Anesthesiology and Reanimation

Anesthesiology and Reanimation is a department that constitutes the initial phase of all surgical operations to be applied in the treatment of health problems and holds the authority to initiate the surgical procedure. All drugs given to prevent the patient's pain and reduce reflexes fall under the responsibility of the anesthesia and reanimation specialist. While anesthesia applications are provided with drugs, reanimation methods involve practices such as cardiac massage and artificial respiration. Anesthesia is performed when the patient's vital signs are within a healthy range, while reanimation applications require vital signs to stop or decrease.

The anesthesia and reanimation unit is of great importance, especially in addressing possible problems that may arise during surgery.

The anesthesia process can only be managed by individuals who have completed their postgraduate education in Anesthesiology and Reanimation. However, during surgeries, collaboration among anesthesia technicians, surgeons, anesthesia specialists, and nurses is necessary.

What Is the Anesthesia and Reanimation Department?

The anesthesia and reanimation department is a medical branch that examines and treats critically ill patients for the purpose of diagnosis and treatment before, during, and after surgery, guiding physicians and healthcare personnel who perform the necessary follow-up and treatments, and performing the surgery when necessary.

What Does Anesthesiology and Reanimation Look at? What Are Its Duties?

• Examines the patient's health condition and conducts a medical examination.
• Suggests the necessary tests, treatments, and consultations based on the examination results and your illness.
• Explains the most suitable anesthesia method for you, the process you will experience from your arrival at the operating room, and what will be done, and answers any questions you may have.
• Administers the necessary medications to prevent pain during surgery and monitors the patient's general health until the end of the operation.
• After the surgery, the anesthetist's task is to wake up and remove the patient from anesthesia. The pain that occurs after surgery is brought under control using special devices with a method planned by the anesthetist.

The Anesthesia and Reanimation department also deals with patients in the intensive care unit. They take on tasks such as closely monitoring the vital signs of patients, using reanimation methods to revive the patient until the risk of death is prevented, and ensuring the patient's survival.

Anesthetists also deal with pain treatment in Algology clinics, applying the necessary procedures for patients' chronic pain problems.

Preoperative Assessment: The anesthesia specialist meets with the patient and conducts evaluations regarding the patient's health condition. During this assessment:

• The patient's general health status and information about existing diseases, if any, are reviewed.
• Allergy status and drug allergies are assessed.
• Medication usage is discussed.
• Information is gathered about any previous surgeries, including the surgical methods and anesthesia techniques used during those procedures.

The current health status is crucial for the safety of the surgery and the patient. If necessary, existing illnesses are reviewed, their potential impact on the surgery is discussed, and treatments are adjusted.

Types of Anesthesia: In cases where intervention needs to be facilitated, and pain needs to be reduced or eliminated, various types of anesthesia are applied. Depending on the type and duration of the intervention to be performed by other physicians and surgeons, the anesthesia specialist chooses from general, regional, local anesthesia, and sedation applications. The necessary anesthesia procedures are then administered to the patient.

Among the types of anesthesia, sedation, which is generally a part of general anesthesia, is applied to relax the patient and induce a light sleep.

Three Fundamental Anesthesia Methods:

General Anesthesia:

• Achieves complete loss of consciousness.
• Preferred for prolonged or major surgeries, with the duration of general anesthesia varying depending on the type and length of the surgery.

Local Anesthesia:

• Involves numbing only the area where an incision will be made.
• Preferred for minor surgical procedures with low stitch count and low complication risk.
• Frequently used in procedures such as abscess drainage, mole removal, tooth extraction, circumcision, dermatological, and aesthetic interventions.

Regional Anesthesia: If the entire area where the surgery will take place is numbed (such as the entire arm or body), it is called regional anesthesia. Patients are not unconscious during the operation but are often sedated. It is a type of regional anesthesia frequently used in some surgeries, especially childbirth, and has four different applications:

1. Epidural Anesthesia:

   • Anesthetic medication is administered through a catheter placed between the vertebrae.
   • This procedure is done with a small needle, and there is no complication of loss of movement after the operation.
   • Approximately 15 minutes after the administration of anesthesia, the sensation of pain is suppressed.
   • Advantages of epidural anesthesia:
     • Effective in relieving labor pains.
     • Consciousness is maintained, but there is no pain during the operation.
     • Accelerates childbirth when applied at the right time.
     • The patient can stand up and walk after the procedure.

2. Spinal Anesthesia:

   • Anesthetic medication is applied directly between the vertebrae.
   • All limbs below the waist experience a loss of sensation after anesthesia.
   • This sensation loss can last up to 6 hours after the operation.
   • It can be applied before cesarean section or normal childbirth.
   • Advantages of spinal anesthesia:
     • Rapid onset of anesthesia.
     • No pain is felt despite being conscious.
     • No nausea and vomiting sensation.
     • Eating and drinking are possible after the surgery.

3. Epidural-Spinal Anesthesia:

   • It is performed by combining both applications.
   • Most commonly used in cases of childbirth through cesarean section.
   • Although there is no pain sensation with epidural anesthesia during the operation, the patient may feel touch and tissue traction. However, when combined with spinal anesthesia, this sensation is eliminated.
   • Other advantages include:
     • Medications administered do not reach the baby compared to general anesthesia.
     • Faster recovery and recuperation compared to general anesthesia.
     • Due to consciousness, the mother can hold her baby immediately.

4. Nerve Block:

   • Preferred for surgeries involving limbs such as legs and arms.
   • Applied based on the principle of numbing nerves in the surgical area.

Roles of Anesthesiology and Reanimation Specialists: Anesthesiology and reanimation specialists undertake interventions to prevent patients from experiencing severe and distressing pain at any stage of the surgical process. They aim to make the postoperative process more comfortable for both the patient and the doctor, organize treatments to accelerate the recovery process, prevent patients from being put to sleep and intervened during surgery, and prevent negative psychological effects on patients by ensuring that they do not remember the process during and after surgery.

Other Responsibilities of the Anesthesia and Reanimation Unit Outside Operative Interventions:

Intensive Care: In the reanimation (resuscitation) department:

• They intervene in waking up patients who were put to sleep during surgery.
• They strive to keep patients with critical health conditions alive using basic treatments or advanced life support methods if necessary.
• They organize treatments to bring their health conditions to the best possible level.
• Due to their experience in closely monitoring the vital signs of patients during surgery and early vital intervention for deteriorating patients, many intensive care units are managed by anesthesia and reanimation specialists.

Algology: Pain is a complaint for many people at some point in their lives due to various factors. Algology specialists use anesthetic materials not only in the surgical process but also in the treatment of acute or chronic pain conditions experienced in daily life. Chronic pain can be a symptom of an underlying disease, but there are also cases of chronic pain with unknown causes. Therefore, chronic pains are now considered as a disease in their own right. The aim of the Algology department is to enable patients with possible minimum pain to lead a more comfortable life. Patients with chronic pain are treated in our hospital with a multidisciplinary approach and in accordance with the basic scientific protocols accepted worldwide.

Interventions for Anesthesia in Our Department:

In our anesthesia and reanimation department, we help our patients go through the surgical process painlessly through many interventional methods. The types of anesthesia applied by the anesthesia department can be listed as follows:

1. General Anesthesia:

   • It is the type of anesthesia that ensures the patient's consciousness is closed during surgery.
   • General anesthetics and materials are used in this process.
   • The type and amount of the administered anesthetic are determined according to the patient's age, weight, existing chronic diseases, and general health condition.

2. Regional Anesthesia:

   • It is the process of locally anesthetizing a specific part of the body, such as the arm, leg, or chest, by injection.
   • This type of anesthesia can be applied through various methods such as spinal anesthesia, epidural anesthesia, or regional nerve block.

3. Local Anesthesia:

   • It involves only numbing a limited area where the procedure will take place.
   • This type of anesthesia can be applied by the operating doctor, but an anesthesia and reanimation specialist can assist the doctor if monitoring the vital signs of the patient is necessary in critical situations.