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Anesthesiologists are the physicians trained
to administer and manage anesthesia given during
a surgical procedure. They are also responsible
for managing and treating changes in your critical
life functions - breathing, heart rate, and blood
pressure - as they are affected by the surgery
being performed. Further, they immediately diagnose
and treat any medical problems that might arise
during and immediately after surgery.
Prior to surgery, the anesthesiologist will evaluate
the patient's medical condition and formulate
an anesthetic plan which takes that patient's
physical condition into account. It is vital that
the anesthesiologist knows as much about your
medical history, lifestyle, and medications as
possible. Some particularly important information
he/she needs to know includes the following:
- reactions to previous anesthetics
If you have ever had a bad reaction to an anesthetic
agent, you need to be able to describe exactly
what the reaction was and what your specific
symptoms were. Give the anesthesiologist as
much detail as possible, such as you felt nauseated
when you woke up or the amount of time it took
you to wake up, etc.
- current herbal supplements
It has recently been learned that certain herbal
products, commonly taken by millions of Americans, may
cause changes in heart rate and blood pressure,
and may increase bleeding in some patients.
The popular herbs gingko biloba (an herb used
for many conditions associated with aging, including
poor circulation and memory loss), garlic (an
herb often used for cardiovascular conditions
and to help prevent colds, flu, and other infectious
diseases), ginger, and ginseng (used as a general
tonic to increase overall body tone; considered
helpful in elevating energy levels and resistance
to stress) may lead to excess blood loss by
preventing blood clots from forming. In addition,
St. John's wort (a popular herb used for mild
to moderate depression) and kava kava (another
popular herb used for depression and to elevate
mood) may prolong the sedative effect of the
anesthetic. The American Society of Anesthesiologists
advises patients planning to have surgery to
stop taking all herbal supplements at least
two to three weeks prior to surgery to rid the
body of these substances.
- any known allergies
Discussing any known allergies with the anesthesiologist
is very important, as some anesthetic drugs
trigger cross-allergies, particularly in persons
who have allergies to eggs and soy products.
Allergies to both foods and drugs should be
identified.
- recent and/or current prescription and over-the-counter
medications
It is also important to let your surgeon and
anesthesiologist know about both prescription
medications and over-the-counter medications
you are taking, or have recently taken. Certain
prescription medications, such as coumadin, a
blood thinner, must be discontinued for some
time prior to surgery. In addition, as many people
take a daily aspirin to prevent heart attack,
and certain dietary supplements, physicians need
to be aware of these habits, as they can prolong
bleeding and interfere with muscle relaxants
used by anesthesiologists.
- cigarette smoking and drinking
Cigarette smoking and alcohol can affect your
body just as strongly (and sometimes more strongly)
than many prescription medications you may be
taking. Because of the way cigarettes and alcohol
affect the lungs, heart, liver, and blood, these
substances can change the way an anesthetic
drug works during surgery. It is important to
let your surgeon and anesthesiologist know about
your past, recent, and current consumption of
these substances prior to surgery.
Undergoing surgery can be a good motivator to
quit smoking. Most hospitals are smoke-free and
physicians, nurses, and other health professionals
will be there to give you support. In addition,
you will heal and recover faster, especially in
the incision area, or if your operation involves
any bones. Quitting smoking also reduces your
risk of heart disease and cancer.
- use of street drugs (such as marijuana, cocaine,
amphetamines, etc.)
Patients are often reluctant to discuss matters
of illegal drug consumption, but you should remember
that all conversations between you and your surgeon
and anesthesiologist are confidential. It is
crucial that he/she know about your past, recent,
and current consumption of these substances.
It is important to keep in mind that the only
interest your physician has in this information
is learning enough about your physical condition
to provide you with the safest anesthesia possible.
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The Department of Anesthesiology
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