Anaesthesiology

The role of a anaesthesiologist in patient care encompasses several crucial aspects. They ensure patient comfort during surgery or cardiac procedures by administering tailored anaesthetics based on individual medical conditions and health status. Additionally, they continuously monitor vital functions such as breathing, heart rate, blood pressure, oxygen saturation, and fluid needs throughout and immediately following surgery, making necessary medical decisions. They manage patient care, including pre-existing medical conditions, during surgery and the immediate post-operative period. Moreover, they oversee pain management during the immediate post-operative phase and provide expert consultation on various aspects of patient care, including pain management, anticoagulation, and airway management.

The type of anaesthesia administered depends on the nature of the procedure. There are four primary types of anaesthesia: general anaesthesia, regional anaesthesia, local anaesthesia, and sedation. General anaesthesia is typically used for cardiac surgeries, rendering patients unconscious, immobile, and unable to feel pain or sensations during the procedure. Conversely, diagnostic or therapeutic cardiac procedures conducted in the Cardiac Catheterization Lab or Electrophysiology Lab may require only local anaesthesia and/or sedation, with varying levels of sedation provided to induce a “twilight sleep” state, allowing patients to remain conscious but potentially fall asleep with little or no recollection of events.

The preoperative interview serves two essential purposes. Firstly, it provides the cardiac anaesthesiologist with vital information about the patient’s health history and habits, enabling them to plan and manage anaesthesia and care effectively during and after the surgery or procedure. For instance, chronic medical conditions like allergies or asthma and substance use habits significantly impact anaesthesia management and patient outcomes. Secondly, it allows patients to ask questions and address any concerns they may have about the procedure or anaesthesia, fostering open communication and ensuring patient comfort and confidence.

During general anaesthesia, patients are rendered unconscious throughout the operation and do not experience pain or sensations. The cardiac anaesthesiologist continuously monitors and adjusts the level of anaesthesia to ensure adequate sedation. While patients may be aware but sedated during pre-surgical preparations, they typically have no recollection of the operating suite activities after the surgery.

The need for a blood transfusion depends on individual circumstances and the nature of the surgery or procedure. While today’s blood supply is considered safe, there are inherent risks associated with blood transfusions. Patients with specific concerns regarding this issue are encouraged to discuss them with their cardiac anaesthesiologist.

While every surgical procedure carries some degree of risk, modern anaesthesia practices have significantly enhanced safety. Serious complications or fatalities resulting from general anaesthesia are rare, owing to advancements in drug safety, sophisticated anaesthesia and monitoring equipment, comprehensive anaesthesiologist training, and adherence to national standards of care.

Side effects from general anaesthesia may occur but are typically transient and manageable. These side effects may include a sore throat, headache, back pain, fatigue, nausea, or vomiting, although the latter occurs less frequently than in the past.

The timing and location of post-operative awakening depend on various factors, including the type of surgery performed. Patients typically wake up in the Cardiac Intensive Care Unit following major cardiac procedures.

Some degree of discomfort following major surgery is normal, but patients receive effective pain relief medication to alleviate pain and ensure comfort. The Cardiac Intensive Care Unit staff are experienced in managing post-operative pain and prioritize patient comfort.

Family members are regularly updated on the patient’s status during surgery, and they may visit the patient once they are transferred to the Intensive Care Unit