Anaesthesiology is the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery. Anaesthesiology is essential to safe surgery and to the relief and management of pain.
Anaesthesiology is an urgent global issue because:
Around 5 billion people worldwide lack access to surgical and anaesthetic care, most of these are in lower income countries. (The Lancet Commission on Global Health 2015)
In 2010 an estimated 16.9 million lives were lost from conditions needing surgical care. This figure well surpassed the 3.84 million deaths from HIV/AIDS, TB and Malaria combined. (The Lancet Commission on Global Health 2015)
The German Medical Association’s official international science journal, shows that after decades of decline, the worldwide death rate during full anaesthesia is back on the rise, to about seven patients in every million. And the number of deaths within a year after a general anaesthesia is frighteningly high: one in 20. In the over-65 age group, it’s one in 10. (Deutsches Ärzteblatt 2011)
Rates of deaths due to anaesthesia or other surgical complications are two to four times higher in in low-HDI countries than in high-HDI countries (Bainbridge et al. Lancet 2012)
Provision of essential surgery procedures would stop c.1.5 million deaths per year. (Disease Control Priorities Third Edition 2015)
With more than 230 million major surgeries occurring annually around the world, the stakes are high.
In some countries:
1 in 7 women die in childbirth. Lack of access to anaesthesia and surgery is a major contributing factor to high levels of maternal mortality (Cavallaro et al. Trends in caesarean delivery by country and wealth quintile: cross sectional surveys in Asia and Sub-Saharan Africa. Bull World Organ 2013 91 914-22)
As many as 90% of anaesthesia departments do not have the equipment to provide a safe anaesthetic to a child. (World Health Organisation 2002)
Types of anaesthesia
There are three main types of anaesthesia:
Local anaesthesia blocks pain in a very specific part of the body. Patients are given a local anaesthetic when they require a fairly minor procedure or they do not need to be heavily sedated.
Regional anaesthesia blocks pain in a large part of the body, such as an entire arm or leg. A spinal anaesthesia, sometimes given to a woman for pain relief during childbirth, is a type of regional anaesthesia.
General anaesthesia blocks pain in the entire body by putting a patient into a state of unconsciousness. Patients are usually given a general anaesthetic when they are having a long operation, or one that would be particularly painful otherwise. Patients should be very closely monitored while they are under a general anaesthetic.