Beyond his analgesic activity in the operating room to ensure the minimum possible complications, the role of the anesthesiologist is also of great importance before and after the operation.
The main objective of the anesthesiologist is to maintain the patient’s homeostasis, i.e. an optimal physiological state. During a surgical procedure, physiological changes occur in the patient which, thanks to various techniques and monitoring, can be corrected in advance in the event of a problem.
Anesthetic techniques and pain control
Pain control is fundamental in analgesia, both during the operation and in the postoperative period. The earlier analgesia is started, the more effective it will be, which should be taken into account in the quality criteria.
In the anesthetic quality criteria, more and more importance is given to post-operative pain. For this purpose, there is a wide range of therapeutic possibilities and techniques adapted to each patient and each surgery.
The anesthetic quality guidelines also emphasize locoregional techniques, which consist of the injection of a long-lasting local anesthetic drug that numbs the nerve and, therefore, the operated area much more effectively than any other analgesic method. This technique must be performed with the aid of an ultrasound scanner to locate the nerve directly and reduce the risk of complications. This ultrasound-guided regional anesthetic technique is one of the greatest advances in anesthesia in recent times.
Pre-anesthetic consultation: how is the patient assessed?
Before any operation, patients are assessed in the pre-anesthetic consultation, where they are classified according to the anesthetic risk stipulated by the American Society of Aesthesiologists (ASA).
Normally, the patient is asked to undergo a series of standard tests such as a blood test, electrocardiogram and chest X-ray. In patients with complex pathologies, more specific tests may be requested, which will increase the patient’s safety before any intervention.
The patient’s physical condition is also fundamental and, therefore, a series of questions will be asked during the consultation so that the patient can inform about associated pathologies, medication, toxic habits, etc.
Finally, a series of guidelines will be recommended to be followed in the days prior to the operation, such as fasting or the prescription of an anxiolytic to make the patient’s arrival in the operating room as pleasant as possible.
The importance of a multidisciplinary team before surgery
The presence of professionals from various specialties in the same center and team, who can contribute their expert point of view, improves patient safety and optimization both preoperatively and postoperatively. For example, the presence of a pulmonologist or a cardiologist during the pre-anesthesia evaluation is very important, as well as the vision of the hematologist, who can evaluate all the blood components when necessary.
What is the risk of complications with anesthesia?
In all anesthesia there is an associated risk that is very low. It can be compared with other risks involved in daily activities, for example: the risk of an adverse event in a healthy person or a person with a medicated and controlled pathology would be, in terms of statistics, the same as a flower pot falling on our head when we go out into the street. It can and does happen, but that doesn’t stop us from going out on the street.
Obviously, the worse the patient’s previous state of health, the greater the risk of an adverse event.
How does the anesthesiologist influence the postoperative period?
The recovery area is the last step before moving the patient to the ward. In this area the patient is kept fully monitored while the education is being completed and the state of analgesia is controlled at all times so that the transfer to the ward is in ideal conditions, both in terms of analgesia and reversal of anesthesia. The stay in the recovery room varies depending on the type of surgery.
HC Marbella Hospital has an AMC recovery area where the patient can be discharged home after meeting certain safety criteria. This is more comfortable for the patient and requires highly specialized professionals in anesthetic techniques, which allow the surgery to be performed without problems and an early discharge with maximum safety.
The treatment of postoperative pain is an important quality criterion. In the recovery area different techniques will be applied to make the patient feel as comfortable as possible, prescribing perfusions of different analgesics, which nowadays thanks to the existence of intelligent syringes control the patient’s analgesia in a very simple way.