One has to carefully understand some key words in the definition.
| Reversible, modulation: |
| Anaesthesia moves the patient is a stage somewhere between the normal life and death. The space available for this movement depends upon the health conditions of the patient. In otherwise healthy patient, it s reasonably wide and so the safety range of movement is also wider. Anaesthetizing this patient is relatively safe |
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| Here the anaesthetist must be modulating within the narrow margin of safety |
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| Whatever way the modulation is done it has to be reversed to bring back the patient.
If the reversibility is blocked due to any reason, then the patient may reach a stage of
no return or return with permanent damage. |
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| Small, titrated, and ncremental: |
| Depending upon the requirement of the patients status and the requirement of the
surgical procedure, the drugs are chosen carefully. |
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| The doses of drugs are carefully calculated and given in smaller doses in incremental
doses as when required without causing any overdosage. |
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The golden words are Eternal vigilance ids the price of safety
| It only means that because the patient is removed from his normal status to a state where he is totally depending at the mercy of someone to take care for sustaining his life, the anaesthetist will be there by the side to monitor the patient minute to minute to ensure that everything is in order. |
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| The anaesthetist cannot move away from the patient once he induced anaesthesia and continuously monitors the vital functions the heart, the respiration, the brain function, renal function etc until the surgery is over and the patient is reversed back to his original status. |
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| Grading the risk for Anaesthesia: |
| A healthy individual subjected for any planned surgery is defined as ASA Gr I |
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| Depending upon the systemic disease the patient suffers and its severity the grading has been done as ASA II, ASA III, ASA IV, and ASA V |
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| The ASA V has been considered as a very poor risk where the chance of survival of the patient is remote. |
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| How to reduce the Risk? |
| Whenever possible rectify the correctable problems before surgery, so that the patient is brought to a better physical condition that the risk is reduced. |
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| Chose the technique of anaesthesia, which causes least damage to the already damaged system. |
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| If possible after discussion with the surgeon modify the surgical procedure, to reduce the stress of surgery. |
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| Finally the competence of the anaesthetist ands the surgeon will certainly reduce the Risk. This factor has been approved world wide. |
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| In modern days, no doubt, in medical field, and in particular, in Anaesthesiology, tremendous advancements (Drugs, Equipments, monitors, ventilator support etc) have enhanced the safety and the risk for anaesthesia has come down dramatically. |
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| Still it is a uniformly accepted fact that compared to all the other specialties; anaesthesia has more than 90 % chance for unforeseen events and dangers. That is why; the anaesthesiology is the second to cosmetic surgery in the payment of highest premium for insurance. |
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