The anesthesiologist's responsibilities have extended to the recovery room and the intensive care unit. Here his knowledge of altered respiratory and circulatory states and his competence in treating these conditions contributes to the betterment of immediate postoperative care.It is reasonable to expect the anesthesiologist to apply his skills in treating acute circulatory and respiratory derangements, as illustrated in a 16-bed surgical unit and an 8-bed medical unit. THE anesthesiologist's sphere of responsibility has markedly expanded from the period when his obligation began with the placement of the mask and ended with the application of the dress¬ ing.In 1923 Albert Miller * wrote:Few surgical fatalities are due to faults in surgical technic. They result rather from depressed or otherwise abnormal condition of the patients, from lack of preparation, from attending features of the operation, such as abnormal postures and improper operating room conditions, and from faulty administration of anesthetics. It is the duty of the anesthetist to understand and to safeguard the patient's physical powers.This was the beginning of the anesthesiologist's concern with the preoperative condition of the pa¬ tient. Much of the success of present-day surgery is due to the anesthesiologist's ability to protect the patient against the hazards of anesthesia and the trauma of surgery, but the patient can be best pro¬ tected only if the anesthesiologist is forearmed with knowledge of the patient's physical status.With the passage of time and a better under¬ standing of disturbed function due to surgery and anesthesia, it was believed that better patient care could be obtained if "the duty of the anesthetist to understand and to safeguard the patient's physical powers" were to be extended beyond the preopera¬ tive and operative phases of surgery. It became obvious that on occasion the same close attention to vital signs, maintenance of proper ventilation, and support to circulation so prominent and effective in the operating room could be life-saving were it to be continued, uninterrupted, into the immediate postoperative period. Recognition of this fact led to the development of the recovery room. To make the recovery room a successful unit, it was necessary that it be placed in close proximity to the operating room, and that the responsibility for patient care and the authority to carry out recovery room pro¬ cedures be delegated to the anesthesiologist. Improved Postoperative Care The improved immediate postoperative care by such an arrangement has been so thoroughly proved that recovery rooms are now almost universally ac¬ cepted. Older operating room suites have been remodeled to incorporate recovery rooms. With continued progress, surgical and anesthesia pro¬ cedures are becoming more complex. As for ex¬ ample, the organs of respiration and circulation are frequently the site of surgery. Hypotensive and hypothermie anesthesia have become popular. Extracorporeal circulation is widely employed.With recognition of the possibl...
