Whether you’re having a cavity filled or a knee replaced, it would be hard to imagine these procedures performed by anyone other than highly skilled doctors. And it would be just as hard to picture these procedures without the use of anesthesia.

Anesthesia is a medical treatment that uses medications (anesthetics) to keep you from feeling pain during surgery and other procedures. Different medical professionals can provide anesthesia depending on the procedure. For more complex and invasive procedures, anesthesia is managed by a physician anesthesiologist.

Types of anesthesia

Anesthesia works by temporarily blocking nerve signals to the brain. The type of anesthesia used depends on the procedure.

• Local anesthesia numbs a small part of the body. It’s used for procedures such as stitching a cut or a skin biopsy. Local anesthesia usually is injected, and you’re awake for the procedure.
• Regional anesthesia blocks pain in a larger area, such as a limb or from the waist down. This anesthesia type is injected or provided through a catheter and is commonly used for childbirth, whether a spinal block for caesarian section (C-section) delivery or an epidural.
• Monitored sedation is used for minor surgeries or less complex procedures that require more than local anesthesia, such as cataract surgery or a colonoscopy. Sedation is usually provided intravenously (IV) and is often combined with an analgesic (pain reliever). Depending on the procedure, sedation can range from minimal (drowsiness) to deep (asleep and unlikely to remember the procedure).
• General anesthesia is used for major procedures, such as heart surgery, organ transplants, and surgery to treat cancer. Medicine is delivered through an IV or mask, making you unconscious. An anesthesiologist monitors the body’s vital functions, such as heart rate and blood pressure, and manages your breathing throughout the procedure.

Anesthesia’s possible side effects and risks

Most anesthesia side effects resolve within 24 hours, often sooner. Depending on the anesthesia type and how it’s delivered, side effects may include:

• Pain, tenderness, or bruising at the injection site
• Itching
• Headache
• Fatigue
• Nausea or vomiting
• Chills
• Sore throat
• Muscle aches
• Difficulty urinating

While millions of Americans safely receive anesthesia every year, it isn’t risk free. Some potential yet rare risks include collapsed lung, nerve damage, and postoperative delirium, and factors such as age and certain medical conditions can make anesthesia riskier for some more than others.  

The anesthesiologist’s unique role

Anesthesia is a key component of an anesthesiologist’s expertise, but not the only one. An anesthesiologist is a board-certified physician who specializes in anesthesia care, pain management, and critical care medicine and is knowledgeable in all areas of medicine and surgery.

“The role of a board-certified physician anesthesiologist, in my opinion, is vital to the patient’s well-being throughout the perioperative period,” says Summit Health anesthesiologist Anthony Surace, MD. At Summit Health, Dr. Surace participates in various procedures, including orthopedic surgery, urological surgery, general and plastic surgery, and gastroenterology procedures such as endoscopy and colonoscopy.

The term perioperative – “peri” meaning “all-around” –implies an anesthesiologist’s care goes beyond surgery itself. Indeed, their role begins well before a procedure and continues after its completion.

Preoperative care

Before a procedure, an anesthesiologist will assess your fitness for it by reviewing your medical history, relevant lab results, surgical history, medications, allergies, and other health factors. Based on this assessment, they can tailor an anesthesia plan to ensure a safe and successful procedure.

“Preoperatively, we make sure a patient is appropriate and optimized medically prior to undergoing whatever their procedure or surgery is,” says Dr. Surace. Your anesthesiologist will discuss this assessment and plan with you and answer questions about anesthesia and your procedure.

“In preparing for procedures, there is nothing a patient shouldn’t disclose to the anesthesiologist,” adds Dr. Surace. “Patients should be completely honest because anything can potentially impact the anesthetic and their physiology.”

Intraoperative care

While your surgeon is at work, the anesthesiologist is taking care of you and may be assisted by a nurse anesthetist or anesthesiology assistant. Your anesthesiologist closely monitors your vital signs and organ function while managing your pain control. “Through vigilance, we ensure that patient safety is of the utmost importance while undergoing anesthesia,” says Dr. Surace.

Postoperative care

Once the surgery or procedure is complete, the anesthesiologist will stop anesthesia and oversee continued monitoring until you wake. Your care team will watch for side effects and complications and address them as needed. The anesthesiologist typically decides your readiness to go home or be moved to another room in the hospital.

The anesthesiologist also creates a plan for your recovery, which may include pain management. “We help minimize the negative things that can impact a swift surgical recovery, such as pain control,” says Dr. Surace.

The future of anesthesiology

Thanks to advances in medicine and anesthesia, many lifesaving and life-changing procedures are possible and safe. Through scientific and clinical research, strides in anesthesiology are ongoing.

Research includes studies on anesthetics, how they work, their effects on specific patient populations, and even how genetic variations affect patients’ responses to anesthesia. Technology is advancing anesthesia delivery and patient monitoring, as well. All taken, efforts are making anesthesia more individualized, more effective, and even safer.

“Anesthesiology is rapidly advancing and one of the most technical fields in medicine,” says Dr. Surace, noting that patient safety is the field’s North Star. “Patients should feel comforted knowing it’s our job to take care of them during their most vulnerable time.”