What Is Anesthesiology Unit?

Anesthesiology Unit: Prepping patients safely for surgery at preoperative period, this unit is a team consisting of anesthesiologists and anesthetic technicians who safely allow the patients feel nothing and prevent having consciousness during a surgery in addition to making them regain consciousness postoperatively.

What Is General Anesthesia Application?

General Anesthesia is identified as a temporary loss of consciousness and decreased reflex activities without a change in vital functions. Causing loss of consciousness and prevent patients from being conscious during a surgery, the General Anesthesia Application eliminates pain and provides comfort with the patient as well as ensuring muscle relaxation by suppressing the reflex activities. So, aim of General Anesthesia is to ensure appropriate surgical conditions. Moreover, maintaining patient’s health and safety during the surgery is also a responsibility of an anesthesiologist.

Anesthesia can only be applied by physicians specialized at the department of Anesthesiology and Reanimation following a medical education. Anesthetic technicians, on the other hand, are an important part of an Anesthesia Team, who were trained to assist anesthesiologists during a surgery.

How Is Anesthesia Applied?

An oral medication, called premedication, is administered in order for patient to feel more comfortable during the surgery. Next, the patient is taken to operating room and venous access is obtained. The patient’s vital functions such as cardiac and respiratory status as well as blood pressure level are monitored in order to follow these functions. After this preparation, the medications, usage of which are only under the authority of anesthesiologists, are administered with an IV drip for general anesthesia. For continuation and safety of respiratory tract, a special tube is placed in the trachea. After ensuring safe anesthetic depth, the surgery can be initiated upon permission of the anesthesiologist. Continuation of the anesthesia is carried out with medications that are administered jointly or separately through respiration or intravenous access. Following termination of the surgery, the anesthetic agents are discontinued and the patient, who is allowed to regain consciousness, is then transferred to recovery room. In this room, the patient gets warmed up and measures are taken against nausea and vomiting. The patient’s pain is relieved, if present, and transferred to ward in a comfortable way.

How Are Patients Anesthetized?

When patient are brought to operating rooms, they firstly encounter an anesthesiologist. With the help of the anesthesiologist, the patient is transferred from gurney to operating table by surgical team. After this, the anesthesiologist place blood pressure monitor, electrodes of cardiac monitor and pulse oximetry (measures oxygen in blood) on the patient, all of which allows the surgical team to closely follow the patient’s vital functions during the surgery.  Oxygen support can be provided with the patient through a face mask for 3 to 5 minutes prior to the anesthesia. Following this step, the anesthetic agents are intravenously administered, which decrease the extent of painful stimuli, create a special state of sleep called anesthesia and ensure muscle relaxation. Later on, anesthetic gases mixed with oxygen are administered thanks to a tube placed in the patient’s trachea by the anesthesiologist. As long as this mixture of gas is administered, the anesthesia goes on. The process ends after discontinuation of the medication and the patient wakes up at the end. During this process, the anesthesiologist keeps waiting next to the patient and practices necessary treatments related to the course of the surgery.

Does The Anesthesiologist Leave The Operating Room After You Are Anesthetized?

The anesthetized patients are not left alone in the operating room in no circumstances. Some patients think that the anesthesiologist leaves the operating room after anesthetizing the patient; however, unexpected changes may occur in vital functions of patients who are even considered quite healthy in preoperative evaluation.  Thus, your anesthesiologist is always on your side and your sole caretaker.

How Long Does The Anesthesia Last?

An anesthetic process may take several minutes or even hours, which is planned based on the type and course of the surgery.  The longer the surgery should take, the longer the anesthesia continues.

Which Patients Cannot Be Anesthetized?

With the advanced anesthetic medications, techniques and devices helping monitor patient’s vital functions and postoperative intensive care unit, it is now possible for the patients, who cannot be anesthetized before, to undergo all kinds of surgeries. Patients with cardiac, renal or severe pulmonary diseases persisting for a long time has a favorable chance of recovery after a surgery. Moreover, these patients can undergo these surgeries for these kinds of diseases in a more comfortable way.

The anesthesiologist examining the patient with this kind of disease detects the degree of the diseases with necessary tests and makes effort to minimize the symptoms with the preoperative treatment. The anesthesiologist may consult with other departments, if warranted. Only purpose of this effort is to select the appropriate medication and technique that will decrease the risks for you. As a result of these evaluations, all patients can be safely anesthetized under appropriate conditions.

Who Follows Your Vital Findings During The Surgery?

Following your vital findings during the surgery is the primary duty of the anesthesiologist. Thanks to appropriate wires placed prior to the surgery, heart beats, oxygen density in tissues and blood pressure levels are closely and continuously followed. Shortly after the anesthetic process is initiated, the patient’s body temperature, carbon dioxide, anesthetic gases, amount of oxygen and event anesthetic depth are continuously measured and recorded by means of advanced anesthetic devices and the wires placed preoperatively.

When Regional or Local Anesthesia Is Applied, Does A Patient Watch the Surgery?

Absolutely, not. Because somnolence can be created in patients by administering intravenous sedatives when regional anesthesia is applied. The patient relieving in this way is not affected by the activities and conversations at the operating room and mildly sleeps at times when discomfort may be felt. Some patients do not want to sleep when effects of regional anesthesia become strong and they do not feel pain. They can pass the time talking to the anesthesiologist during the surgery if they want to. As a shielding curtain is placed between the patient and the operation site in all surgeries, it is already impossible for patients to see the surgical site.

Why Should We Fast Before the Surgery?

A patient, who will be anesthetized, should have an empty stomach. Under the anesthesia, foods and acid-containing gastric juice in a full stomach come upwards through esophagus and may leak into trachea, which is an undesirable situation during a surgery and can cause aspiration pneumonia and life-threatening complication. 

Adult patients should refrain from consuming solid food as of 12:00 a.m. at night prior to the surgery. If the surgery is to be performed afternoon, patients can have light breakfast at 6:00 a.m. in the morning. Up to 6 hours before the surgery, fluids (water, sugared water, tear, linden tear or clear juices) can be performed as well as solid foods (meal, desert, cookie etc.) up to 8 hours before the surgery.

General Intensive Care

What Is General Intensive Care?

NB Kadikoy Hospital provides medical services 24/7 at the wheel of Internal and Surgical Intensive Care Departments, Anesthesiologists and Intensive Care Specialists based on the multidisciplinary approach. Our Intensive Care Unit servicing with hi-tech medical devices and specialized physician team is located in the brightest area of the building, making sure that natural daylight can be directly seen. The Intensive Care Unit has a capacity of 9 beds in total, 1 used as an isolation bed, in addition to General Intensive Care Unit. On the other hand, the General Intensive Care Unit consists of five Level 3 beds and four Level 2 beds. Artificial respiration devices are placed on sides of each bed and all patients are followed through a Central Monitoring System. In the meantime, a calling bell button, placed next to each bed, can be easily accessed.

Patients Whose Treatments Are Followed at General Intensive Care Unit:

  • Patients with severe infection,
  • Patients with severe respiratory failure,
  • Patients who require close postoperative follow-up,
  • Patient with body trauma,
  • Patients with cerebral hemorrhage,
  • Patients with sudden stroke,
  • Patients experiencing poisoning.

Intensive Care Unit is the area where a patient with critical condition is treated with vital support. In contrast to other departments, Intensive Care Units have cutting-edge high technological devices. With the physicians and nurses specialized in this field, these units are very special areas where a patient is much more closely followed and vital support is fully provided.

The patients admitted to an Intensive Care Unit are included in a patient care and follow-up plan by nurses from day one. A thin nasal tube is placed in patients who cannot swallow or should not swallow, through which foods are directly sent to the patient’s stomach. Gastrointestinal tract is used whenever it is possible to nourish the patients. However, nutrition of the patient is achieved with a vascular access if there is defect or problem in the gastrointestinal tract.

Sepsis and Intensive Care

What Is Sepsis?

Sepsis is a severe disease, with which the body reacts to an infection. Normally, the body responds to an infection by targeting the infection site. However, in sepsis, the immune system starts a chain reaction to fight against the infection. The body’s response, in this case, causes to develop symptoms in the whole body instead of localizing in the infection site, which is also called “systemic response.”  As a result of this systemic response, fever, rapid heartbeat and rapid respiration are seen in patients with sepsis. The response against the infection may get out of control in some patients and the body’s balance may deteriorate, resulting in damage of single or multiple organs. This systemic response is more dangerous than the infection itself. Therefore, medical approach is very important for the patients with sepsis. The patients should absolutely be followed and treated at an Intensive Care Unit.

COPD, Pneumonia and Intensive Care

What Is COPD?

Acute exacerbation of COPD is defined as a deterioration period accompanied by increased shortness of breath and decrease in daily activities, alteration in amount and color of sputum, intensified coughing, high fever and/or mental deterioration in a stable patient. Persistence of one or several of these symptoms for at least 24 hours is identified as “Acute Exacerbation.”  Symptoms of the exacerbation can also be accompanied by some complaints such as malaise, fatigue, sleep deprivation, depression and confusion. The acute exacerbation develops once in 1 to 4 years in patients with COPD. On the other hand, acute exacerbation with mild symptoms does not require a hospitalization process and can be treated at home. However, patient experiencing moderate and severe exacerbation must be admitted to an Intensive Care Unit and treated accordingly.