It’s very important for the surgeons and the anaesthetists to work together. There is always a little bit of friendly banter between the two. They are saying that they’re not putting them to sleep quick enough, and them saying we’re not operating quick enough. But when you have a really good surgeon anaesthetic team, when you work together and communicate, it makes everything run so much better.
So, the anesthetists, we ask them if they will put patients to sleep. So if it’s an emergency setting and someone’s a bit older, more complicated, we work with them to say, this is what we want to do. Are you able to put them to sleep for us to do that? Sometimes they’ll say no, and then we’ll say, OK, so we can’t do that operation. Then we have to make a decision about what the best thing to do is. Often they’ll say we can do it, but it’s really risky, in which case then it helps us to counsel the patient. But then they can establish the best way to put them to sleep. They’re really important for pain management, so they can do procedures before they go to sleep, or while they’re asleep, or after they wake up. In terms of they can put what’s called an epidural in, or a spinal anaesthetic in which gives better pain relief for big operations afterwards. So we need to think about that. We need to tell them what they’re going to do so they can try and anticipate what to do from that perspective.
They can also suggest to us that we can do operations that aren’t putting people to sleep, so we can put them under a different type of anaesthetic whether awake but paralysed, or under a local anaesthetic for higher risk patients if they are more likely to have problems with the general anaesthetic. Then during the operation, they tell us if they’re concerned, if something we’re doing is causing their heart rate to go up, or their blood pressure to go down, then we have to speak to each other to try and make sure that the risks to the patient are as low as possible throughout.
We also, we work together electively before the operation and especially in emergency settings when the anaesthetists are covering different specialties, we have to communicate with them to make sure that their patients are coming, and getting prepared as quickly as possible to reduce the time between operations that people are sitting around waiting for things to happen.
So when you have a good anaesthetist and a good surgeon that work together very well, it’s great. If there’s a little bit of animosity, then it doesn’t work quite so well. But it’s nice in the elective setting often for a list on say a specific day of the week, it’ll be the same surgeons, and the same anaesthetists, and they’ve seen the patients beforehand. So, that’s much better. That’s more common with sort of cancer lists and big case lists. With day cases and smaller lists, then you often get a bit of a mismatch in difference, because those patients are high turnover. But we love our anaesthetists, and hopefully they love us as well.
