Anaesthesiology

If surgery is a journey, the anaesthesiologist is the one making sure you travel through it safely. 

Anaesthesia refers to the medicines used to prevent pain. Anaesthesiology is the medical specialty that ensures these pain control medicines are used safely and effectively around surgery. An anaesthesiologist is a doctor trained to:

• Evaluate your health and risk factors before the procedure
• Select the appropriate type and dose of anaesthesia
• Monitor your breathing, blood pressure, heart rate and oxygen levels throughout the procedure, staying ready to act the moment something changes
• Help manage pain afterwards and respond to unexpected changes or complications during a procedure
• Coordinate intensive care for critically ill patients, when needed

The type of anaesthesia depends on the procedure, your medical history and the level of pain control or immobility required.

General anaesthesia is designed to achieve four goals, also called the 4 A’s: analgesia (pain relief), amnesia (loss of memory of the procedure), anaesthesia (unconsciousness), and akinesia (prevention of movement). Your anaesthesiologist balances these throughout the procedure. You do not remain aware of the procedure and will generally need assistance with breathing while the anaesthesia is active. It is commonly used for major operations and procedures where complete immobility is required.

In regional techniques, you remain conscious unless sedation is given, but a larger area of the body is numbed. For example, spinal and epidural anaesthesia numb the lower body by acting on the spine. Nerve blocks target a specific area, such as an arm or leg, and are used to reduce pain after surgery.

Local anaesthesia numbs a small, specific area. It may be used for minor procedures such as removing a small skin lesion or stitching a wound.

Sedation uses medicines to make you relaxed, drowsy or less aware during a procedure. Depending on the level of sedation, you may still be able to respond to instructions and breathe without assistance.

Preparing for Anaesthesia Before Surgery

• In this first stage, your anaesthesiologist reviews your medical history, allergies, medications, previous operations and any earlier problems with anaesthesia.
• Your anaesthesiologist takes conditions like asthma, diabetes, high blood pressure, heart disease or sleep-related breathing problems into account when planning your anaesthesia.
• You may also undergo a physical examination and investigations such as blood tests, an ECG or other tests when clinically required.
• You will receive instructions about fasting, regular medicines and what to expect on the day of surgery.

A commonly used guideline is the 2-4-6-8 rule which means clear fluids up to 2 hours before, breast milk up to 4 hours before, a light meal up to 6 hours before, and fatty or heavy meals up to 8 hours before anaesthesia. However, your anaesthesiologist may adjust these timings based on your health condition and the type of procedure.

During surgery

• The anaesthesiologist gives you the anaesthesia and keeps a close watch on your breathing, oxygen levels, blood pressure, heart rate and body temperature throughout the procedure.
• The anaesthesia plan can be adjusted throughout the procedure based on your response and the surgical requirements.
• Pain relief may also be planned so that any discomfort or uneasiness is controlled as you wake up.

After surgery

• Anaesthetic medicines are gradually stopped and you are monitored as you recover.
• The team assesses your alertness, breathing, circulation and pain before deciding when you can move to the ward or another level of care.
• For some procedures, anaesthesiologists may also use regional blocks or other pain-management techniques to reduce pain after surgery.

The type of anaesthesia used depends on the surgery and the patient’s condition, so it varies from person to person. At the CK Birla Hospital, anaesthesia and pain management specialists are involved in care across several surgical and medical areas, including:

• Cardiac surgery
• Neurosurgery
• Obstetric and gynaecological procedures
• Orthopaedic surgery
• Paediatric procedures
• Oncology and cancer surgery
• Urology
• ENT surgery
• Bariatric and minimally invasive surgery
• Plastic and reconstructive surgery

Our anaesthesia team also supports procedural sedation for gastroenterology and endoscopy procedures, and works closely with the Pain Management and Emergency & Critical Care departments for perioperative pain relief and critical care coordination.

At the CK Birla Hospital, our anaesthesia specialists work as part of multidisciplinary teams, with access to critical care facilities when a patient’s condition or procedure requires closer monitoring. Our anaesthesia care focuses on:

• Experienced anaesthesiologists, pain management and critical care specialists
• Multidisciplinary coordination across surgical and critical care teams
• Detailed pre-anaesthesia assessment
• Continuous monitoring of vital functions
• Advanced perioperative pain management
• Modular OTs and dedicated ICU facilities
• 24/7 critical care support
• Individualised anaesthesia planning

If you are preparing for surgery and have concerns about anaesthesia, discuss them during your pre-anaesthesia assessment. Your anaesthesiologist can explain the proposed technique, fasting requirements, expected recovery and any individual risks relevant to your health.