Table of Contents
The main duty of an anesthesiologist is to administer general anesthesia in order that a patient is placed in a medical coma. This is performed in order to allow surgery to be performed without the patient responding to pain or remembering the surgery. If general anaesthesia is not needed, or if it is contra-indicated, then local or regional anesthesia is performed in order to induce pain relief (analgesia) in a part of the body. In the case of a mother delivering her baby during childbirth, a way to reduce the pain would be by the administration of a local anesthetic via an epidural. This allows the mother to be awake and active in labor and during delivery of the baby. The administration of a general anaesthetic would not make this situation possible.
In general, the duties of an anaesthesiologist in the operating room include the following:
- To provide medical care to patients in numerous situations, most of the time of which are acute medical issues.
- Pre-operative evaluation of patients.
- Creating a plan for the anaesthesia that is individualised for every patient - alternatives, risks and benefits of the chosen anaesthetic methods have be discussed with the patient before surgery in order to get informed consent from the patient.
- Consulting with the members of the surgical team to decide whether a patient can be operated on or not.
- Proper airway management and making sure they are prepared for a difficult airway.
- Intra-operative life support and providing pain control.
- Intra-operative stabilisation.
- Proper post-operative management of patients - making sure the patient is fully awake before they are taken back to the ward, or making sure that a patient is stabilsed for handover to staff in the intensive care unit (ICU).
Outside the operating room, an anaesthesiologist's duties can include dealing with:
- In- and pre-hospital emergencies.
- Critical care management in ICU's.
- Acute pain clinics and consulting with patients complaining of chronic pain.
For a doctor to specialise in anaesthesiology, they have to complete the 5-6 year undergraduate degree first in order to become a medical doctor. Thereafter, depending on the country you live in, you have to perform 1-2 years of internship training before becoming eligible for a specialist post. These posts also have to be available at the institution you wish to train further at. If you have applied and were successful at the interview stage, then you will be placed in a specialist post to receive mentorship and training from an anaesthesiologist consultant.
An anaesthesiologist will have to have adequate knowledge of the following areas in order to provide their services.
- Pharmacology of the most commonly used drugs - these include the inhalational anaesthetics (sevoflurane, desflurane), intravenous anaesthetics (propofol, thiopentone), narcotic analgesics (morphine, fentanyl), vasopressors (adrenaline), muscle-relaxants (suxamethonium, pancuronium) and muscle-relaxant reversal drugs (neostigmine).
- Using and interpreting monitors such as electrocardiography (ECG), electromyography (EMG) and electroencephalography (EEG). Knowledge of neuromorphology, neuromuscular monitoring, entropy monitoring and cortical stimulation mapping is also important.
- Using and knowledge of the different settings of mechanical ventilation.
- Anatomical knowledge of the nervous system in order to perform nerve blocks in different parts of the body.
- Knowledge in areas such as pulmonology, cardiology and obstetrics is important in order to be able to assess the risk of anaesthesia so that informed consent is given by the patient.
- Knowledge regarding how anaesthesia affects certain age groups such as babies, children and the elderly.