Anesthesiology is the medical specialty dedicated to the relief of pain and care of patients before, during and after surgery. Dr. Yelena George, anesthesiologist at St. Maarten Medical Center leads her team with 14 years of education and more than 20 years of experience.
In Europe, the nickname for anesthesiologists are ‘angels’ because they hover over the patients while they are in surgery, ensuring that they are doing well. “I can understand why they call us angels, as my role is to be my patients’ health advocate; to diagnose and treat complications that may arise during anesthesia. Many persons are nervous about anesthesia but I am there to help ease their worries and to take care of them during their surgery,” says Dr. George.
How do you care for the patients before, during and after surgery?
Before any patient undergoes surgery, a visit at the Policlinic with the anesthesiologist is required. I answer questions and concerns that my patient may have. One of the first questions is usually something along the line of ‘Really, I need to see a doctor to put me to sleep?’ Meeting with the anesthesiologist prior to surgery is important because we have to review test results and asks questions about the patient’s health. We discuss and recommend anesthesia options and the patient has the right to choose. In some cases, we would give an advice to postpone surgery until the patient is in better health.
During surgery, we control pain and continuously monitor body functions. We do this with anesthesia medication and equipment.
After surgery, we make sure that the patient is recovered from anesthesia and is provided with post-operative pain management.
What types of anesthesia is provided at SMMC?
There are three main types of anesthesia, regional anesthesia, Intravenous (IV) sedation and general anesthesia, all of which are provided at SMMC.
Regional anesthesia numbs a certain part of the body which is required for surgery. The patient is awake but is unable to feel the pain while the surgeon is working. Regional anesthesia is the first choice for caesarian sections, which provides safety for the mother and child.
Intravenous anesthesia the anesthesiologist will give medication via an IV. The medication relaxes the patient and may range from minimal, meaning the patient is drowsy but able to speak - to deep, meaning the patient won’t remember the procedure.
General anesthesia can be provided via an anesthesia mask or IV. This makes the patient lose consciousness and is thus used for major operations.
What complications may arise during anesthesia?
Some patient may be allergic to anesthesia drugs, but this cannot be known until the patient first undergoes surgery. If the anesthesiologist notices this, he or she is trained to respond immediately and effectively to ensure that the patient is safe and that the surgery goes smoothly.
In very rare circumstances, a patient may encounter anesthesia awareness where the patient can recall surroundings or event related to surgery under general anesthesia. This happens because the usual dose of anesthesia cannot be used safely. If it does occur, the doctor makes sure the patient is safe and does not feel pain.
In the St. Maarten Medical Center we use a Bispectral Index (BIS) monitor, which is a device to monitor the depth of anesthesia during the surgery. This device helps us ensure patient safety during surgical procedures.
What are anesthetic risks for surgical procedures?
A number of conditions like obesity may increase risk of other complications such as locating veins, determining the right dose of medication, providing sufficient oxygen and airflow and restoring breathing.
Other health conditions, listed below, may threaten similar complications.
- High blood pressure
- Heart disease
- Diabetes
- Stroke
- Seizures or other neurological disorders
- Allergies to anesthesia
- Smoking, drinking two or more alcoholic beverages a day
- Obstructive sleep apnea
- Lung conditions
- Kidney problems
How does anesthesia help during labor and childbirth?
At the SMMC pregnant women may choose to use anesthesia to ease labor pain and child birth. However, this is not always included in most insurance plans. Anesthesia during labor and childbirth is always provided when a prolonged labor requires caesarian section and also for planned caesarian sections.
If the woman is having vaginal delivery, upon request, the anesthesiologist can administer epidural anesthesia. A woman can plan in advance with her doctor to have an epidural. If during labor, she feels that the pain is unbearable, she can also make the request then.
Analgesics, delivered via an IV or injected into a muscle can temporarily relive pain, though it does not the eliminate pain.
How does an epidural work? Is it safe?
An epidural is a regional anesthesia injected into an area of the spine. It works by numbing the nerves and prevents the patient from feeling pain until the drug is worn off.
Potential short term side effects of an epidural are a decrease in blood pressure, a sore back and infection.
When an experienced doctor administers an epidural, there is no cause to worry about injury which is extremely rare. We are trained to provide the best care within safety to our patients.
How will my doctor know how much anesthesia to give me?
Anesthesia is tailored to each individual; there is no specific dosage for all patients. This is why the poli-clinic with the anesthesiologist before a planned surgery is important. When administering anesthesia, the doctor takes into factor the patient’s age, weight and specific illnesses and carefully adjust anesthesia levels.
How has anesthesiology care developed over the years within the SMMC?
Over the years we have made wise investments in medical equipment to improve the quality of care. In the Operating Room (OR) we have modern equipment; anesthesia machine and monitoring invasive and noninvasive, to deliver safe anesthesia to the patient.
Also, In the Intensive Care Unit (ICU) we are able to provide fully mechanical ventilation, including noninvasive ventilation, despite the age of the patient.
As equipment to provide safe anesthesia continues to be developed, we can expect that the SMMC will continue to stay abreast and implement new technology to provide quality care to our patients.