Beyond the Veil: The World of Anesthesiology

By Saanvi Khurana

The field of anesthesiology -- what could it possibly behold? A world where every breath is a lifeline, where skilled hands are the key to success, and where cutting-edge science meets to produce the best, possible outcome: a painless, peaceful sleep amidst a patient’s most critical moments.

Anesthesiology is one of the most “critical care” fields, being a field of medicine that focuses on pain management and anesthesia care. Without this type of doctor, can one possibly imagine how excruciating a surgery or procedure might be? More than that, an anesthesiologist can be extremely versatile, multitasking in ways that are not limited to but can include supervising patient care, delivering anesthesia, ensuring optimal patient safety, and being present during surgery. Thus, it’s extremely vital to understand what exactly the field is composed of and various conditions that may involve intervention from an anesthesiologist.

To go back in time, the art of anesthesia seems to have been linked with a dentist rather than a general care doctor -- as a matter of fact.  In 1846, a dentist from Boston named William T.G. Morton first publicly demonstrated anesthesia by using sulfuric ether, now known as ethyl ether, to anesthetize a patient who needed to get a tumor removed. 

Since then, the field of anesthesiology has developed, requiring extremely precise individuals who were willing to dedicate their studies to specialize in this drug. More specifically, anesthesia is made up of various anesthetics that produce a numb, loss of awareness feeling. They can be administered through skin patches, inhalation, injection, or other forms. However, to put them into broader categories, they could be classified as regional, general, monitored, and local -- all of which depend on the patient's medical condition, procedure, and age. Most surgeries also require IVs, which are intravenous agents. Even with the smallest dose, sleep can be induced while the patient is still able to breathe on their own. How cool, right?

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What conditions can involve anesthesia? In general, this medical intervention prevents patients from pain, but conditions that do require involvement from this field are major surgery procedures such as heart surgery, organ transplants, back surgeries, hip or knee replacements, and countless more:

Anesthesiology Discover Page

Hernia Repair: Hernia repair surgery, also known as herniorrhaphy, is the most common treatment for hernia, which is when a part of one’s organs bulges through an opening or weakness in the muscle or tissue that contains it. This uses local anesthesia (LA)  -- used for superficial hernias where anesthesia is injected at the site of repair.

Non-Cardiac Chest Surgery: This is a chest surgery including the esophagus, diaphragm, mediastinum, lungs, and trachea. This uses general anesthesia (GA) -- it’s a state of controlled unconsciousness induced by medication to prevent the feeling of pain.

Hysterectomy: This is a surgery where the uterus is removed, often being the most common surgical procedure for women after a C-section. It can also be used to treat fibroids or endometrial cancer. This uses general anesthesia  (GA) -- it involves being unconscious during the procedure, though spinal anesthesia (SA) could be used to be numb from the waist down. It can also be known as regional anesthesia (RA) or spinal block.

Gastrectomy: This is a surgical procedure that removes all or most parts of the stomach. It may generally be caused due to a specific stage and position of cancer or may be used for various stomach ulcers (peptic ulcers) or life-threatening obesity. This uses general anesthesia (GA) -- it involves being asleep during the operation and may include an epidural due to the incisions this surgery requires.

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Are there other uses of anesthesia? Indeed, there are! A common misconception about the field may be that anesthesia is only for surgeries, though it can also be used for certain screening and diagnostic tests, tissue sample removal such as skin biopsies, or dental work. Some of these may not involve anesthesiologists due to the lower intensity of the procedures, but regardless, the field of anesthesiology remains at play here.

Career possibilities as an anesthesiologist are endless. Specialization is a wonderful tool that allows everyone to remain involved in their field with such diverse occupations. For example, an anesthesiologist could diversify among the following options, though they are not all:

• Cardiothoracic Anesthesiologist

• Pediatric Dental Anesthesiologist

• Staff Anesthesiologist

• Anesthesiologist Assistant

• Night Anesthesiologist

Common misconceptions about anesthesiology are vast. Many believe that as an anesthesiologist, all they have to do is put the patient to sleep before surgery. However, it’s more than that! An anesthesiologist is a perioperative physician -- they are responsible for the patient throughout the surgical experience. They may feel as if the anesthesiologist is only there for the start, but they have to remain in the room until surgery is over and until the patient is fully conscious. Anesthesia can wear off before a surgery is complete, or it may take hours. However long it takes, the anesthesiologist must remain on duty to ensure the patient is doing fine.

 And finally, to address one of the most common misconceptions -- anesthesia will not put the patient through serious complications or death that easily! It may seem highly risky, but it truly has the biggest effect if the patient has underlying health conditions such as obesity, diabetes, heavy alcohol use, poor lung function, etc. Anesthesis does affect vital signs, but patients in a fragile state are more at risk. Even so, many patients are completely fine after anesthesia is delivered by the anesthesiologist. 

Being an anesthesiologist, there comes a great deal of responsibility, yet a rewarding challenge that brings many opportunities. Alertness is a great quality of anesthesiologists -- they must be constantly alert to intervene at any moment. They must also consider the worst-case scenarios and act under pressure to maintain caution in every step they take. After all, too much, or even too little, of this drug can have great impacts on the patient. 

However, it is indeed a very exciting journey, as technical skills must be used to perform procedures on patients. Intellectual skills of problem-solving can turn it into a puzzle -- though you want to focus more caution than the regular puzzle would be! Emotional support is another beneficial skill to have, such as trying to help the patient get through their anxiety of having surgery.

Anesthesiology is indeed a beacon of modern medicine, offering a great understanding of pain management along with patient care. Its diverse field, great skills, and remarkable advancements make it a unique branch of medicine that everyone can appreciate. Between consciousness and unconsciousness, it’s truly a magnificent field to explore and learn about. After all, anesthesiologists are like magicians: they make you disappear and reappear in a different state of mind.

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Resources

Made For This Moment | Anesthesia, Pain Management & Surgery. (2024). Made for This Moment | Anesthesia, Pain Management & Surgery. https://www.asahq.org/madeforthismoment/anesthesia-101/role-of-physician-anesthesiologist/#:~:text=ongoing%20back%20problems.-,What%20is%20an%20anesthesiologist%3F,treat%20the%20entire%20human%20body.

Clinic, C. (2022). Anesthesiologist: What They Do, Specialties & Training. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/22540-anesthesiologist