American Society of Anesthesiologists (ASA) - Anesthesiology For The Surgical Patient

Anesthesiology For The Surgical Patient

Preoperative Clinic

Anesthesiologists play a vital role in assessing a patient’s medical readiness for surgery. They are unique in their advanced knowledge of both the medical illnesses and the potential effects of surgery on the human body. The anesthesiologist’s preoperative evaluation may be very brief (such as in the case of a surgical emergency) or very prolonged (as in the case of a patient with multiple chronic medical problems who is to undergo an extensive operation). In all cases, however, the anesthesiologist performs a focused history and physical examination, reviews available laboratory and special test results and assesses the need for additional testing prior to proceeding with surgery.

Intraoperative Care

It is estimated that nearly 40 million anesthetics are administered each year in the United States. Anesthesiologists provide or participate in more than 90 percent of these anesthetics. In the operating room, they are responsible for the medical management and anesthetic care of the patient throughout the duration of the surgery. The anesthesiologist must carefully match the anesthetic needs of each patient to that patient’s medical condition, responses to anesthesia and the requirements of the surgery. Anesthesiologists practice in either a “solo” or “Anesthesia Care Team” model. “Solo” practice involves the physician anesthesiologist directly caring for a single patient throughout an entire surgical episode. The “care team model” involves the physician anesthesiologist medically supervising and directing the work of non-physician anesthetists, such as nurse anesthetists (NA) or anesthesiologist assistants (AA). Although NAs and AAs are not physicians, theses providers have been trained in the technical aspects of administering anesthesia. Regardless of the provider, however, the anesthesiologist is the director of the Anesthesia Care Team. Anesthesiologists have important functions outside of the operating room, but the majority of their vital work takes place in the surgical suite. Their main roles during surgery are:

• Provide continual medical assessment of the patient.
• Monitor and control the patient’s vital life functions, including heart rate and rhythm, breathing, blood pressure, body temperature and body fluid balance.
• Control the patient’s pain and level of consciousness to make conditions ideal for a safe and successful surgery.

Most of the time, the patient won’t even realize the anesthesiologist is providing these critical functions during surgery, but rest assured you have a physician by your side making sure your health and safety is protected at all times. For more information on the Anesthesia Care Team, visit ASA’s patient website.

Postanesthesia Care Unit, or 'Recovery Room'

After surgery, patients are transferred to the PACU, where they continue to emerge from the effects of anesthesia under the watchful eyes of the peri-anesthesia nurse with anesthesiologist consultation immediately available. Evidence of recovery – including activity level, adequacy of breathing, circulation, level of consciousness and oxygen saturation – is continuously monitored. Pain control is optimized. In most cases, the anesthesiologist decides when the patient has recovered enough to be sent home following outpatient surgery or has been stabilized sufficiently to be moved to a regular room in the medical facility or transferred to an intensive care unit.