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Do you trust your Anesthesiologist?

John BluntJJohn Blunt Posts: 116
edited 06/11/2012 - 8:34 AM in Back Surgery and Neck Surgery
We all talk about finding the right doctor or surgeon and we also talk about how to choose the best doctor for ourselves and whether we have faith and trust in him. But, how many of us choose our Anesthesiologist/ or if you are in the UK your Anesthetist. After all when you go into the operating room your whole life is completely in their hands. Most doctors say that they work with very good anesthesiologists, but how many of us ever even see them well in advance of our surgery. Usually you don't know who it is until a person in scrubs and a surgical mask approaches you when you are on a gurney waiting to go into the OR to tell you that they will be putting you to sleep. We should perhaps be asking them if they will also be waking us up. Sadly we know far less about them that we do about our doctors and many of us don't seem to know too much about him either.

So how do you trust someone that you never really met with your life. It is an anomaly to me!

I was wondering what the thoughts would be on this matter as clearly it is a subject that is greatly overlooked?

John B


  • John,

    I have always thought of the anesthesiologist as the doctor with one of the most difficult jobs.

    They are playing with the natural functions of your body to ensure we don't have a painful experience.

    I watched a fusion surgery on a girl who was in a bad car accident and she had to have several pints transfused during her surgery. The anesthesiologist talked about how he had to monitor 8 different components of the body and to keep a safe level of medicine in her and adjust as more blood is less and new blood is introduced.

    I also think that any hospital that is a larger, more reputable hospital is going to have a more stringent policy on the quality.

    The surgeon is also dependent upon the anesthesiologist to be very qualified. He obviously doesn't want to lose a patient, and the risk is larger for the anesthesiologist to cause death, then the surgeon is most scenarios .... just my opinion.

    I should also mention if I had concerns about any doctor, surgeon or anesthesiologist - I would not push forward. I think that is a good decision on anyone's part. Make sure you are comfortable - and don't do it if you have reservations.

  • what an excellent thread you have started. This is one area that I think most of us over look. I am curious to see what others will have to say about this.

    And Jason , you also bring up some very valid points....thanks.....take care....Miki
  • I never worry what the surgeon is up to, I always stress about the anesthesia guy or anesthetist. I think it is a combo of me giving up absolute control to this person, knowing this person is really the one controlling my life, and the one aspect of the procedure I know I little bit about so I latch on to it.

    The hospital I work at(and had first surgery at) you met with anesthesia either during the week before surgery or at the bedside before you wheel into the OR.

    The hospital I've ended up with future surgeries, I've met the guy in the OR when I have no contacts in and am blind as a bat. I know I come off a little aggressive when I start in: What drugs will you use to put me down? What drugs will you use to keep me down? What size tube will you intubate me with? I will not allow students of any sort to intubate me as I like my teeth, I think I need a 7.5 tube, I think Diprivan and Norcuron should be the drugs you use to maintain anesthesia, please induce me with fentanyl to start with then versed, succs, and lidocaine. I do not like to be induced with gas as I do not like the mask on my face.

    Whoa, got to be a lot for the poor guy(never had a girl.) The one who usually does my doc's surgeries just smiles at me and pushes fentanyl till I pass out. That's the way to deal with me.

    Bad experience-had to have emergency surgery(not at my hospital) and I heard the substitute guy complaining about having to stay late cuz of my surgery. Yeah, when I said I don't like to be induced with gas, he put a mask on me. I woke up after surgeon had left the room paralyzed but NOT sedated. Couldn't even blink my eyes, trying to scream I was awake, they were suctioning my airway. Finally regained some movement and started fighting and grabbing the suction catheter cause I felt like I was suffocating. He yelled at me and told me to settle down. WRONG person to say that to. People forgot that sometimes an intubated patient CAN hear or remember things and I did. I reported him to the head of anesthesia, especially the part about me hearing he was mad to stay late.

    Yeah, we put a lot of faith in them and they ARE the ones in charge of our lives in that room.
  • Thanks for your View Jason, I am glad that you for one have the confidence that you do. It will be very interesting to see who adds to this string and what they have to say.

    MIKI, Thanks for that, it will indeed be interesting to see how this string expands. Take Care.

    EMURSE, Thanks for your input too. SCARY! Your experiences kind of underwrites my reasons for creating this question.

    I look forward to more input here.

    John B
  • Years ago it was standard practice for everyone to meet with the anesthesiologist days or weeks prior to surgery, so that the anesthesiologist could determine if you were a risk or not. Of course this afforded the patient an opportunity to ask questions and learn about the guy holding their life in his/her hands. Over the years this duty was "streamlined" to a nurse who would go over your paperwork and interview you along with all the other patients processing through that day. It seems it became more about efficiency and less about the patient, if it ever really even was about the patient and their peace of mind.

    Now here's a twist. I have many friends who are anesthesiologists and CRNA's (nurse anesthetists) so I have been able to pick their brains for information over the years. I also found out that one of the more difficult things for them, is knowing the individual they are running anesthesia for. While they are honored to be asked (and yes a person can request a specific anesthesiologist) it's a double edged sword. If something were to happen while you were under anesthesia (an act of God or something like that), the fact that you are a friend makes it terribly emotional for the anesthesiologist. Some say they don't know if they could continue in the field if something like that were to occur.

    The reason I bring this up, is because the ability to be "detached" from the patient, gives them the ability to think and react without it being clouded by emotion. Hesitation or indecision could be disastrous.

    So is it really better to know your anesthesiologist? Angie talks about how she tries to control the way they do things and yet she ultimately has no control. Is that really a bad thing? I want the individual controlling my anesthesia to feel confident and in control (within reason, not over confident).

    I too fear anesthesia more than the surgery itself, too much could go wrong too quickly with terrible consequences. I cannot live my life paralyzed with fear though. So I chose to educate myself and then trust those who are trained to do their job. Every one of my friends who are in anesthesia, do so because they love it. They are brilliant, generally over achievers and the kind of person you want by your side.

    I've had a few hair raising experiences with anesthesia. It doesn't mean that I can afford to become totally paranoid about it though.

    Anyway, good topic.

  • Your input is alway excellent of course and I am sure it is well taken.

    However, while I totally understand the reasoning behind the principle, are the doctors not also in the same boat as the anesthesiologists? They too get to know their patient and they too are human just like the anesthesiologists?

    While I also fully understand that doctors don't want to lose patients it seems like we are putting the responsibility of them knowing the anesthesiologist and their capability, back to the docs again and we both know that they can make the odd mistake on occasions.

    It seems that the rules have been made more for the anesthesiologist perhaps than the patient to some extent although this is, of course, a very subjective issue.

    It will be interesting to hear of other peoples experiences and/or views don't you think.

    Thanks once again
    Take Care

    John B
  • dilaurodilauro ConnecticutPosts: 9,865
    My Anesthesiologist BETTER be someone I have TOTAL faith and confidence in. For seven of my surgeries, I was fortunate enough that my wife worked at the hospital and knew most of the doctors. She she made sure which doctor was going to be my Anesthesiologist.
    Last year, my wife had some surgery and the same thing, she made sure who the Anesthesiologist was.

    Many people tend to overlook this area and take it almost as a given.
    You would be amazed at just how many things could go wrong during this portion of the surgery. Its involved in the beginning, during and then after wards.
    Each segment is so important to the overall success of the surgery.
    Ron DiLauro Spine-Health System Administrator
    I am not a medical professional. I comment on personal experiences
    You can email me at: rdilauro@veritashealth.com
  • I've been on both ends....the anesthesia provider for neurosurgeons and ortho spine surgeons..and had 2 cervical surgeries in a hospital where I did not know anyone except my ortho spine surgeon and the one meeting I had with the neurosurgeon he worked with at the time. What I did know in both situations is that usually certain anesthesia providers work well with the particular surgeon, have mutual respect for the capability of each. No profession is perfect and we have our misfits even in anesthesia.

    With the advent of insurance requiring morning of surgery admissions, at most regular hospitals you meet the anesthesia person that morning. University programs sometimes work differently where many consults (medical clearance, etc., and anesthesia interviews) are done in advance, but even then due to scheduling it is rare that the anesthesia person you met ahead of time will be the same one the day of surgery.

    Now some anesthesia departments employ RNs who phone ahead and do a preliminary interview so the actual day of surgery interview is more focused. Both times the anesthesiologist and nurse anesthetist allowed me to ask questions and express my concerns/preferences. The nurse anesthetist visited me the next day as well.

    Personality quirks abound in all professions, so it does boil down to having blind faith that this person will be competant. Each patient presents their own history, challenges, etc. that must be incorported in the anesthesia plan.

    I know I try very hard to get to interview the patient as soon as I can, try to make a personal connection (especially those having an ACDF for which I tell them I've been there too and can appreciate their concern.)

    I take great pride in my management of each case, have a patient awake pain free, no nausea (we give meds ahead of time) able to move all extemities (that's the first thing the surgeon wants to see)and continuously reassure them that their surgery is finished, their surgeon is very pleased, and everything went well.

    With the advent SSEP monitoring, my anesthesia technique has now been changed to allow this constant monitoring (done by a specialized company technician.) We never stop learning! I love what I do and take great satisfaction in knowing my patients do very well and the surgeons respect how diligently I take care of their patients. We are a team!

    Unfortunately, we always hear about the negative events. No one mentions the thousands of anesthetics that are done every day, competantly, and with good interpersonal skills with the anxious patient.

  • I will be honest, I have no issues going "under". I did the first time, but I have been put under 3 times within a 14 month period, and other then nausea when I wake up, I haven't had any issues. I actually look forward to it because I know when I wake up I will be fixed. :)

    I put total trust in everyone involved in my procedure. I feel that if I don't I will just drive myself crazy with worry. The first time I was put under I worried that I might be allergic to the medicine. Now that I know I'm not, I'm OK with it.

    Like classical2mu, we are putting blind faith in these people to keep us alive. You must have faith, and trust that you will be OK.

    Take care,


  • That things could be done a bit more perfectly more of the time. I am very grateful to the professionals who take their job seriously and really do care. It shows. The not so good experiences I have had were with one anesthesiologist who messed up the first time, p-o'd the neurosurgeon who chewed him out and then when I had an unscheduled emer surgery, the same guy was on call. He made so certain that I was under for the surgery, that I was burping anesthesia gases for many many days.

    I did forget the key about how surgeons have their more trusted anesthesiologists they prefer to work with. I have benefited from that many times and of course so has the surgeon. One less thing for them to be worried about.

    Great discussion John. No real one perfect answer. The key though as many have touched on it, is faith. Not necessarily blind faith, but faith none-the-less.

  • It seems that this matter is indeed very subjective and everyone has had their own personal experiences. I fully appreciate and understand that. However, The Anesthesiologist has a huge responsibility bearing in mind that not every surgery that takes place in the world on a daily basis is necessarily life threatening of itself, but the anesthesia potentially can be. The margin for error is far more critical for the anesthesiologist every time and I am really quite amazed at the lack of interest that most people show in this subject, particularly when you investigate the real seriousness of the service that is performed.
    Papa Ron hit the nail on the head in his post when he said "Many people tend to overlook this area and take it almost as a given.
    You would be amazed at just how many things could go wrong during this portion of the surgery. Its involved in the beginning, during and then after wards.
    Each segment is so important to the overall success of the surgery." WELL SAID SIR!

    Very interesting indeed.

    Thanks once again for the posts.

    John B
  • I have noticed that there is a LOT of difference between hospitals.

    Having had 7 surgeries in the past 3 1/2 years, I've come to really respect the one hospital over the other one.

    The first hospital, I wake up pain free and usually (except for a few times) fairly nausea free.

    The other place - those have been the most painful awakenings and have proven to be the more painful recoveries overall. And it's not a type of surgery issue, I think. Some were the same surgery on the same ankle, just different dr./hosp/anethesiologists.

    That said - I do have a TERRIBLE time with nausea post-op. So bad that this last time the wonderful anesthesiologist told me that I need to put down that I am allergic to anesthesia from now on. I'm grateful that I have this on my record - now I don't have to think it's just me being weak.

    Can I add - I LOVE the blocks they can do now! My arm (shoulder scope) was completely numb for 24 hours post op because the anesthesiologist said he felt it helped healing if he can block all pain for that first day.

    There is nothing better than going in hurting and coming out with a ZERO pain level. If it weren't for the nausea I'd almost ask for surgery just to get those blissful hours/days post-op with no pain.
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