Introduction The definition of general anesthesiology Generally, talk about anesthesia and its complications in some councils, and we hear comments such as: Give the patient an overdose! Or the patient''s sensitivity has not been tested before he was given anesthesia! Or someone saying: How do you numb a patient with heart disease? Or even saying that anesthesia caused the bleeding !! Or that the anesthesia caused excruciating pain for the patient after the operation !!
And such inaccurate (or mostly incorrect) comments do not belong to a specific community but rather are common to many eastern and western societies.
No one but the anesthesiologists themselves are blamed for failing to introduce this science! But there are also historical reasons that caused these misconceptions or participated in that, including the history of the development of medical science in general and anesthesiology in particular.
It is also noticeable that the anesthesiology questions are missing in most medical pages in the media that contribute to medically educating the general public. We see that the questions usually revolve only about heart disease, respiration, skin diseases and some habits that affect physical, psychological or sexual health.
Also, one of the reasons is that the time for the anesthesiologist and the patient to meet in the past is often limited to a few minutes before beginning anesthesia, and in this meeting, dialogue is often conducted in a way that the patient cannot remember or absorb all that is mentioned during it.
Perhaps the persistence of this kind of illiteracy in some societies is the reason for the lack of progress in the science of anesthesiology and the lack of medical education specialized in its culture.
A lot of the public (and some intellectuals) think, for example, that the drug is a nurse or a technician, so who is the drug? Who is the anesthesiologist?
Anesthesia machine
Is the drug a doctor or a technician?
Here too, the factor of history comes to add to the confusion of some.
To begin with, any ambiguity or misunderstanding must be clarified by saying that the drug is a doctor who has graduated from the medical school just like any other doctor and has specialized in a separate science in itself is the science of anesthesiology for a period of up to five or six years after graduating from the Faculty of Medicine.
The anesthesiologist is now the patient''s physician before, during and after the surgery.
As for the reasons for this confusion, they are many, but we focus here on the issue of differentiating between the anesthesiologist and the anesthesiologist.
Who is the anesthesiologist?
He is an important component of the anesthesia team, but rather the right-hand man of the anesthesiologist, and as his name suggests he is a technician (or nurse) who specializes in technical sciences related to anesthesia.
According to the scientific regulations of the colleges of anesthesia, the presence of the anesthesiologist is one of the necessary and binding matters before starting the anesthesia.
The anesthesia technician is good at dealing with a lot of issues related to anesthesia and making the necessary equipment for that, including ventilators, endoscopes, drug pumping devices, etc.
However, it should also be noted that some medical centers (especially in European countries and some US states) allow anesthesia technician to perform anesthesia under the supervision of an anesthesiologist, which is not permitted in most countries of the world.
Perhaps some medical center in the Arab world also allows this, but this matter is not allowed (as far as I know) in medical centers in the Kingdom of Saudi Arabia.
What is anesthesiology?
Anesthesiology is the science that qualifies a specialist to conduct anesthesia in a way that makes the patient under the influence of the anesthetic (i.e. in the case of unconsciousness) and not feel any pain if necessary, and at the same time to maintain the integrity of the organs and organs in the body and the continuity of its work properly Awakening the patient (i.e. regaining consciousness) and working to continue controlling the pain caused by the operation after its completion.
And sometimes medical care by the anesthetic continues (if necessary) after the end of the surgery in the intensive care department (intensive care), where the specialty of critical pathology is one of the partial specializations of anesthesiology.
Definition of anesthesia
Anesthesia is a recoverable (non-permanent) state of loss of consciousness.
Generally, anesthesia consists of two main components: sleep (anesthesia) and pain reliever (analgesic), and a third component, muscle relaxation.
Why do we need to numb the patient?
The basic principle is that the surgery is performed while the patient is unconscious, does not move (paralyzes his movement), and does not feel pain until the body can bear the pain of surgery.
Although partial anesthesia may fulfill the previous purpose (i.e. removing pain without a lack of awareness), some patients prefer general anesthesia as a psychological option.
As for the benefits from anesthesia, they are more than collected in this regard, but it is sufficient to point out that they are technical, medical, and surgical benefits, for example, the ability to perform some operations in different positions of the patient''s body.
Including controlling the patient''s pressure to raise or lower during the procedure so that the percentage of bleeding sometimes decreases or there are no complications for the operation, for example some types of brain operations.
An example of anesthesia and its steps
Here we take the appendix removal process for a simplified explanation of the anesthesia process from the first meeting of the patient with the anesthesiologist until the patient''s stay in the hypnosis department through the recovery section.
After the surgeon determines the need for the operation, the anesthesiologist usually interviews the patient to ask him about:
His health history
Medicines used by the patient
Duration of the patient to stop eating and drinking (6 hours)
Reviewing any tests the patient needs.
After that, the anesthesiologist exposes a simplified explanation of the anesthesia and indicates any side effects, especially many occurring such as nausea and minor pain in the throat (see the definition of side effects and their types) or serious complications that are rare or complications related to the patient''s own condition such as heart and breathing patients .
This explanation is a patient''s right, and if he does not want any increase, he must mention that, and because the law requires the patient to sign a declaration of his full consent and knowledge of these side effects, this cannot be done without the patient''s understanding of what is agreed upon!
It also contains the disclaimer of the doctor''s responsibility for any claim in the future.
Definition of side effects and their types
The side effects of anesthesia have specific ratios and information. These ratios depend on several things, including:
Patient age, type of surgery, and other diseases associated with the surgically treated disease.
Including the duration of anesthesia, the type of anesthetic drug used and the type of anesthesia used, general or partial,
Including hereditary or family diseases as well, whether the patient smokes or not.
Examples
For example, nausea and vomiting abound among young women who smoke, after ear, strabismus, or gynecological operations, or if the patient had previous experience of the same problem after anesthesia.
The length of the anesthesia may mean the extension of the recovery period in the recovery room (ie after the anesthesia), especially for the elderly, as the body needs a longer period to get rid of the drug and its effects.
Likewise, patients with kidney failure or some liver patients have a longer drug effect due to the slow process of disposal of the drug through these two important organs.
Certain genetic diseases cause side effects, including interaction with anesthetics, which may cause serious effects, and usually avoids dealing with these drugs and replaces them with safe ones, in case the drug knows the history of the patient and his family.
Some side effects of some drugs used in anesthesia abound in some patients with diseases of the nervous system, and these drugs are avoided initially until these effects are avoided.
Smoking has many negative effects on the body, especially causing atherosclerosis, which may increase the incidence of heart attacks, especially in the case of hypotension during anesthesia.
The smoker may also suffer from some breathing difficulties after the completion of the anesthesia due to the presence of an excited lung from the smoke, and its excitability increases the presence of the breathing tube used during the anesthesia, which may also cause an increase in cough, which may negatively affect the process (especially eye operations) and also causes Increased pain due to heavy movement during coughing.
Anesthetic gas container
Allergy to some anesthetics
A serious side effect is the body''s sensitivity to some anesthetics.
What is the reason for that? What are the pathological effects of that? How can this be avoided? How is the treatment done?
Allergy may be explained by an unwanted reaction of the body with the drug, i.e. (side effects), but what is meant here is that the drug works (the foreign body) of the body and stimulates the immune system, i.e. the interaction of antibodies in the body with the stimulus to it, i.e. the medicine (or part of its composition).
This reaction results in several symptoms including difficulty breathing, a sharp in pressure, swelling of the eyelids, gums, and the body in general, changes in blood clotting until the condition ends with death in the absence of treatment or a slowdown in diagnosis, and anesthesiologists are trained to deal with This case during the scheduled training program.
When this condition occurs, treatment with adrenaline, the amount of many fluids, and breathing support with medication and respiratory system if necessary.
Why isn''t an allergy test done before giving the drug?
Conducting an allergy test is done according to the medical condition, and often this does not happen unless this type of sensitivity occurred during anesthesia and after using several medications in order to diagnose the condition and know the type of medication that causes this and avoid it.
From the aforementioned, it is clear that this type of testing cannot be performed in a preventive manner due to the difficulty of determining the target, and because many different drugs are often used, depending on the situation.
Also the cost of such tests, and the difficulty to justify them, as well as the low occurrence of such interactions.
Is it possible to interact with the test materials?
Yes, and the possibility of serious symptoms from these stimuli (or medications) occurring during the test, which cannot be justified.
If these tests are not taken, except for necessity determined by the doctor.
Cardiac resuscitation device
Questions about anesthesia
Anesthesia needle ... what do you mean?
It is the first dose of the drug, the effect of which lasts only minutes, due to the distribution of the drug throughout the body other than the brain, including (thiobinton, propofol, ketamine, etomidate).
Does the patient wake up during the operation? How does the anesthesia needle work?
After the first dose of the anesthetic, the anesthesia usually continues with the patient inhaling the anesthetic gas in addition to oxygen, which means the continuity of the anesthetic effect as long as the patient breathes either by preparing breathing or automatically.
Thus, this means that the patient will sleep and not wake up under the drug.
The effect of
