| Imagine that you are in hospital,
waiting to have an operation. It is time to go to the theatre; the anesthetist
approaches you and speaks. But instead of the reassuring words" I'm just going
to give you something to send you off to sleep", you hear: "Let me take you on a
trip towards death". Terrifying? Maybe, but that is what having a general
anesthetic is all about. "If you give a small amount of an anesthetic drug, it
won' t have any effect. If you give more, it will put the patient off to sleep,
but if you give more still it can kill the patient." In a modem hospital, before you are given an anesthetic, an anesthetist asks you a number of questions to decide which drugs to use. Most importantly, they check the state of your heart and lungs and ask if you have asthma, angina or have ever had a heart attack. They want to know about any drugs you are taking, so that they do not give you an anesthetic that reacts badly with them, and they will also find out if you have any allergies. As well as putting you to sleep, the anesthetist is also responsible for controlling your pain. Then how can the anesthetist tell that they have put their patients far enough under? Mostly, by experience. There is no such thing as an awareness monitor, though all the patient's body functions, such as heart rate, gases going in and out and oxygen levels in the blood, are monitored. If the anesthetic is not deep enough and the patient becomes "light', the monitors should tell the anesthetist that something is wrong long before the patient becomes aware. This is why the anesthetist watches the patient carefully throughout the operation. At the end of your operation, the anesthetic is mined off. It might seem surprising that the anesthetist is often the unsung hero of the operating thestre. Many people, including some nursing staff, do not realize that the anesthetist first has to qualify as a doctor. They then take three further examinations to qualify as anesthetists because of the number of things they have to take into account when carrying out their work They do not simply need to know about the drugs they use; they must also know about all the other drugs on the market so that they can avoid dangerous interactions. They have to keep abreast of any new surgical technique, to make sure they give an appropriate anesthetic for any operation. The "journey towards death" has come a long way. But one fascinating fact remains: whether it is ether or a complex cocktail being used to "put someone to sleep": no one yet knows exactly how anesthetics work. |