Anaesthesiology is a separate established speciality of field of Medicine . It is the branch of science which has expanded its spectrum and has witnessed exuberant advancement as far as technology, research and modernisation of methodology is concerned. The evolution of the subject ranges from the era of ancient times when crude conventional methods were used . Today, Anaesthesiology as a subject is an accomplished branch with advent of highly advanced equipments , state of art technology , sophisticated gadgets and modern safe pharmacotherapeutics.
The Anaesthesiologist not only plays important role in managing patients inside operation theatre but also takes complete responsibility of providing safe pre-operative and post-operative period to surgical patients. The job of Anaesthesiologist is full of challenges requiring utmost vigilance , at par excellence and efficiency.
When a patient is posted for surgery, its the anaesthesiologist who makes the patient unconscious and pain free so that surgeon could operate upon . The Anaesthesiologist is responsible for smooth sailing of ship during whole peri-operative period. The final outcome after any surgery depends upon intra-operative stability which depends upon pre-operative condition of patient .
If patient is high risk , for eg. If patient is suffering from some diseases like diabetes or hypertension or heart disease etc. , surgery and anaesthesia both become more challenging and are associated with systemic risks and chances of complications. Hence, proper and detailed pre- operative anaesthesia checkup is of utmost importance. The Pre-Anaesthetic Checkup ( PAC ) is important task done by qualified anaesthesiologist well in advance before planned surgery.
Dr. Umesh Ramtani, Hon. Secretary, ISA-NCB explained that PAC has many advantages , few are as follows:
1.A rapport is developed between doctor and patient
2.Patient is counselled and explained about procedure of anaesthesia and surgery
3.The anxiety of patients is allayed as they get some idea about operation
4.Doctor plans the technique of anaesthesia and can do basic preoperative preparation in advance
5.Doctor can take on records the detailed history of patients suffering from any chronic diseases like diabetes, hypertension , heart disease , kidney disease , tuberculosis or any other chronic diseases and note down any medications which patient must be taking and modify the anaesthesia accordingly
6.Proper written consent can be taken during PAC
7.During PAC, patients are advised about Nill By Mouth period necessary for any surgery. Patient should be strictly Empty stomach including stoppage of smoking, tobacco chewing and alcohol intake . In this way , we counsel the patients towards abstinence from addictions and drug abuse .
PAC is mainstay in improving post operative results. Dr. Ramtani stressed that In Medical Colleges, Corporate hospitals and large institutes, there should be separate PAC clinic as per norms and its the NEED OF AN HOUR . Likewise in Dept of Anaesthesiology , IGGMC, Nagpur there is special PAC Clinic in OPD premises and as per protocol , Proper PAC of all patients to be posted for surgery is done , as informed by Dr. Ramtani.
In todays Medico legal era, all the patients to be operated for major surgeries and planned procedures should undergo proper pre- anaesthetic evaluation so as to avert avoidable complications and improve peri-operative surgical outcome. In emergency surgeries, PAC is generally done just before operation due to time constraints accordingly as per situation.
The Pre-Anaesthetic Checkup is important aspect of ‘SAFE ANAESTHESIA’ and ‘ QUALITY CARE’ . The Team Indian Society of Anaesthesiologists, Nagpur City Branch ( ISA-NCB ) 2018-19 is working with a motto of ‘ SAFETY, QUALITY & ACCLIVITY’ and abides to promoting safe medical practices to improve quality care and to acclimb new heights of success.