This is a question for those more experienced than I. I have to give a 45min presentation to a group of general surgery residents on anesthesia. Any particular topics that you wish surgeons had a bit more knowledge about?
Thanks in advance!
You have the opportunity to change some minds there, so don't take it lightly. You should focus on myths about anesthesia/anesthesiologists, hoping that they will spark a healthy discussion about what happens behind the blood-brain barrier, aka the drapes. I would try to focus on the really important stuff, hoping to make them curious and ask for more details.
I would first begin by explaining the main components of an anesthetic plan: analgesia, +/- hypnosis, +/- amnesia.
Then I would talk about ways of providing analgesia: inhalational gases, opiates, local anesthetics. The latter would lead to a presentation of types of blocks: neuraxial, regional, field etc., emphasizing what the surgeon can do both for better intraop and postop pain control (also pointing out that it's always easier to prevent pain than to treat pain). If time permits, I would touch a bit on the main advantages and disadvantages of each.
I would focus on explaining GA (controlled coma) and the sequence of doing things (induction, intubation, maintenance, emergence, extubation), the pitfalls and possible (severe or frequent) complications of each. I would explain what happens during each phase, and all the ways it can go wrong; this should be a lengthy discussion, that would also present examples of the complicated thinking that go into every single decision for an anesthesiologist. I would also try to point out what the surgeon can do to help the anesthesiologist, from simple things such as holding the tube for the anesthesiologist during intubation. The entire OR staff should be a team that works together for the benefit of the patient; nothing is beneath anybody (the best surgical attendings don't shy away from pushing the stretcher together with the anesthesia attending).
And then I would end with the message that's really important to walk away with: the importance of communication and mutual respect.
If you are still a resident, you don't really fathom yet the magnitude of collaboration between a good private surgeon and a good anesthesiologist who frequently work together. It's a dance, that can be downright beautiful when executed properly. It's also very helpful to present it to surgical residents, who many times see the academic egotistical version, where the surgeon just dictates and generally behaves like a primadonna/arsehole. The key to a safe procedure with the best outcome for the patient is
communication. That goes both ways, and it does not happen in a clash of egos. The more friendly the surgeon and the anesthesiologist are towards each other, the better for the patient. The more information is being exchanged, the better for the patient. For example, the good surgeons will announce, and even ask permission for, anything that could significantly affect the patient: "Can I start?", "Injecting local...", "Incision!", "Insufflating...", "Will be done in 20 minutes." etc. On the other hand, the dance partner (the anesthesiologist) will facilitate the surgeon's work in every way possible, from moving cases around to accommodate the surgeon's schedule, to moving the table even when the surgeon does not ask and realize that s/he's operating in an uncomfortable position, to asking if the surgeon needs more muscle relaxation, to tying the surgeon's scrubs, to playing circulator while s/he's out of the room etc.
The better the couple works together the better the patient outcomes. This should be the message you want the future surgical attendings to walk away with. Everything else they can learn from their anesthesiologist buddies, while working together in the OR.