the medical treatment of the patient.

They monitor the patient’s bodily functions, evaluate the best way to treat vital organs, and provide a balance of medications tailored to the needs of each individual.

The functions they need to control include:

  • Heart rate and rhythm.
  • Breathing.
  • Blood pressure.
  • Body temperature.
  • Fluid balance.

The anesthesiologist monitors these vital measures and the level of pain and unconsciousness of the patient throughout the operation.

After surgery

After the surgical procedure, the anesthesiologist remains responsible for the overall care of the patient.

They will reverse the effects of the anesthesia and continue to evaluate the patient and keep them comfortable as they recover.

During this process, the anesthesiologist will direct other healthcare workers, including nurse practitioners.

Critical care, emergency and other roles

The anesthesiologist also plays a key role in critical care, treatment, and trauma.

They evaluate patients, make diagnoses, support breathing and circulation, and help ensure infection is prevented.

Anesthesiologists are also qualified to contribute to emergency medicine, providing airway and cardiac resuscitation, advanced life support and support, as well as pain management.

They also help stabilize patients.

Specializations

Some anesthesiologists will seek additional training and qualifications to specialize in pain medicine and intensive care, and many also specialize in particular areas.

These include:

  • Cardiac anesthesia, for heart surgery.
  • Pediatric anesthesia, for pain management and anesthesia in children.
  • Neuroanesthesia, related to surgery for the nervous system, brain, and spinal cord.
  • Obstetrics, which offers pain relief during labor and delivery.

Other areas of medical care include anesthesia and care of the dying in hospices.

Pain management and tips

An anesthesiologist who specializes in pain relievers can help patients who have pain due to a variety of causes, such as headaches, burns, diabetes, and herpes, or when they experience chest pain, abdominal pain, pelvic pain, among others.

His role in this field includes:

  • Treat the patient.
  • Prescription of drugs and rehabilitation services.
  • Perform procedures to relieve pain.
  • Advice to patients and families.

They can also lead a multidisciplinary team, coordinate other healthcare professionals, and act as advisors on the best way to care for patients with pain.

Critical care

Anesthesiologists who work in critical care are sometimes referred to as intensivists.

The anesthesiologist-intensivist helps diagnose and treat disorders that affect every system in the body, whether it involves circulation, digestion, kidneys, nervous system, or any other system.

Anesthesiologists working in intensive care are also qualified to help when a patient is unconscious, whatever the reason.

This involves coordinating the general medical management of a patient and coordinating with a variety of medical professionals and possibly also with the patient’s family and friends.

Obstetrics

Anesthesiologists participate in maternity units, where they administer pain relief and help with complications.

An obstetrician can give some types of pain relief medications, but if this is insufficient, anesthesiologists can administer stronger medications intravenously.

An epidural delivers numbing medicine to the lower back to reduce pain from contractions.

If a cesarean section is needed, stronger anesthetics can be given in the same place, to completely numb the lower body for surgery.

If serious complications arise, the anesthesiologist may need to administer general anesthesia.

The anesthesiologist can provide or supervise the administration of medications such as morphine, fentanyl, and others.

The patient can be given control over their pain management, under the supervision of the anesthesiologist.

They can be given an infusion pump that delivers additional pain medication each time the patient presses the button.

Types of anesthesia

There are four main categories of anesthesia used during surgery and other procedures: general anesthesia, regional anesthesia, sedation, sometimes called “controlled anesthesia care,” and local anesthesia.

Sometimes patients can choose what type of anesthesia will be used.

The anesthesiologist will discuss the types of anesthesia that would be safe and appropriate for the operation or procedure you need, and will explain your options clearly.

General anesthesia

It’s what people often think of when they hear the word “anesthesia.”

During general anesthesia, the patient is unconscious and has no sensation.

Many different medications can be used during general anesthesia.

Some are anesthetic gases or vapors that are given through a breathing tube or mask.

Other medications are given intravenously to induce sleep, relax muscles, and treat pain.

The patient falls asleep soundly, unconscious, for the duration of the operation.

Anesthesiologists work with each patient individually to determine which combination of medications is best based on their health, their other medical conditions, the medications they take, allergies, and the type of surgery they are having.

The most common side effect of general anesthesia is subsequent drowsiness.

This usually goes away within the first hour or two after the surgery is finished.

Some patients may experience a sore throat or nausea.

If the patient has a history of dizziness or nausea after previous operations, be sure to mention it to doctors, as they may need medication before surgery to help prevent nausea after the operation.

Serious reactions to general anesthesia are very rare.

The anesthesia team has immediate access to emergency medications to treat any type of reaction, and will monitor vital signs continuously throughout surgery and recovery.

Regional anesthesia

It makes an area of ​​the body go numb to prevent the patient from feeling pain.

It can completely block sensation in the area of ​​the body that requires surgery.

The anesthesiologist injects local anesthesia near the group of nerves that provides sensation to that area.

Two very common types of regional anesthesia are spinal and epidural anesthesia.

Either can be used for childbirth or for orthopedic procedures, such as knee and total hip replacement.

Sometimes an epidural catheter is placed to allow continuous pain relief for one or more days after surgery.

This is common after surgery on the chest or abdomen, even when general anesthesia is used during the operation.

Nerve blocks are another type of regional anesthesia that can provide pain relief to a smaller area, such as an arm or leg.

Examples include a femoral nerve block to numb the thigh and knee, or a brachial plexus block to numb the shoulder and arm.

Having regional anesthesia for surgery does not mean that you have to be wide awake.

Many patients prefer to receive sedation so that they can relax and doze during the procedure.

Sometimes regional anesthesia is used in combination with general anesthesia for major surgery on the chest or abdomen.

This technique has the advantage that patients do not need as many opioid pain relievers after surgery.

Sedation

This is also known as ‘controlled anesthesia care’, it is what people have referred to in the past as ‘twilight’.

Medications are given, usually through an IV, to make the patient feel sleepy and relaxed.

Different levels of sedation are possible, depending on the type of procedure and the patient’s preference.

Under mild sedation, often used for eye surgery, a patient is awake and can answer questions or instructions.

With moderate sedation, the patient can fall asleep, but is easily awake.

Deep sedation is almost the same as general anesthesia, which means that the patient is sound asleep, although he can breathe without assistance.

Deep sedation with a drug called propofol is often used for procedures such as upper endoscopy or colonoscopy .

Local anesthesia

It is the term used for drugs such as lidocaine that are injected through a needle or applied as a cream to numb a small area.

Local anesthesia alone can provide enough pain relief for limited procedures, such as sewing a deep cut or filling dental cavities.

It is often used in conjunction with sedation during minor outpatient surgery.

At the end of many operations, the surgeon may inject local anesthesia to provide additional pain relief during recovery.