The medical expertise of this specialty has caused a dramatic expansion of the role of the anesthesiologist. Although historically, anesthesiologists have been known primarily as physicians who administer anesthesia to alleviate pain and suppress consciousness of the patient undergoing surgery, they also provide medical care and consultations in many other settings and situations in addition to the operating room.

The anesthesiologist is the perioperative physician ("peri-" meaning "all-around") who provides medical care to each patient throughout his or her surgical experience. This includes medically evaluating the patient before surgery (preoperative), consulting with the surgical team, providing pain control and support of life functions during surgery (intraoperative), supervising care after surgery (postoperative) and medically discharging the patient from the recovery unit.

Operating Room

An estimated 40 million anesthetics are administered each year in the United States. Anesthesiologists provide or participate in more than 90 percent of these anesthetics. In the operating room, they are responsible for the medical management and anesthetic care of the patient throughout the duration of the surgery. The anesthesiologist must carefully match the anesthetic needs of each patient to that patient's medical condition, responses to anesthesia and the requirements of the surgery.

Within the confines of the operating room suite, which is often comprised of several separate operating rooms, the activities of the anesthesiologist are seen by few people outside of the surgical and nursing team. Even the patients themselves are unable to recall much of their involvement with this vital specialist because most of the anesthesiologist's critical work is done while the patient is anesthetized. The role of the anesthesiologist in the operating room is to:

• provide continual medical assessment of the patient
• monitor and control the patient's vital life functions -- heart rate and rhythm, breathing, blood pressure, body temperature and body fluid balance; and
• control the patient's pain and level of unconsciousness to make conditions ideal for a safe and successful surgery.

Post-anesthesia Care Unit (Recovery Room)

This is where patients are transferred after surgery, allowing them to emerge fully from the effects of the anesthesia under the watchful eyes of skilled nursing personnel with anesthesiologist consultation immediately available. While safety is, of course, the foremost priority during surgery, it is also of utmost concern that the patient be monitored and continually assessed while fully regaining consciousness. In most cases, the anesthesiologist decides when the patient has recovered enough to be sent home following outpatient surgery or has been stabilized sufficiently to be moved to a regular room or ward in the medical facility.

Pain Management

In addition to the patient's pain being relieved or blocked entirely during a surgical procedure, it is equally important to provide adequate pain relief post-operatively for the patient's comfort and well-being. After surgery, the anesthesiologist is involved in prescribing pain-relieving medication and techniques that are best for each individual patient to maintain a level of comfort and to follow proper rest.

Because of their specialty training, anesthesiologists are uniquely qualified to prescribe and administer drug therapies for acute, chronic, cancer and childbirth pain. In childbirth, the anesthesiologist manages the care of two people, providing pain relief with epidural or spinal blocks for the mother while managing the life functions of both the mother and the baby.

Critical Care and Trauma Medicine

As an outgrowth of the post-anesthesia care unit, critical care units are now found in all major medical facilities throughout the country. The role of the anesthesiologist in this setting is to provide medical assessment and diagnosis, respiratory and cardiovascular support and infection control.

Anesthesiologists also have the medical background to deal with many emergency situations. They provide airway management, cardiac and pulmonary resuscitation, advanced life support and pain control. As consultants, they play an active role in stabilizing and preparing the patient for emergency surgery.

Cardiac Laboratory Procedures

Anesthesiologists are often available during cardiac catheterizations and angioplasty procedures for emergency airway management or resuscitation if necessary.

Diagnostic Procedures and Nonsurgical Treatments

As medical technologies have advanced, so has the need for anesthesiologists to become involved in caring for patients during radiological imaging or scanning procedures, gastrointestinal endoscopies, invitro fertilization, lithotripsy procedures, electroshock treatment, nutritional support and respiratory therapy.