This article explains the highly skilled role of the anaesthetist in New Zealand today. There is information for parents on what to expect from an anaesthetist and when you are likely to come into contact with them.
What is an anaesthetist?
An anaesthetist is a highly trained doctor, who has undergone 6 years basic medical training, then a further 7 years specialised training to become an anaesthetic specialist.
They are responsible for your medical care and anaesthesia, while you are undergoing a surgical operation. During labour they may be responsible for your pain relief if you choose an epidural.
Anaesthetists work closely with surgeons to ensure your well being around and during any operation. Specialist nurses or technicians work closely with anaesthetists too, assisting them in their procedures.
In teaching hospitals in NZ you may be cared for by an anaesthetic registrar, who is a fully qualified doctor, but still training in anaesthetics. They will always be working under the direction of a fully qualified specialist.
When will I need to see an anaesthetist?
If you or your child undergoes surgery then the anaesthetist is responsible for your well being before, during and after the operation. They are specialists in pain management so you may also see an anaesthetist on the ward if your post operative pain is not under control.
If you have an epidural in labour, or a spinal anaesthetic for a Caesarean section then the anaesthetist is responsible for this also. For more information on either of these procedures, please see the links below.If you have concerns about pain relief, or you have had a previous back injury which could affect the success of placing an epidural, you may wish to see an anaesthetist in pregnancy. This can be arranged by your LMC.
Anaesthetists also work in Intensive Care Units (ICU) as they are specialists in airway management, ensuring that patients are breathing as well as possible. Therefore you may come into contact with anaesthetists if any of your family members became acutely ill. Anaesthetists are also called to Accident & Emergency if a patient there needs airway management, due to extensive trauma.
How do I find an anaesthetist?
Anaesthetists work in every operating theatre in New Zealand, whether that is in a public hospital or private hospital. If you need a consultation with an anaesthetist prior to an operation, your surgeon (obstetrician, gynaecologist, paediatrician, Ear, Nose & Throat or general surgeon) will arrange that for you. The public do not usually consult an anaesthetist directly.
What will an anaesthetist do?
As you can see there role is highly specialised and varied. As a parent you are most likely to come into contact with them for an epidural in labour, or for an anaesthetic for an operation for yourself or one of your children.
Anaesthetists and epidurals
- Prior to commencing the procedure the anaesthetist will ensure that you are in good health and that an epidural is appropriate for you.
- If an intravenous drip is not already placed in your hand they will do this.
- A little local anaesthetic will be injected into the middle of your back. Once the skin is feeling numb the anaesthetist will insert the epidural catheter into your back and insert drugs through it.
- They will stay with you for a short while to ensure that you are well following the procedure and that it is providing effective pain relief for you.
- The anaesthetist will stay in contact with you and your LMC during your labour to check that you are pain free.
Anaesthetists and their role during operations
Prior to an operation
An anaesthetist will come to talk to you about your general health and well being. For example, whether you smoke, if you have asthma, whether you have had previous anaesthetics and how you felt afterwards. They will want to know if you are allergic to anything and whether you take any medication or drugs. They may listen to your chest sounds, using a stethoscope.
If the operation is for your child then they will obviously need to get health information from you. You will be encouraged to stay with your child until they go to sleep and be there waiting for them when they wake up. If they need a drip in their hand, some cream called ‘Emla’ can be put on before hand to make the skin go numb. You or your child may be given a premed, a drug to help you relax.
They will then either do a regional anaesthetic (spinal or epidural) or a general anaesthetic (put you to sleep). They will have discussed this with you beforehand.
During the operation
The anaesthetist will be with you or your child constantly during the operation and be responsible for your well being. You will be attached to a monitor by sticky pads on your chest and a cuff around your upper arm, which will tell the anaesthetist about your heart rate, blood pressure and breathing. You will be asked to wear an oxygen mask also, to ensure that you get enough oxygen during the operation.
After the operation
The anaesthetic team will prescribe appropriate pain killers for you or your child and will check on your well being with the nurses caring for you.
What can I do to help my anaesthetic go well?
- Always bring any medications you are taking into hospital with you. The anaesthetist will want to discuss this with you.
- Smoking increases the risk of complications in anaesthesia, which are normally very low in healthy people. Cut down, or even better give up prior to the operation.
- Be sure to share any information about your health with the anaesthetist. Once you are asleep, you cannot tell them what they may need to know.
- Ask your anaesthetist questions. Write them down before hand if you are nervous.
- To prepare your child for an operation, find out as much as possible about what to expect and if possible ask the ward staff to show the child things like an oxygen mask before hand. If your child is going straight to theatre as a day case, then contact your practice nurse to ask her to help you prepare your child for the operation.
- Your child will need to fast beforehand (very unpopular with kids!). This is a must. You will be given instruction on how long before hand they cannot eat for and whether they can have sips of water.
- And remember that your anaesthetist needs to know about any loose teeth, before they put your child to sleep!
Useful websites & articles on anaesthesia
To find out more about epidurals in labour visit this article on the different types of Pain Relief in Birth
For more information on Caesarean Section and what to expect, click here
The website of the New Zealand Society of Anaesthetists has a public arena, with clear information explaining their role.