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Department of Anesthesiology and Reanimation - Tanfer

Department of Anesthesiology and Reanimation

Department of Anesthesiology and Reanimation

The Department of Anesthesiology and Reanimation is responsible for all kinds of anesthesia procedures related to all surgical interventions for all age groups, as well as for medical evaluation prior to such interventions and pain management during and after such interventions under the care and treatment services provided by our hospital.

Anesthesia service involves medical evaluation prior to intervention, pain management during and after intervention and follow-up of all vital functions by experienced anesthesiologists. Analgesia and sedation in diagnostic and therapeutic interventions, outpatient surgery anesthesia, and anesthesia practices for painless labor, infants and children, and anesthesia practices in all surgical specialties are also included.

Our team consisting of professionals experienced and scientifically well-qualified with world-class technological background perform anesthesia procedures for the departments of heart surgery, brain surgery, pediatric surgery, gynecology, orthopedics, thoracic surgery, vascular surgery, otorhinolaryngology, urology and ophthalmology. The anesthesia practices and services successfully provided by our specialists include general anesthesia and regional anesthesia practices such as epidural anesthesia, spinal anesthesia, combined spinal-epidural anesthesia, as well as the anesthesia methods for upper extremity surgeries in which only surgical site is anesthetized, and pain pumps allowing patient-controlled analgesia for postoperative pain management.

Who is an anesthesiologist?

The physicians who studied medical school for six years and then completed their specialization in anesthesiology and reanimation department for four years are referred as anesthesiologist. Anesthesia and reanimation specialists who administer anesthesia in appropriate dosages to patients from all age groups before and during surgical operations also ensure the reanimation of patients after surgery and relief their pain. Works in coordination with almost all specialties, and decides which kind of anesthesia is to be administered to the patient by taking the account of the general condition of the patient who is referred by a surgeon as a result of examinations and the characteristics of the surgery, and then administers the anesthesia. The process, which begins with the administration of the medication required for the patient to enter the operating room comfortably before the surgery, continues with the anesthetization of the patient with appropriate techniques. Observes and monitors several parameters of the patient who is under anesthesia such as respiratory, kidney and brain function, blood level, fever and urine amount during operation. After the surgery, he/she inspects the patient’s respiratory function and pulse by monitoring the patient until all vital functions are restored and the pain is relieved. Anesthesiologists who monitor pregnant women in the course of painless delivery also work in intensive care units and in cases where urgent intervention is required such as sudden cardiac or respiratory arrest.

 

Types of Anesthesia

The types of anesthesia administered to facilitate the intervention or relief or eliminate pain when necessary can be grouped under several topics. The anesthesiologist chooses between general, regional, local anesthesia and sedation depending on the type and length of the intervention to be performed by other physicians and surgeons. He/she administers the anesthetic procedures he/she deems necessary to a patient. Sedation, which is a type of anesthesia and part of general anesthesia, is generally administered to relieve the patient and to create a state of mild drowsiness.

 

General anesthesia

The patient met by anesthesiologist in operating room is taken on operating table and then anesthesiologist firstly connects the necessary devices such as heart rate monitor, and pulsoximeter which measures the oxygen in the blood to the patient. With these devices, the vital functions of patient are constantly monitored during operation. Then, special medications to provide muscular relaxation and drowsiness are administered intravenously. The anesthesiologist then delivers inhalation anesthetics, i.e, different anesthetic gases together with oxygen. Hence, the patient is rendered unconscious in a controlled manner. After ensuring the continuity of respiration, surgical intervention is initiated and delivery of these gases continues as long as the operation continues. The anesthesiologist is present near the patient all the time during the operation. Anesthesiologist constantly monitors all vital functions such as pulse, oxygen concentration in tissues, blood pressure, body temperature and respiration and never leaves the operating room. The depth of sleep is constantly observed by anesthesiologist and modern anesthesia devices to avoid situations such as awakening and reanimation during operation. The duration of general anesthesia depends on the type and duration of operation. Upon the completion of operation, anesthesiologist cuts the delivery of all inhalation anesthetics and withdraws the tubes inside the airway. The patient is taken to reanimation room to wake up and recover and the general condition of the patient is checked. Painkillers are administered to relief existing pains, when necessary. When the patient is fully conscious, patient-controlled analgesic administration phase is implemented. Here, the patient enables the introduction of a certain amount of painkiller in addition to the IV drip at the push of a button in case his/her pain is exacerbated. With this pre-programmed device, administration of excessive painkiller dose is eliminated and the patient’s comfort is improved. 

 

Regional anesthesia

It is the type of anesthesia which is commonly used in certain surgical operations and especially during delivery. In addition to spinal and epidural anesthesia types for both normal and cesarean delivery, combined spinal epidural anesthesia can be used. With these regionally implemented methods, the patient does not feel pain during the surgery even he/she is conscious. 

Spinal anesthesia can be administered in surgical operations at waist level or below this level, and before cesarean or normal delivery. It is the type of anesthesia enabling the mother to feel no pain or ache during cesarean delivery and to hold her baby in her arms right after the delivery. During the administration of the anesthesia, the patient is seated, the waist region is sterilized and then injection is made inside the spinal sac where the spinal cord and nerves inside the cerebrospinal fluid are located. Numbness in feet and legs starts within a short period of time. Numbness is felt from the lower parts of chest level to the legs. The administration of the spinal anesthesia which acts more quickly with a dosage lower than the epidural anesthesia thus completed. The anesthesiologist conducts necessary checks by being present in the operating room all the time during the operation. It is normal that the feel of numbness continues for 2-3 hours following the completion of cesarean delivery. The advantages of the spinal anesthesia can be listed as follows:

  • Anesthesia acts quickly.
  • No pain is felt even the patient is conscious.
  • No nausea and vomiting is felt.
  • Eating and drinking after surgery is possible.

Epidural anesthesia is type of regional anesthesia which stops the conduction of pain in a certain region like spinal anesthesia. In addition to many surgical interventions, it is also administered during normal and cesarean delivery to control labor pain. Even the method of administration is similar to spinal anesthesia; the injection is made through a thin tube, which is called as catheter, into the epidural space, in other words, out of the spinal sac located in the cerebrospinal fluid. The feeling of pain is suppressed nearly 15 minutes after the anesthesia. The advantages of the epidural anesthesia can be listed as follows:

  • It is effective for the relief of labor pains.
  • Patient is conscious but feels no pain during the operation.
  • Accelerates the labor if administered at the right time.
  • Patient can stand and walk after the procedure.

Combined Spinal Epidural Anesthesia is a type of anesthesia in which spinal and epidural anesthesia methods are administered in combination. Firstly, anesthesia by spinal injection is administered and right after epidural anesthesia is administered by a catheter. Although the patient feels no pain in epidural anesthesia, she can still feel contacts and contractions on tissues but this feeling disappears when it is administered in combination with spinal anesthesia. Other advantages:

  • The medication administered does not reach the infant in contrast with general anesthesia.
  • Healing and recovery is faster in comparison to general anesthesia.
  • The mother can hold her baby in her arms right after the labor since she is conscious.
  • No sense of pain and ache.

 

Local anesthesia

Local anesthesia which should be distinguished from regional anesthesia is administered in a specific part of the body for small surgical interventions. Local anesthesia, which is commonly used in procedures such as abscess drainage, mole removal, tooth extraction, circumcision, dermatological and aesthetic procedures, is administered by injection, spraying or rubbing on the skin. With this type of anesthesia which acts within nearly 15 minutes, only the area where the procedure is carried out is anesthetized without any loss of consciousness and sense.