Dr Michelle Casey expands on the role of the anaesthetist in cancer surgery.
The anaesthetist, also commonly referred to as an anaesthesiologist, is one of the doctors who form part of the team of healthcare professionals who will be taking care of you when you’re admitted to hospital for an operation.
One of the main roles the anaesthetist has is to help create conditions that will help the surgeon perform an operation. Major operations weren’t possible before the time of anaesthesia, and considering the first general anaesthetic took place in 1846, it’s not all that long ago!
Patient and doctor interaction
The anaesthetist will visit you in the ward before your operation. He/she will ask questions about your medical history, including what medical conditions you have, previous operations you have undergone, any allergies you may have, what medication you use, what your social habits are (smoking) and how active you are.
Don’t be surprised if we ask you how far you can walk or how many stairs you can climb, as this will give us a good indication of how fit you are and how well you will cope with the anaesthetic and the operation.
At times an anaesthetist will make suggestions about what further measures can be taken or what other tests can be done to make your anaesthetic and the operation as safe as possible.
Choice of anaesthetic
The choice of anaesthetic will be discussed with you. It’s based on what type of operation you will be having, and what the anaesthetist feels will be the safest option for you.
A general anaesthetic is often described as a deep ‘sleep-like state’. When you are under general anaesthesia you aren’t aware of anything that is going on around you.
A regional anaesthetic can be a nerve block (like when your dentist injects a local anaesthetic to numb the nerves in your mouth), a spinal anaesthetic or an epidural technique.
A spinal anaesthetic is when a thin needle is used to inject some local anaesthetic around your spinal cord. This will result in your lower body and legs feeling numb for a few hours.
For certain smaller operations or procedures, such as a biopsy, the anaesthetist may only need to give you some sedative medication to help you relax and to keep you calm.
Day of surgery
On the day of surgery, you won’t be able to eat any food for six hours before the operation. You may, however, drink small amounts of clear fluids, such as water, for up to two hours before surgery. The reason for this is, that under anaesthesia, there is the risk that everything that is left in your stomach may soil your lungs. So fasting will help keep you safe.
Safety and pain control
Anaesthetists play a very important role in keeping you safe while you are having your operation. We continuously monitor and can control your heart rate, blood pressure and how much oxygen is in your blood.
For major operations, we will keep track of how much you bleed and will transfuse blood when required (if you have agreed to receive blood, that is).
Another important role of the anaesthetist is to ensure that your pain is well-controlled and that you’re comfortable following your operation.
Anaesthetists can manage pain by giving you painkillers in your drip, or to drink, or in certain cases they can do special nerve blocks.
We will also give you medications to prevent any nausea and vomiting which may occur after the operation. All these measures help you feel comfortable following your operation, and help pave the way to a good and speedy recovery.
MEET THE EXPERT – Dr Michelle Casey
Dr Michelle Casey is a specialist anaesthetist at the University of Cape Town’s Department of Anaesthesia and Perioperative Medicine. She has an interest in paediatric anaesthesia, liver transplants and adult and paediatric chronic pain. In 2017, she completed a postgraduate diploma in Interdisciplinary Pain Management.