Tuesday, January 24, 2012

ENT and Anesthesia

There is some overlap in the domains of ear, nose, and throat surgery and anesthesiology, especially regarding the airway. Surgeons operate on the mouth, throat, and trachea, giving them an intimate knowledge of anatomy and ways to access the airway. On the other hand, anesthesiologists are responsible for the patient's breathing during the surgery itself. And while anesthesiologists have an array of tools to help with placing the challenging breathing tube, surgeons have the ultimate back-up, the cricothyrotomy, a surgical airway involving cutting into the neck to get to the trachea.

Both specialists need to respect each other to keep the patient's safe. The ENT surgeon can often give insight into the airway as they have seen the patient in clinic and occasionally done a bronchoscopy. However, anesthesia is much more than intubating patients, and thus, the anesthesiologist has the expertise in understanding how to mitigate the stress of surgery given a patient's other medical problems. The anesthesiologist is central to the pre-operative evaluation, selecting monitors, and determining the best medications for each case. Teamwork and shared respect are key to a smooth surgery.

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