Before facing surgery, it’s normal to have a few worries. Patients are concerned about infection, bleeding, even sponges and instruments abandoned in their bodies. During the COVID pandemic, patients were worried they might not even get the surgery they need due to restrictions in elective surgeries. If you’re facing surgery, you might also be worried about “going under.” When a patient is given local or regional anesthesia or placed in what’s called “conscious sedation,” they are more or less aware of what’s going on. It’s the application of “general anesthesia” that gives many patients pause.
Few outside of the medical profession give much thought to anesthesiologists––until something goes wrong. Avoiding problems and keeping patients safe is why standard anesthesia monitoring is employed. So what exactly is being monitored during anesthesia?
Prepping
Fifty years ago, as many as one out of every 10,000 patients died from anesthesia-related complications. Today, anesthesia is very safe with complications around one in every 200,000. However, for patients with pre-existing cardiac conditions and certain higher-risk surgeries, it can be much higher.
Before surgery, the anesthesiologist is responsible for checking the equipment. This starts with checking the anesthesia machine and its components for proper functioning, including the oxygen analyzer, volatile agent vaporizers and breathing circuit. Checking airway equipment, emergency medications and all other monitoring systems that will be utilized during surgery is also done by the anesthesiologist prior to surgery and similar to the checklist performed by pilots.
Before surgery and the start of anesthesia, the anesthesiologist will make sure the patient is properly connected to monitors. Vital signs are tracked by a variety of devices attached prior to surgery. These include an inflatable blood pressure cuff wrapped around your upper arm and a pulse oximeter that is attached to your finger, toe, or earlobe to measure oxygen levels in your blood. Electrocardiograms or EKG will monitor your heart activity, while your body temperature is checked by different types of thermometers. Finally oxygen and carbon dioxide analyzers check the levels of these gasses as you inhale and exhale. For some surgeries, additional invasive and non-invasive monitors might be used to monitor a patient extra carefully. Your anesthesia care team will discuss this with you prior to surgery.
During Surgery
Throughout the case, the anesthesiologist is continuously monitoring the patient’s vital signs, including their oxygenation, ventilation, circulation, and temperature.They treat blood pressure and heart rate changes, administer medications for pain and support the surgeon during the procedure as needed. A great anesthesiologist makes everything look easy!
Following surgery you may experience short-lived side effects including chills, fatigue, headaches, or nausea, or even memory loss, which usually resolve quickly. You should avoid driving or making major decisions for 48 hours after your surgery or procedure.
If you or a family member is facing surgery, talk to your surgeon and your anesthesiologist about the anesthesia being used to come up with the best plan for you. But you can rest easy knowing a highly-trained professional will be watching over you every step of the way.
Written by John Bankston
References
- Retained Surgical Foreign Bodies after Surgery
- COVID 19 and surgery‐ how this pandemic is changing the way we operate
- How Safe Is Anesthesia? 5 Common Concerns
- Anesthesia-related Cardiac Arrest
- Responsiveness to the chlorhexidine epidural tragedy: a mental block?
- Recommendations for standards of monitoring during anesthesia and recovery 2015 : Association of Anaesthetists of Great Britain and Ireland
- Monitoring During Anesthesia
- Standards for Basic Anesthetic Monitoring
- Anesthesia