The Anaesthetist’s Essential Role in Surgery

The importance of anaesthetists in surgery

The last few years have seen a boom in cosmetic procedures, but along with this boom comes the unfortunate reality that some, including breast augmentations, are being performed in private clinics where there may not necessarily be safeguards in place to protect patients, including appropriately trained practitioners, doctors and anaesthetists. It is this last role that is causing a lot of recent concern with the rising number of procedures being performed under a twilight procedure that shouldn’t be. The Anaesthetists essential role in surgery is not to be undervalued.

Dr Mark Magnusson - Anaesthetists Essential Role
Dr Mark Magnusson

The Royal Australasian College of Surgeons, the Australian and New Zealand College of Anaesthetists and the Australian Society of Plastic Surgeons are calling for tighter regulations in clinics and any facility where a cosmetic procedure is taking place. Dr Mark Magnusson, Australian Society of Aesthetic Plastic Surgeons (ASAPS) President and Specialist Plastic Surgeon, says, “An area of particular concern for me in terms of patient safety is the use of an insufficient level of anaesthesia for invasive procedures such as breast augmentations or the procedure being performed in non-accredited facilities. Accreditation is difficult and requires that the facility meets a number of key requirements designed to maximise patient safety: adequate numbers of appropriately trained staff, safety equipment and protocols, infection control measures, adequate space and equipment. Cutting corners may reduce cost, but what is the real cost if it puts patients at risk.”

Cutting corners can cost lives

The problem arises when certain clinics offer breast augmentations for much less than what you’d pay at a fully qualified and experienced plastic surgeon’s clinic where you will also find appropriately trained anaesthetists. You need to realise what paying less actually means. It usually means that the medical facilities, staff and/or procedures being offered are not as comprehensive or skilled as they are in hospitals or fully accredited practices where specially trained anaesthetists oversee any procedure being performed.

Anaesthetists are highly trained specialists

What few people realise is that anaesthetists are as well trained as any plastic surgeon, and are fully qualified medical doctors who also have a further five years of training specifically in anaesthesia. It’s definitely not just a case of administering a needle with the right drugs.

Dr Magnusson explains, “A Specialist Anaesthetist is a fully qualified medical specialist who, after obtaining their medical degree, has spent a few years working in the hospital system before starting a further five years of training in anaesthesia. In fact, their specialty training is as long as that of a surgeon.

Clinical anaesthesia is built on the knowledge of physiology (how the body works) and pharmacology (how medications work in the body). Anaesthetists have an extensive knowledge of medicine and surgery and understanding of the basic sciences. They know how the body responds to anaesthesia and surgery, and how a patient’s health affects these responses. In Australia and New Zealand, anaesthesia training is supervised and accredited by the Australian and New Zealand College of Anaesthetists (ANZCA).

Anaesthetists assess patients before their procedures and play an important role in caring for the patient before, during and after surgery. They may also provide anaesthetic care for patients undergoing non-surgical procedures, particularly if the procedures are long, complex or painful, especially laser resurfacing. Anaesthetists play a pivotal role in resuscitating acutely unwell patients, including trauma victims, and help to manage patients suffering from acute or chronic pain.”

Excessive doses or under dosed anaesthesia during a procedure can cause massive problems, including death. It is a serious issue that Dr Magnusson says needs to be addressed. “There are well publicised cases where excessive doses of local anaesthetics have led to heart problems and emergency transfer to hospitals. Other ways to cut the price of surgery is by trimming back on the staff in the room, not using the most up to date or appropriate equipment and performing procedures in facilities that aren’t licensed.”


It comes down to consumer or patient awareness to ensure that the practitioner or surgeon they choose to perform their procedure also employs the services of a fully trained and experienced anesthetist. Unfortunately, the industry is not so fully regulated as to ensure that every practitioner does so, and until it is it falls back onto the patient to be diligent, aware and ask questions.