Anesthesiologists provide individualized patient care

Fall 2019

Anesthesiologists are the physicians responsible for the careful administration of anesthetics before, during and after surgery.

Until 1846, surgeries were conducted without anesthetics. Since then, the dedication of physicians to minimizing pain has transformed this practice into a highly specialized area.

Today, anesthesiologists are involved in many areas of the hospital, from the operating room to the Intensive Care Unit to outpatient clinics in the treatment of chronic pain.

Patients can take comfort in knowing the anesthesiologist is with them for the duration of the surgery, providing specialized care.

“Our department is committed to patient-centred care,” says Dr. Homer Yang, Chief, Department of Anesthesia and Perioperative Medicine at London Health Sciences Centre (LHSC).  “We are involved in perioperative discussions with patients regarding the type of anesthetic best suited for an upcoming surgery. During the surgery we administer the anesthetic and are the resuscitation expert in the operating room. During post-operative recovery we are the pain management expert.”

In the pre-surgery stage, anesthesiologists will work with patients to determine the best anesthetic to mitigate potential negative reactions and improve patient outcomes.

Questions patients can expect from the anesthesiologist before surgery include:

  • What types of medication are you are currently using or have recently stopped using? (Bring your over-the-counter medications, prescriptions , herbal products and vitamins)
  • Do you have a family member who has experienced a bad reaction to anesthesia?
  • What types of surgeries have you previously had?
  • Do you have a medical or genetic condition that could react with the anesthesia?
  • What type of surgery are you having?

 

“There is really no typical case in anesthesia,” says Dr. Yang. There are many factors based upon the individual patient that determine the anesthetic dose.

Depending upon the type of anesthetic being administered, it may be in the form of a needle or a mask; it may be general (gas or intravenous) or regional such as an epidural.

For general anesthetic the patient is completely unconscious and an induction agent such as propofol is administered first, followed by the general anesthetic. If a patient requires sedation which is different from general anesthesia, one may not be completely unconscious but in various stages of drowsiness. Dr. Yang describes the sensation of sedation as “drifting in and out as one sleeps on a summer morning, sometimes hearing the lawn mower going by.”

During surgery, anesthesiologists are there to ensure the correct amount of medication is provided to keep the patient safe and anesthetized.

Following surgery, anesthesiologists are present in the Post-Anesthesia Care Unit (PACU) to help care for patients. There are some common side effects that patients may experience when they ‘wake up’ such as a dry mouth or sore throat. Other less common side effects may include nausea, vomiting and heightened emotions but these are dependent upon the individual. The anesthesiologist is there to help with immediate post-operative care and pain management.

At LHSC there are over 90 consultants, 20 fellows and 40 residents in anesthesia helping provide high quality, patient-centred care.

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