Anaesthesia and Anaesthesiologist: The Perception of Attendees at a Medical College in Rural Haryana

Introduction: Anaesthesia as a specialty is reaching its zenith with multiple sub-specialties, but anaesthesiologist remains obscure personnel behind the drapes due to lack of public perception and knowledge pertaining to their role. The aim is to the study was conducted to assess the perception and knowledge of general public about the role of anaesthesia and the anaesthesiologist. Subjects and Methods : A prospective, cross-sectional study, conducted in a 500-bedded, rural medical college over a 3-month period. A total of 172 attendees accompanying their patients for surgical procedures were enrolled and assessed based on preformed, pretested questionnaire in the pre-anaesthetic clinic. The questionnaire contained 30 questions to determine their knowledge and attitude towards anaesthesia and anaesthesia provider. Results: Out of total 172 participants, 43.02% % recognized anaesthesiologist as specially trained doctors. Eighty two (47.67%) of the attendees knew that anesthesia is administered by an anesthesiologist but 71.5% were not aware of their role in providing peri-operative care. The attendees apprised of anesthesiologists role in labour analgesia, chronic pain management, intensive care units and emergency resuscitation was Sixty seven (39%), forty nine (28.49%), forty five (26.7%) and twenty six (15.1%) out of 172 respectively. Majority of the attendees (93.6%) were receptive to know more about anaesthesia. Conclusion: The awareness regarding role of anaesthesiologist in general public is still low and the perception of people about anaesthesia as an evolved specialty is lacking. This calls for corrective measures to be taken by the anaesthesiology fraternity for propagation of anesthesiology skills via social media and other government aided platforms.

Prevention and management of breakthrough pain during neuraxial labour analgesia

While neuraxial analgesia is considered the gold standard for labour analgesia, breakthrough pain can occur and can significantly impair maternal satisfaction. The early identification of breakthrough pain, for example, during epidural delivery suite rounds, is not only important for adequate maternal analgesia, but also in anticipation of using the epidural catheter for other potential obstetric interventions. Identifying patients at high risk for experiencing breakthrough pain enables the anaesthesia provider to adjust their anaesthetic plan. In case breakthrough pain does occur, it should be managed promptly and aggressively, with the goal to restore adequate analgesia within a maximum of 60 minutes. This chapter reviews potential causes of breakthrough pain and strategies that can be used to prevent problems and rescue poorly functioning catheters. Results of rescue interventions should be assessed in a timely fashion and the epidural catheter should be replaced if satisfactory analgesia is not obtained.