Role of the Anesthesiologist

If you’re preparing for surgery, you’ve probably given a lot of thought to the education, training, and experience of the surgeon performing the procedure. But you may not have thought much about the anesthesiologist or the importance of his or her medical expertise in your procedure — before, during, and after — to keep you safe and comfortable.

Anesthesiologists meet with you and your surgeon before surgery to assess your health and make decisions to ensure your anesthesia care is as safe and effective as possible. They monitor your vital signs during surgery, including how well your heart and lungs are working while you’re unconscious, and they take care of you after surgery to make sure you’re as comfortable as possible while you recover.

Anesthesiologists also play a key role in taking care of patients who are having minor surgery or who may not require general anesthesia, such as women in labor who need to be awake and alert but require effective pain management. They also help patients who have serious pain from an injury, or chronic or recurring pain such as migraines or ongoing back problems.

What is an anesthesiologist?

Anesthesiologists are medical doctors just like your primary care physician and surgeon. They specialize in anesthesia care, pain management, and critical care medicine, and have the necessary knowledge to understand and treat the entire human body. Anesthesiologists have 12 to 14 years of education, including medical school, and 12,000 to 16,000 hours of clinical training.

Anesthesiologists evaluate, monitor, and supervise patient care before, during, and after surgery, delivering anesthesia, leading the Anesthesia Care Team, and ensuring optimal patient safety.

Anesthesiologists specialize in anesthesia care, pain management, and critical care medicine.

What types of anesthesia do anesthesiologists provide?

Anesthesiologists are usually in charge of providing the following types of anesthesia care:

  • General anesthesia. This type of anesthesia is provided through an anesthesia mask or IV and makes you lose consciousness. It is used for major operations, such as a knee replacement or open-heart surgery.
  • Monitored anesthesia or IV sedation. IV sedation causes you to feel relaxed and can result in various levels of consciousness. Depending on the procedure, the level of sedation may range from minimal (making you drowsy but able to talk) to deep (meaning you won’t remember the procedure). This type of anesthesia is often used for minimally invasive procedures such as colonoscopies. IV sedation is sometimes combined with local or regional anesthesia.
  • Regional anesthesia. Pain medication to numb a large part of the body, such as from the waist down, is given through an injection or through a small tube called a catheter. You will be awake but unable to feel the area that is numbed. This type of anesthesia, including spinal blocks and epidurals, often is used during childbirth and for surgeries of the arm, leg, or abdomen.
  • Local anesthetic. This is an injection that numbs a small area of the body where the procedure is being performed. You will be awake and alert but feel no pain. This is often used for procedures such as removing a mole, stitching a deep cut, or setting a broken bone.

How does the anesthesiologist care for you during surgery?

Anesthesiologists guide you throughout your entire surgical experience:

  • Before surgery In the days or weeks before your surgery, your anesthesiologist will be sure you are fit for surgery and prepare you for the procedure by asking detailed questions about your health, examining you, and reviewing tests. Your anesthesiologist will answer your questions about the surgery and anesthesia. Be sure to let your anesthesiologist know about any medical problems you have, such as heart disease, diabetes, or asthma; what medications you are taking (prescription, over-the-counter, and herbal supplements); and whether you’ve had problems or concerns with anesthesia in the past. Use this time to ask questions. Understanding your care will make you feel more comfortable and confident as you prepare for surgery. Your anesthesiologist will create an anesthesia plan developed specifically for you to ensure a safe and successful procedure.
  • During surgery – The anesthesiologist manages your pain control and closely monitors your anesthesia and vital body functions during the procedure, working alone or with an Anesthesia Care Team. Your anesthesiologist will manage medical problems if they occur during surgery, as well as any chronic conditions you have such as asthma, diabetes, high blood pressure, and heart problems.
  • After surgery – In the recovery room, the anesthesiologist supervises others who will care for you and monitor your recovery — your breathing, circulation, consciousness, and level of oxygen — and is immediately available if there are questions or concerns. The anesthesiologist typically is the person who decides when you have recovered from the effects of anesthesia and are ready to go home or be moved to a regular room in the hospital or the intensive care unit. The anesthesiologist also creates a plan for your recovery and may be involved in pain management after you go home.

How are anesthesiologists involved in treating chronic pain?

Anesthesiologists specialize in pain control, and some focus their practices on treating patients with chronic pain. If you suffer from pain that won’t go away, such as migraine headaches, back pain, or pain caused by a condition such as fibromyalgia, ask your doctor about a referral to an anesthesiologist who specializes in treating chronic pain.