Know the Role and Responsibilities of the Anesthesiologist

An anesthesiologist is a specialist who has the responsibility of providing anesthesia (anesthesia) before a patient undergoes surgery or other medical procedures. In addition, anesthesiologists also study pain management and patient care. The background of the anesthesiologist is a general practitioner who has completed an anesthesiology specialist education.

Before undergoing the surgical procedure, you will be sedated to make your body immune and fall asleep. This anesthetic action is called anesthesia. Administration of drugs under anesthesia aims to make you feel painless. Anesthesia works by blocking nerve signals in the body and brain, thereby preventing the brain from processing pain and remembering what happened during surgery.

Types of Anesthesia

Broadly speaking, anesthesia is divided into three types, namely local anesthesia, regional anesthesia, and general anesthesia.

• local anesthetic

  Anesthesia only makes one specific body part immune, such as the hands, feet, or certain parts of the skin. Anesthetic drugs are given in the form of ointments, injections, or sprays. While receiving local anesthesia, you will remain awake so you can see the procedure being performed. Local anesthesia lasts only a short time and patients are generally able to go home the same day.

• Regional anesthesia

  An anesthetic is injected near a nerve or nerve branch, with the aim of numbing most areas of the body but maintaining a state of consciousness. Examples are epidural and spinal anesthesia given to women during childbirth or during surgical procedures.

• General anesthesia

  After anesthesia, the anesthesiologist will intubate (insert breathing apparatus) to ensure that the patient's airway is safe, and provide breathing support during surgery.

  General anesthesia aims to:

  o Reduce patient anxiety.

  o Keeping the patient asleep during the surgical procedure.

  o Minimize pain during surgery.

  o Relax the muscles so that the patient remains relaxed.

  o Blocking memory during operation.

The Anesthesiologist's Role

Broadly speaking, anesthesiologists have a role in several medical aspects, namely:

• Preoperative, during surgery, and postoperative management.

  Anesthetists play an important role in assisting surgeons and working closely with nurses in preoperative preparation, monitoring the patient's condition and performing anesthesia during surgery, and observing the patient's condition postoperatively. The anesthetist ensures that the patient's condition does not worsen.

  Technically, the anesthesiologist's role begins with administering anesthetic drugs. Then the anesthesiologist will perform the intubation. Intubation is a technique used to maintain the airway and provide oxygen, by inserting a special tube (endotracheal tube/ETT) into the windpipe through the mouth.

  During the operation, the anesthesiologist will check and confirm the patient's vital signs, including:

  • Respiration.
  • Heart rate.
  • Blood pressure.
  • Body temperature.
  • Total body fluids.
  • Oxygen levels in the blood. The anesthesiologist will also make sure the patient is comfortable and does not feel pain. After the operation is complete, the anesthetic will be stopped and the patient will be transferred to the treatment room until he is conscious. The anesthesiologist then monitors the patient's condition until the anesthetic effect wears off.
• Intensive and critical care

  In addition to operative procedures, the anesthesiologist also has the responsibility to provide treatment in critical conditions for patients who require intensive care. Together with other medical teams, for example nurses in the ICU (Intensive Care Unit), the anesthesiologist in charge of:

  • Monitor critical patient conditions more closely,
  • Determine the steps for administering fluids and drugs in the ICU,
  • Perform intubation to provide mechanical breathing assistance via a ventilator or manually if necessary.

  In dealing with critically ill patients, anesthesiologists will often collaborate with other specialists, such as internal medicine doctors, surgeons, pediatricians, and neurologists, according to the patient's diagnosis and the branch of specialization involved.

• Competence and Actions performed by the Anesthesiologist

  The competencies and actions performed by the anesthesiologist include:

  • Perform preoperative assessment of the patient's condition.
  • Monitor the patient's vital functions before, during, and after surgery.
  • Understanding/interpreting the results of the physical examination, history taking (medical history tracing), and supporting examinations including laboratory tests, CT-scans and MRIs, echocardiography, X-rays, and ECG.
  • Understand how to position the patient safely and comfortably during surgery.
  • Determine the type of anesthesia and observe the patient's condition before anesthesia, while the patient is under the effects of anesthesia, until after anesthesia.
  • Understand anesthesia in general surgery, eye surgery, ENT surgery, gynecology, and obstetrics, both in adult and pediatric patients.
  • Perform emergency measures such as central venous and arterial catheter placement, pleural puncture for pneumothorax, and tracheostomy to provide respiratory support in emergency cases.
  • Understand the management of trauma and emergency conditions that threaten the patient's life and be able to carry out initial treatment and stabilization of these conditions.
  • Able to perform first aid measures and cardiopulmonary resuscitation (CPR).
  • Able to manage airway and use facemask, laryngeal mask, and intubate airway. As well as determining the choice of respiratory support for the patient, either through mechanical breathing aids (ventilator), or manual breathing assistance.
  • Perform critical patient care and case management in Intensive Care Unit (ICU).
  • Able to manage acute and chronic pain.

Anesthesiologists can pursue further education or subspecialties. Some of these subspecialties include:

• Pain Management Consultant (Sp.An-KMN)
• Pediatric Anesthesia Consultant (Pediatric Surgery) (Sp.An-KAP)
• Intensive Care/ICU Consultant (Sp.An-KIC)
• Consultant Neuroanesthesiologist (anesthesiologist in neurosurgery cases) (Sp.An-KNA)
• Cardiothoracic Anesthesia Consultant (Cardiac, Thoracic) (Sp.An-KAKV)
• Consultant Obstetric Anesthesia (obstetrics, handling labor pain) (Sp.An-KAO)
• Ambulatory Anesthesia Consultant (Sp.An-KAP)
• Regional Anesthesia and Pain Management Consultant (Sp.An-KAR)

What to Do Before Meeting the Anesthesiologist

The type and dose of anesthetic drug given is based on the type of surgery to be performed, the part of the body that will receive medical treatment, current health condition, medical history, duration of medical action, history of allergies to drugs that have been consumed, to a history of previous surgery if there is.

Inform the anesthesiologist about your medical history, allergies, and medications you are currently taking. If possible, carry a record of your medical history.