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Surgical Resources: Guide to Anesthesiology

Anesthesiology is the branch of medicine that specializes in the use of drugs and other medical agents that cause insensibility to any pain done to the body. Anesthesiology can also be referred to as the continuity of patient care that involves the preoperative evaluation, intraoperative, and postoperative care for the patient. There are subspecialties that the Anesthesiologist can know as well such as cardiothoracic anesthesiology, critical care, pain management, pediatric anesthesiology, neuroanesthesia, obstetrical anesthesiology, and ambulatory anesthesia.

Although many people think that an anesthesiologist and anesthetist are the same, there is a distinct difference between the two. An anesthesiologist has a doctorate, an anesthetist does not. An anesthesiologist is a physician or doctor who specializes in the practice of anesthesiology, an anesthetist is a technician, or even a nurse who is trained to administer anesthetics to patients. Their role in the healthcare field is an important one. Surgeries, treatments, and many other medical causes can be controlled with anesthesia. Surgeries would not be able to be performed comfortably without the use of anesthesia, and if the medicine is not administered correctly there can be serious consequences. Hence, the reason there is anesthesiologists.

Job Description of Anesthesiologist

Anesthesiologists have to go to college, medical school, and even through specialized medical training. On average, an Anesthesiologist makes around $320,000 per year. They are physicians or doctors who focus on surgical patients and pain relief. They administer medicines to prevent patients from feeling any sensations or pain during the procedure, and to closely monitor the patient’s progress while on the medications. This allows them to adjust the pain medications accordingly. They can also administer any medications throughout recovery times according to their vitals. They can also treat patients going through labor and delivery, who have chronic pain, or other illnesses that cause pain. The anesthesiologist is responsible for the patient’s life functions.

Job Description of Nurse Anesthetist

Nurses were the first, and foremost to administer anesthesia to patients. They are one of the primary providers of anesthesia needs for millions upon millions of patients in the world today. A nurse anesthetist is a registered and advanced practice nurse who works side by side with anesthesiologists, surgeons, and other doctors to provide anesthesia for medical and surgical procedures for patients. They care for the patient before, during, and after the procedure. They administer and maintain the medication, do the patient assessment, prepare for the anesthesia, oversee the patient’s recovery, and care for the patients post operative needs.

Training Required To Be An Anesthesiologist

An Anesthesiologist is a highly trained medical professional who has to undergo extensive training on top of their basic medical education. They must successfully complete four years in an undergraduate college, and then four years in a medical school program. Once medical school is finished, they then have to take an additional four years in specialized training for anesthesia. The first year of specialized training they serve a general internship, and trained hands on.

Once this is completed, a three year residency program then has to be completed. This is to teach the anesthesiologist about anesthesia and other medical practices hands on. They also have to study a number of other aspects of the medical field such as: cardiology, internal and critical care medicine, surgery, and pharmacology. They have the option to choose a specialized field of study such as obstetrics or neurosurgery. They will have to undergo specialized training in that field in addition. Once this schooling and training is done, they can go out into the field on their own. However, as technology advances, they have to continue to take classes on this specialized medical information. Any and all students interested in becoming an Anesthesiologist have to have a strong background in biology, chemistry, physics, and mathematics.

Career Outlook For Anesthesiologists

The career outlook for Anesthesiologists and other medical field professionals is expected to increase and be great because of the growing population and the demand for more doctors to fulfill their health care needs. There are no actual statistics to show the career outlook, the opportunities for physicians is likely to increase by 10 to 20 percent over the next ten years. Doctors with specialties such as Anesthesiologists will be the ones to experience the greatest increase in employment due to the demands for specialty care. As technology continues to expand, Anesthesiologists will be able to perform more complex procedures and treatments that were once untreatable creating a rise in demand for their specialty.

Types of Anesthesia

There are a number of factors that go into the type of anesthesia you’re administered. Some of these factors include, but are not limited to: your medical history, physical exam results, blood tests and EKG or ECG, the type of surgery, your age, and surgical position. You can have local, regional, epidural and spinal, or general anesthesia. Peripheral nerve blocks are also another form of anesthesia that can be given.

  • Local anesthesia is an injection straight into the surgical area. It is used for minor procedures, and you may stay awake or get relaxants during the procedure.
  • Regional anesthesia is an injection of a local anesthetic or numbing agent around the nerves or spinal cord to block any pain in a limited part of the body. Sleep or relaxation medication is usually administered as well.
  • General anesthesia is given intravenously or through the vein. It can also be inhaled. You become completely unaware of your surroundings, and do not feel any pain during the procedure. General amnesia or forgetfulness is common after general anesthesia is given.
  • Epidural and spinal anesthesia is a local anesthetic that is injected near the spinal cord and the nerves that connect to the spinal cord. This blocks pain from the belly, legs, hips, and knees of the patient.
  • Peripheral nerve blocks are a local anesthetic that is injected near a special group of nerves to block any and all pain from that area.

Procedural sedation may be given in some cases along with the anesthesia. These are meant to relax the body during the procedure. Some of these medications include, but are not limited to: local anesthetics, intravenous or IV anesthetics, and inhalation anesthetics. Muscle relaxants and reversal agents are also used at times during the procedure.

  • Types of Anesthesia: A lot of educational information regarding the various anesthetics out there, what each is used for, and how they work.

Side Effects of Anesthesia

All types of anesthesia involve some sort of risk; complications and major side effects are uncommon. The specific risks involved depend on the health you’re in, the type of anesthesia that was used, and the response you have to the anesthesia. Surgery side effects are increased with age. Medical conditions such as heart, circulation, or nervous system problems can increase the risks. Medications that you take can also propose a risk when receiving anesthesia. Make a list, and share it with your doctor. Smoking, drinking, or using illegal drugs can also have an effect on you with anesthesia. Local anesthetics can have toxic effects on the body when given in large quantities. This can affect your blood pressure, breathing, and other bodily functions. Nerve damage might be a side effect with regional anesthesia since the medication is being injected right into the nerves. It can cause persistent pains, numbness, and increased sensation. Other complications with this type of anesthesia include heart and lung difficulties, swelling, infection, or bruising at the injection site.

Spinal anesthesia can cause a headache which is the most common side effect that occurs in younger people. General anesthesia usually has little to no side effects on persons who are otherwise healthy. Since this anesthesia affects the whole body, rather than smaller places, side effects are more commonly seen with this type. They are generally mild, and can be treated easily. An endotracheal tube is often inserted in the breathing air way. This is to reduce the risk of aspiration or fluids getting into the lungs. Some anesthetic medicines can cause allergic reactions. These are rare however, and can be easily treated. A rare condition that might occur in some individuals called malignant hyperthermia can be triggered by some anesthetics. Muscles relaxants and inhalation anesthetics are normally to blame for this.

  • Anesthesiology: This Yale website provides an in depth look into anesthesiology information and becoming an anesthesiologist. It also gives information on the types of medications used in this medical specialty.
  • Side Effects to Anesthesia: Information from Harvard on the side effects of anesthesia, and the treatments that can reverse the side effects.

History of Anesthesia

Going back to the third century BC, painkillers for procedures and surgeries were sought after. Morphine was one of the first drugs found; it was made from opium poppy, and is still used today. Present is South America, Curare, a poison that was used on arrows was found in 1516. It was a muscle relaxant drug that killed its victims with paralyzing affects. In the early 1800’s and before, all anesthesias was usually opium, laudanum, cocaine, cannabis, mandrake root, or very large doses of alcohol. There were also other methods of anesthesia that were non drug involved such as bloodletting and hypnosis. In 1655, the first IV injection was performed. This was done with an opiate and a quill.

Humphrey Davy discovered nitrous oxide gas, and found that it was an effective pain killer in 1800. It then took more than 44 years to be used as an anesthetic. In 1802, the use of ether was popular, and then 1805, chloroform was introduced. These were the first inhalants. These inhalants were used in the mid 1800’s during childbirth, medical procedures, and even dental procedures that are painful. It was difficult to give the right dose of these inhalants, had side effects, flammable, and some were slow to work. Even with the knowledge of these agents, during the Civil War, surgeries were performed without these inhalants. 1895 brought spinal anesthetics, and by 1989 were widely used.

There were a number of deaths due to the overdose of anesthetics after WWII. The end tracheal tube made using these anesthetics easier, and with fewer fatalities than before. The discovery of naso tracheal intubation technique was also helpful when under anesthesia. The American Society of Anesthetics was founded in 1936, and in 1938 the American Board of Anesthesiology affiliated themselves with the American Board of Surgery. It achieved its independent status by 1941.

  • History of Anesthesia: Long overview of the history and types of anesthesia used throughout the past to the present.