What do anesthesiologists do during surgery? Do they check their phones every day?

During an operation, the surgeon was concentrating on operating the instruments, the nurses were busy passing the instruments, and the anesthesiologist was sitting in the corner, occasionally looking down at his phone... This scene caused many people to misunderstand: "Are anesthesiologists very idle? Is their job just to give an injection of anesthetic?"

But the truth is just the opposite: anesthesiologists are the most "secret" guardians in the operating room, and every decision they make is directly related to the life and death of the patient. Behind those moments that seem to be "looking at the phone" are countless thrilling moments that ordinary people cannot see.

The work of anesthesiologists begins before surgery:

Many people think that the task of anesthesiologists is just to "make the patient fall asleep", but in fact, their work has already started 48 hours before the operation:

1. Preoperative evaluation:

According to the patient's age, medical history, and examination reports (such as cardiopulmonary function, allergy history), the anesthesia risk is assessed and a personalized plan is developed. For example: How can patients with hypertension avoid a sudden drop in blood pressure during surgery? How can long-term smokers deal with complications after endotracheal intubation?

2. Anesthesia method selection:

Is it general anesthesia, hemiplegia or local anesthesia? Which drug combination should be chosen? This requires a comprehensive judgment based on the type of surgery, the patient's physical condition and the needs of the surgeon.

3. Communicate with patients:

Soothe the patient's anxiety, inform him of the anesthesia process and precautions, and even predict the patient's concealed medical history (such as secretly stopping antihypertensive drugs, drinking habits, etc.).

If preoperative assessment is wrong, it may lead to fatal risks such as anaphylactic shock and malignant hyperthermia (with a mortality rate of up to 80%) for patients during anesthesia.

This process must be completed the day before the operation, regardless of when the anesthesiologist gets off work. In many cases, it is already dark when the anesthesiologist returns home.

During surgery: Anesthesiologists are “physicians who regulate vital signs”

When the patient enters the anesthesia state, the work of the anesthesiologist really reaches its climax - the anesthesiologist needs to monitor the patient's vital signs throughout the process and respond to emergencies within a few seconds:

1. Anesthesia induction period: precise control of the "falling asleep" process

Intravenous drugs are used to quickly put the patient into an anesthesia state while maintaining a patent airway to avoid hypoxia.

During intubation, the tracheal tube must be placed within 30 seconds. Any carelessness may cause laryngeal spasm, tooth damage or even suffocation.

2. Intraoperative maintenance period: dynamic balance of "life parameters"

Real-time monitoring: more than 10 data including electrocardiogram, blood pressure, blood oxygen, respiratory rate, body temperature, bispectral index (BIS), etc., and immediate processing if any abnormality occurs.

Regulating drugs: Adjust the dosage of anesthetics, analgesics, and muscle relaxants at any time according to the intensity of surgical stimulation (such as skin incision, suturing), amount of bleeding, and patient response.

Respond to emergencies:

Sudden drop in blood pressure → rapid rehydration or use of pressor drugs;

Slow heartbeat → injection of atropine, other drugs or other methods;

Massive bleeding → coordinate blood transfusion and maintain circulatory stability…

3. What you think is “looking at your phone” may actually be a life-saving operation

The multifunctional monitor in front of the anesthesiologist is connected to the patient's vital data, while the mobile phone or tablet in their hands may be:

Record anesthesia orders (detailed medication and vital signs data required);

With the development of informatization, professional apps can be used to calculate drug dosage and blood transfusion volume;

Consult the patient's latest examination report or literature guidelines.

Case: Records from a tertiary hospital in 2018 showed that during a rectal cancer surgery, a patient suffered from ventricular fibrillation. The anesthesiologist completed defibrillation and drug rescue within 15 seconds, bringing the patient back from the brink of death.

After surgery: The anesthesiologist’s responsibility does not end

When the surgery is over and the surgeon can leave, the anesthesiologist must:

1. Resuscitation management:

Gradually reduce the amount of anesthetic drugs to ensure the patient's safe awakening and avoid agitation, vomiting, or respiratory depression.

2. Implement analgesia plan:

According to the degree of surgical trauma, a postoperative analgesia plan (such as intravenous pump, nerve block) is developed to reduce the patient's pain.

3. Follow-up:

Visit the patient within 24 to 72 hours after surgery to check for anesthesia-related complications (such as headache, nausea, or other complications).

Why do we say “surgeons cure diseases, anesthesiologists save lives”?

Data speaks:

According to the "China Anesthesia Development Report", in the past 30 years, the anesthesia-related mortality rate in my country has dropped from 1/5000 to 1/200,000, reaching the international advanced level. Behind this is the extreme control of details by anesthesiologists.

The work of anesthesiologists has in fact won the recognition of most surgeons:

Many surgeons said frankly: "We dare to perform major surgeries because we have a reliable anesthesia team behind us."

The "Invisible Guardian" under the Shadowless Lamp

A successful operation requires not only the superb skills of the surgeon, but also the "full escort" of the patient's vital signs by the anesthesiologist. The anesthesiologist is like a highly alert pilot. Although the plane is in autopilot mode most of the time, once it encounters air currents, it must respond correctly within a few seconds.

Please remember: when you see anesthesiologists "looking down at their phones", they are likely researching how to better improve the quality of anesthesia and ensure patient safety.

In other words, when the anesthesiologist seems to be idle, the patient is safe. If the anesthesiologist is busy, everyone else will be nervous!

Yang Li, Department of Anesthesiology, Yuncheng Central Hospital

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