Most surgical patients lack knowledge about roles of physician anesthesiologists

Most surgical patients know a physician anesthesiologist will "put them to sleep," but what they don't realize is that this medical doctor plays a major role in preparing them for the operation. Just as important, these physicians keep them safe and preserve their health during surgery and help them recover as quickly and as comfortably as possible, according to a study presented at the ANESTHESIOLOGY™ 2014 annual meeting.

Of 100 surgical patients surveyed at one hospital, 92 percent said they knew the physician anesthesiologist is responsible for "putting you to sleep before an operation," but fewer than half realized that these specialists also ensured the patient was fit for surgery, managed pain after surgery, monitored blood loss, and controlled nausea and vomiting.

"We're truly the first physicians to perform any intervention on the patient - even before surgeons- and we're the first to put that patient on the right path to a successful procedure," said Ferdinand Iannaccone, D.O., lead author of the study and an anesthesiology resident at Rutgers New Jersey Medical School, Newark, N.J. "If patients knew more about all that we do before, during and after surgery, it could greatly aid in relieving their anxiety associated with surgery and patients could become more involved and better informed regarding the decisions about their care. All of this contributes to a better experience and outcome for the patient. "

For example, patients who fear pain that may occur after surgery can speak with their physician anesthesiologist to learn about effective ways of preventing and controlling pain. The same goes for concerns about postoperative nausea and vomiting and the interventions physician anesthesiologists can provide to avoid this complication.

Patients should also be aware that they may have a choice in the type of anesthesia they receive for certain types of surgery. For example, a patient undergoing a knee replacement might be able to have regional anesthesia that allows for a quicker, more comfortable recovery, meaning rehabilitation and normal activity can begin sooner. But another patient may not wish to be awake during surgery and instead opt for general anesthesia.

The study authors surveyed the patients immediately before surgery to determine what they knew about the role of their physician anesthesiologist.

According to the survey, patients didn't realize that physician anesthesiologists:

•Give blood if necessary - 73 percent
•Control nausea and vomiting - 67 percent
•Monitor blood loss - 63 percent
•Ensure the patient is fit for surgery - 58 percent
•Control pain after surgery - 57 percent
•Control pain during surgery - 40 percent
•Monitor the patient's vital signs - 40 percent
•Wake the patient up after surgery - 36 percent
•Put the patient to sleep - 8 percent

Overall, 76 percent of those in the study said they felt the roles of their physician anesthesiologist were adequately explained during the pre-admission testing (PAT) visit. A patient typically meets with the physician anesthesiologist for the PAT a week or two before surgery to learn more about the anesthesia plan and to ask questions. There is no standardization to the information provided in this visit, and the study shows that even after this visit many patients don't fully understand the important functions performed by their physician anesthesiologist or what questions they should ask.

The study results suggest that PAT should be standardized and include more information. Researchers plan to repeat the study after redesigning the PAT process at Rutgers to begin with a short interactive tutorial via tablet that touches upon the important roles performed by the physician anesthesiologist, focusing closely on the areas least understood by patients.