Definition and Overview

An anesthesia consultation, also called pre-surgical anesthesia assessment, is an appointment between the patient and an anesthesiologist before a medical or surgical procedure is carried out.

A surgery, whether minor or major, is always accompanied by risks, such as bleeding, pain, and discomfort. These things may render the procedure unsuccessful or prevent the patient from even going through with the much-needed treatment.

Thus, anesthesia is a common fixture in health care settings. It is a kind of drug that is introduced into the body usually by injection; it eliminates the pain that comes with the surgical procedure, at least temporarily. Depending on the medication, it can numb the area to be operated on, make the patient unconscious, or prevent the patient from remembering the procedure, which can cause emotional trauma.

Anesthesia is classified into three different types:

  • Local anesthesia - only the specific part of the body that is going to be operated on is injected with anesthesia. This means that the patient is awake all throughout the procedure. Local anesthesia is typically used in dental procedures such as tooth extraction and root canal therapy as well as minor surgeries such as vasectomies and breast biopsies.

  • Regional anesthesia – This type of anesthesia numbs a large area and is used in more invasive surgery such as Caesarean sections and most procedures that involve the lower part of the body.

  • General anesthesia – This type of anesthesia makes the patient unconsciousness throughout the surgical procedure. While an injection is sufficient for both regional and local anesthesia, the drug used in general anesthesia must be delivered intravenously or inhaled through a gas mask that is worn during the surgery. The risks are higher in general anesthesia, so vital signs like blood pressure and heart rate are monitored throughout the procedure until the patient wakes up in the recovery room. General anesthesia is used in major surgeries such as open-heart surgery and organ transplantation.

Who Should Undergo and Expected Results

An anesthesia consultation occurs when:

  • The patient is recommended to undergo any type of operation including giving birth
  • The patient is believed or has been known to experience allergic reactions to certain anesthetics
  • When the level of anxiety is high, especially for those who may have to go through general anesthesia
  • There’s an existing medical condition that may prevent or change the method on how the anesthesia is administered
  • The patient is referred by his physician or surgeon to an anesthesiologist

As a form of assessment, the process can help the anesthesiologist decide the best type of anesthesia to administer and the ideal dosage. The doctor will also have a better understanding of the possible special needs of the patient (e.g., pediatric anesthesia).

How Does the Procedure Work?

The patient is referred to an anesthesiologist at least a day or a few hours before the surgical procedure. The anesthesiologist will then:

  • Review the medical records of the patient
  • Conduct a physical exam, which include the monitoring of the vital signs
  • Discuss any condition that may alter or prevent the administration of anesthesia such as allergic reactions or heart ailment
  • Walk the patient through the administration of the anesthesia
  • Relate the role he is going to play during the entire surgical procedure
  • Determine the kind of anesthesia to administer, as well as the ideal dosage
  • Explain the risks and limitations of the anesthesia
  • Answer questions the patient may have
  • Counsel the patient especially if he is anxious about the procedure

The consultation usually takes less than an hour. The anesthesiologist then coordinates closely with the surgeon who’s going to perform the procedure.

Possible Risks and Complications

Sometimes an initial consultation is inconclusive for the anesthesiologist, so he cannot derive an ideal plan for the patient. In this case, he needs to work closely with the other health providers, particularly in extracting more medical information about the patient.

References:

  • American Society of Anesthesiologists. Practice guidelines for postanesthetic care: an updated report by the American Society of Anesthesiologists Task Force on Postanesthetic Care. Anesthesiology. 2013;118:291-307. PMID 23364567 www.ncbi.nlm.nih.gov/pubmed/23364567.

  • Malhotra V, Mack PF. Quality of care and patient safety. In: Miller RD, Pardo MC, eds. Basics of Anesthesia. 6th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 47.Page Title: What is Anesthesia Consultation: Overview, Benefits, and Expected Results

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