What happens when a patient goes under anaesthesia?
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First things first – what happens when a patient falls asleep under anaesthesia?
Dr Koh Zheng Ning, a consultant in the Department of Anaesthesia at both Alexandra Hospital (AH) and National University Hospital (NUH), was quick to clarify – her job is not just about helping patients sleep and wake up after surgery. It is also an anaesthesiologist’s job to remain by the patient’s side in the Operating Theatre (OT), throughout the surgery.
She explained that she continually keeps track of the patient’s heart rate, blood pressure, breathing and oxygen level. To check how deeply asleep they are, she monitors their brain activity.
“The body can still experience pain even though the patient is unconscious, so pain medications are administered to ensure that the patient remains comfortable.”
– Dr Koh Zheng Ning
At the end of surgery, the anaesthetic medications are stopped, and the patient gradually awakens.
Dr Koh would check the patient’s alertness by calling their name and checking for a response, before removing the breathing tube.
But this is not all that Dr Koh does.
When asked to describe her work, she explained that the field and reach of anaesthesiology is vast. Not only does she manage patients in the OT, but she also manages pain for patients in the wards, holds patient consultations in clinics, and provides pain relief for labouring mothers in delivery suites.
Dr Koh’s day begins with the invigorating aroma of her iced coffee as she makes her way to work. Then, she changes into OT scrubs, before screening her first patient of the day.
After ensuring that her patient is fit to undergo anaesthesia, Dr Koh heads into the OT to prepare anaesthetic drugs and to discuss the anaesthetic plan with her team. Once the patient is brought in, she administers oxygen and starts the medication. She looks out for the patient throughout the surgery, and ensures that they are well before being moved to the recovery room.
On a typical OT day, Dr Koh can see up to 15 patients, depending on how long each patient case lasts. Some can be as short as 30 minutes, while others might involve surgery for a few hours.
Dr Koh also explained that beyond this routine, “I do night calls two to three times a month, where I stay in the hospital overnight to care for patients requiring emergency surgeries or procedures.”
Some of these night calls involve taking care of pregnant women, where Dr Koh helps relieve pain for mothers in labour and for those in emergency C-sections.
“Obstetric anaesthesia is one of my special interests, and it is so satisfying to help labouring mums relieve their labour pains. My favourite part of the process is when the mothers go, ‘Wah, this is magic’.”
– Dr Koh Zheng Ning
But of course, anaesthesia does not come without risks, like most medications. The type of anaesthesia provided for each patient depends on the surgery they are undergoing, their risk profile and medical history.
“The risks for a young adult with no medical problems would be much lower than for an elderly patient with heart and lung problems,” Dr Koh advised.
As for those with chronic conditions, they are not to worry. “We work closely with other specialties to ensure these patients are well optimised before surgery, and closely monitor them throughout and after surgery,” Dr Koh reassured.
She also added that she and her team believe in crafting “a tailored, individualised anaesthesia plan” that would allow the patient to undergo the surgery comfortably – both physically and emotionally.
Patients can take comfort in the fact that there is a well-trained team of anaesthetists who will be with them every step of the way.
“We are there before you fall asleep, with you throughout surgery, and will be the first face you see when you wake up,” smiled Dr Koh.
