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PRE-ANESTHETIC THOUGHTS Dr. T. Prasandan Chief Cardiac Anesthesiologist |
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The science of anesthesia has advanced tremendously in recent years & assimilation of modern technology in patient management has brought in an array of diagnostic, monitoring and drug delivery gadgets in the armamentariurn of anesthesiologists. Optimum use of these technological backup with a dedicated input from the anesthesiologist supported with better understanding of the clinical condition of the patient has made anesthesia and there by even complicated surgical procedures like open heart surgery very safe. Empowered with the confidence of handling the critical patients in the operation room, expertise in establishing invasive monitoring lines & airway and experience in manipulating the vitals like breathing, heart rate and blood pressure, anesthesiologist is now venturing into the care of the critically ill ICU patients. All these OT and ICU activities of anesthesiologists are less known to the patient as most of the management are done while he is unconscious or too weak to remember and to a patient’s relative . they are all done behind closed doors and hence less known to them as well . Let them be as it is. There are things more important to the patient than the knowledge, skills and qualifications of the doctor, the complicated language he use to describe the clinical conditions and the sophisticated machinery available to support the treatment. They arc the assurance on how safe the treatment is, how comfortable he will be during the treatment and confidence the doctor can instill in him even during the most difficult medical situations. When a patient comes for an open heart surgery, he usually would have chosen surgery as his last option . Whether they express it or not, they are all scared. But when the risk, benefit and the safety of the procedure arc properly and honestly explained, most of the patients become confident and feel relaxed. If the anesthesiologist makes a timely preoperative visit and promise a pain-free post operative period, the patient feels very grateful and reassured that there is some body who would look after his pain. These are very simple things but make a big, big difference for a patient in agony. Related are the thoughts of the patient and his last meal before the surgery. Most of the time he is told that he will have his last meal at 9:00 or 10:00 in the night and after that he will have no food at all . This usually gives the impression of the last supper of the life. It is worse when somebody says, “tonight you can take any food you like”. This echoes like fulfilling one of the last wishes. This is entirely my personal view. But still, I would prefer you can have your usual meal by 10:00 in the night. Then don’t take anything till surgery. We will give you the next meal after surgery as soon as you are stable”. That makes him look into a life after surgery and gives great confidence not only to the patient, but also to his anxious relatives. Let us treat the disease. Let us treat the feelings as well.
Here at our Cardiac Centre, the department of “Cardiac Anesthesiology” was started by our dear colleague late Dr. Shahidul Islam. His untimely demise on 23” April this year has literally shattered us. Very knowledgeable, highly skilled and dedicated professional with helping attitude, Dr. Shahid had been our strength. We pray for the eternal peace of his soul and pledge to follow his ideals. We lost him when we were all prepared to expand the department. By the time I joined in Dec ‘98, Dr. Muzeeb had already come over to our department. Dr. John Russell from Royal Adelaide Hospital, Australia had been with us in the initial days and his contribution and advices on commissioning equipments and Medical pipelines and designing protocols are well appreciated. Our initial days had been a big struggle, right from procuring medicines to having self imposed long duty hours for better outcome of the cases we take up. Dr. Murali P. Vettath, the chief surgeon and clinical director of the centre along with other surgical colleagues Dr. Kuldeep, Dr. Remakanth and Dr. Kalam gave us enough support throughout the long duty hours, sharing the responsibilities right from the initial days itself. Hard work never disappointed us. We got excellent results. Results that could be achieved only by sincere team work. At this moment, I admire the able support being given by our technician Mr. Sathya and all other colleagues in the OT, JCU, Ward, Lab and other areas all through these days. Now we are conducting anesthesia regularly for CABGs and other open heart procedures. We are taking up beating heart surgeries also where the anesthetist's role is demanding.in the O.T., we are equipped with sophisticated anesthesia machine with ventilator, oxygen analyzer, gas monitoring systems and multi-channel patient monitor which makes anesthesia safe. The availability of all the required life saving medicines and equipments with the constant vigil of the trained ICU staff help us to get good outcome. We dedicates our good results to the efforts of all our colleagues. |
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