Tribute to my Anesthetic Colleagues
Over the last 40 years of my career as an ENT surgeon, there are quite a large number of very good anesthetic colleagues with whom I had the opportunity to work with and share some of their experience. I remember many of them with fond memories and I salute them.
Early days
I recall my younger days as a medical officer cum anesthetist after completing the house surgency, when I joined a small hospital in a small town in south kerala –Kottarakkara- where the lady doctor used to practice as an Obstetrician and Gynecologist. I was given the job of anesthetizing the patients using good old Ether given as inhalation drip from a glass dropper bottle over cotton filled facial mask. There were hardly any monitoring systems in place except my fingers of my left hand feeling the pulsation of the temporal arteries, to make sure the patient is alive. Looking back it was a scary job. And a sleepy afternoon for the young doctor on call after inhaling half of the ether.
Years on, now Anesthesia is a major specialty with highly trained doctors, most modern equipments and drugs without any side effects. Anesthesia these days are very safe. In olden days the ENT surgeons used to do many cases under local anesthesia which was very uncomfortable for the patients. Most of the time, the surgery was not completed as the patients ran away from theatre as they cannot tolerate the operating “torture”.
ENT Anesthesia-Challenges to the Anesthetist
Of all patient groups, ENT patients have the highest likelihood of having a difficult airway. The management of anesthesia for patients having ENT surgery presents numerous challenges for anesthesiologist in order to accommodate the needs of the patient and the surgeon. The field encompasses a variety of surgical procedures ranging from tonsillectomies, to major head and neck tumor resections. Laser surgery of the larynx and trachea creates additional challenges. Sharing operative field and often patient\’s airway with a surgeon is always a challenge, so too giving a controlled hypotension in certain surgeries like ear and nasal surgeries. A smooth intubation, bloodless field and smooth extubation is what the surgeons always want. While working in OT, a good rapport with anesthetist is important.
Even after the operation is completed, ENT anesthesiologists continue caring for their patients in the Post operative care ward.
Thanks to my anesthetist colleagues working with me now in Jubilee hospital and those whom I associated with my profession in the past four decades.