Alabama State Society of Anesthesiologists

Before your surgery, you will meet an important physician specialist -- your anesthesiologist. A vital member of the surgical team, your anesthesiologist has the critical responsibility for your welfare when you undergo anesthesia. The anesthesiologist is your advocate in the operating room.

Who are anesthesiologists?
Today's anesthesiologists are physicians who complete a four-year college program and graduate from college before undergoing an additional four years of medical school education just like your surgeon and primary care physician. After this same medical education as other physicians, your physician anesthesiologist must under go an additional four years of medical education specializing in the medical specialty of anesthesiology (the medical practice involving caring for patients undergoing anesthesia). After completion of this 12 years of education, your physician anesthesiologist undergoes an examination process, including a comprehensive written examination and a rigorous oral examination that covers all aspects of medicine and anesthesiology to become Board Certified. With 12 years of education your anesthesiologist is the most educated and most qualified person to administer and/or direct your medical care during your anesthetic experience. We apply our knowledge of medicine to fulfill our primary role in the operating room to ensure your comfort during surgery and to make educated medical judgments to protect you during this vulnerable experience. These medical judgements include treating and regulating changes in your critical life functions -- breathing, heart rate, blood pressure, level of consciousness -- as they are affected by the surgery being performed and the medication being administered. We are the medical specialists who are the doctors who will immediately diagnose and treat any medical problems that might arise during your surgery or during your recovery period in the postanesthesia care unit.

The role of an anesthesiologist extends beyond the operating room and recovery room. Anes-thesiologists work in intensive care units to help restore critically ill patients to stable condition. In childbirth, anesthesiologists manage the care of two persons: they provide pain relief for the mother while managing the life functions of both the mother and the baby. Anesthesiologists are also involved in pain management, including diagnosis and treatment of acute and chronic problems.

May I choose my anesthesiologist?
You usually have a choice as to who your anesthesiologist will be. Your surgeon may refer you to an anesthesiologist or you may select one based on a personal recommendation or based on your own previous experience. However, you must make that choice known in advance so that arrangements may be made to honor your request. Since your anesthesiologist is responsible for your comfort, safety and medical care during surgery, it is important that you meet before entering the operating room.

Why is there a preoperative interview?
Anesthesia and surgery affect your entire system, so it is important for your anesthesiologist to know as much about you as possible. During a preoperative visit, an anesthesiologist will carefully evaluate you and your medical history and will inquire about your recent medications. In addition, this physician will inform you about the procedures associated with your surgery, discuss the anesthetic choices, their risks and benefits, order appropriate laboratory tests and prescribe medication for you, if needed, before your operation. If you have not met your anes-thesiologist during a preoperative interview, you will meet immediately before your surgery. At this time, your anesthesiologist will review your entire medical chart for a clear understanding of your needs and medical condition.

What are the types of anesthesia?
There are three main categories of anesthesia: general, regional and local. With general anes-thesia, you are unconscious and have no aware-ness of the surgical procedure or other sensations. If you have regional anesthesia, your anesthesiologist injects medication near a cluster of nerves to numb only the area of your body that requires surgery. You may remain awake or you may be given a sedative. For some surgical procedures, a local anesthetic may be injected into the skin and tissues to numb a specific location. Your anesthesiologist, in consultation with your sur-geon, will determine the best type of anesthesia for you, taking your desires into consideration whenever possible. These options will be discussed during your preoperative interview with the anesthesiologist.

During the surgery, what does my anesthesiologist do?
Your anesthesiologist is personally responsible for your comfort and well-being before, during and after your surgical procedure. In the operat-ing room, the anesthesiologist will direct your anesthesia and manage vital functions, includ-ing heart rate, blood pressure, heart rhythm, body temperature and breathing. The anesthesiologist also is responsible for fluid and blood replacement, when necessary. He or she will regulate the anesthesia so that you will be comfortable until your anesthetic care is completed.

Frequently, people requiring surgery may have other medical conditions, such as diabetes, asthma, high blood pressure, arthritis or heart problems. Because of your preoperative evalua-tion, your anesthesiologist will be alert to these conditions and well-prepared to treat them dur-ing your surgery and immediately afterward. Your continued medical management during surgery is necessary to help you have a speedy recovery. As doctors, anesthesiologists are uniquely qualified to treat not only sudden medical problems related to surgery itself, but also your chronic conditions that may need special attention during your procedure. This is because their medical training provides a strong background in the principles of internal medi-cine and critical care.

After surgery, what can I expect?
Your anesthesiologist continues to be responsible for your care in the recovery room, often called the postanesthesia care unit. Here, the anesthesiologist directs specially trained nursing staff members who monitor your condition and vital signs as you recover from the effects of anesthesia recede and to make you more comfortable as you go to your hospital room or go home. Your anesthesiologist will determine when you are able to leave the recovery room.

Will I receive a separate bill from the anesthesiologist?
Your anesthesiologist is a physician specialist like your surgeon or internist, and you will receive a bill for your anesthesiologist's professional service as you would from your other physicians. If you have any financial concerns, your anesthesiologist or an office staff member will answer your questions. You will note that your hospital charges separately for the medications and equipment used for your anesthetic.

Many people are apprehensive about surgery or anesthesia. If you are well-informed and know what to expect, you will be better prepared and more relaxed. Talk with your anesthesiologist. Ask questions. Discuss any concerns you might have about your planned anesthetic care. Your anesthesiologist is not only your advocate but also the physician uniquely qualified and expe-rienced to make your surgery and recovery as safe and comfortable as possible.

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