Anaesthesiology is a rapidly evolving and indispensable specialty in modern medicine, extending far beyond the operation theatre. Anaesthesiologists play a crucial role in perioperative care, including preoperative assessment, intraoperative monitoring, postoperative pain management, and critical care services. Despite their pivotal contribution to patient safety and surgical outcomes, the visibility and recognition of anaesthesiologists among the general public often remain limited. Misconceptions regarding their role may lead to inadequate understanding of anaesthesia practices.¹

Several studies conducted globally and within India have reported poor awareness regarding anaesthesia techniques and the responsibilities of anaesthesiologists. A lack of knowledge has been associated with increased preoperative anxiety, misconceptions about anaesthesia-related risks, and reduced participation in shared decision-making. With the expanding use of internet and social media platforms, public exposure to medical information has increased, potentially influencing awareness levels. However, awareness may still vary according to demographic and socioeconomic factors. ²

Limited data are available from Western India, particularly the Rajkot region, assessing public knowledge about anaesthesia and anaesthesiologists. Evaluating current awareness levels and identifying associated factors is essential to bridge knowledge gaps, improve patient education strategies, and strengthen doctor–patient communication by shared decision making. Therefore, our study was undertaken to estimate the knowledge of patients and attendants regarding anaesthesia techniques and the role of anaesthesiologists in a tertiary care hospital.

This cross-sectional study was conducted in the Outpatient Department of AIIMS, Rajkot, after obtaining approval from the Institutional Ethics Committee. The study duration was six months. Patients and attendants visiting the OPD were approached for participation. After explaining the purpose of the study, verbal informed consent was obtained. A validated questionnaire consisting of 22 questions divided into three sections (demographic details, knowledge about anaesthesiologists, and knowledge about anaesthesia techniques) was administered through a personal interview in the participant’s preferred language. Confidentiality of responses was maintained throughout the study. Participants aged 18–60 years of either sex were included in the study. Both patients and attendants fulfilling the eligibility criteria were enrolled. Individuals who refused consent, those belonging to medical or paramedical professions, critically ill patients, and mentally challenged individuals were excluded from the study to avoid bias and ensure reliability of responses. The collected data were compiled and entered into Microsoft Excel. Responses were summarized using descriptive statistics. The number of similar responses for each question was calculated and expressed as proportions and percentages of the total study population. Associations with demographic variables were analyzed descriptively to assess patterns of awareness.

A total of 384 participants were included in the study. The age ranged from 19 to 60 years, with a male predominance. Most participants belonged to the lower middle socioeconomic class. A considerable proportion reported use of internet/social media, while a smaller proportion knew a doctor or paramedical staff personally. Around one-third had previously received anaesthesia, and none could recall the name of their anaesthesiologist.

Regarding perception of the anaesthesiologist’s role, a substantial proportion identified them as assistants to the surgeon, while many respondents were unaware of their exact role. Knowledge sources were mainly hearsay or previous anaesthesia exposure, and a significant number reported not knowing who an anaesthesiologist is.

When asked about intraoperative responsibilities, responses varied considerably, with many participants either attributing assistance to surgeons or expressing lack of knowledge. Awareness of postoperative roles was also limited.

Awareness of complications and side effects was notably low, with a majority unable to comment on their frequency. Media exposure to anaesthesiology portrayal was minimal. However, most participants expressed willingness to receive detailed information from an anaesthesiologist prior to surgery.

The present study evaluated awareness regarding anaesthesia techniques and the role of anaesthesiologists among patients and attendants in a tertiary care hospital in Western India. Overall, while a fair proportion of participants demonstrated partial knowledge about anaesthesia techniques, substantial gaps persisted regarding the exact role, responsibilities, and perioperative involvement of anaesthesiologists. Awareness appeared to vary across education levels, socioeconomic strata, internet use, and previous exposure to anaesthesia. Importantly, although knowledge deficiencies were evident, most participants expressed willingness to receive detailed information from anaesthesiologists prior to surgery, highlighting an opportunity for improving patient engagement and shared decision-making.

In our study, only a small proportion correctly identified anaesthesiologists as physicians, while many perceived them primarily as assistants to surgeons. Similar findings were reported in an Indian study by Mathur et al.1, where a significant proportion of respondents had limited understanding of the independent role of anaesthesiologists. Uma and Hanji 2 also observed poor recognition of anaesthesiologists as perioperative physicians among the Indian general population. Internationally, Gottschalk et al.3 reported that patients in the United States, Australia, and Germany frequently underestimated the scope of anaesthesiologists’ responsibilities. Likewise, Ribeiro and Mourão found that patients often perceived anaesthesiologists as technical assistants rather than specialists responsible for critical decision-making. 4

With regard to areas of work, most participants in our study associated anaesthesiologists primarily with the operation theatre, while awareness of roles in ICU, preoperative assessment clinics, and pain clinics was comparatively lower. Lal et al., 5 in an Indian tertiary care center, reported similar findings, where OT involvement was commonly recognized but ICU and pain management roles were poorly acknowledged. Sagün et al. in Türkiye and Djagbletey et al. in Ghana also documented limited public awareness of anaesthesiologists’ involvement beyond the operating room. These findings suggest that despite expansion of the specialty into critical care and pain services, public perception remains OT-centric globally. 6 7

Regarding knowledge of anaesthesia techniques, a majority in our study correctly identified that both general and regional anaesthesia are used and that general anaesthesia may involve both inhalational and intravenous agents. This contrasts with findings by Lal et al., where only a small proportion recognized different types of anaesthesia. Similarly, Geddawy et al. in Saudi Arabia reported generally poor knowledge of anaesthesia modalities among the public. The relatively better awareness observed in our study may be attributable to higher internet usage and educational attainment among participants, suggesting a positive influence of digital information exposure. 8

Awareness of anaesthesia-related complications was notably low in our cohort, with most respondents unable to comment on their frequency. Comparable observations were reported by Nagrampa et al.9 in predominantly Hispanic patients and by Yamoah et al.10 among African American populations, where misconceptions and uncertainty about anaesthesia risks were common. Garcia-Marcinkiewicz et al. further highlighted that inadequate health literacy significantly limits patient understanding of anaesthetic care. Poor awareness of complications may contribute to anxiety, unrealistic expectations, and reluctance to engage in shared decision-making.11

Encouragingly, a large majority of participants in our study expressed willingness to receive detailed information from anaesthesiologists before surgery. Bondy et al. demonstrated that structured anaesthetic education significantly reduces preoperative anxiety. Similar findings were noted by Geddawy et al., where patients expressed interest in learning more about anaesthesia when given the opportunity. 12 13

The high willingness of participants to receive detailed information highlights the need to implement structured Shared Decision-Making (SDM) in anaesthetic practice. SDM involves active collaboration between the anaesthesiologist and patient in selecting the most appropriate anaesthetic technique after discussing risks, benefits, and alternatives. Incorporating SDM into preoperative assessment clinics can enhance patient autonomy, reduce anxiety, improve satisfaction, and strengthen trust in perioperative care. Our findings support the need to formally integrate SDM into routine anaesthetic counselling. 14

Limitations: This study was conducted at a single tertiary care center and may not represent the broader community. Additionally, responses were self-reported and may be influenced by recall bias.

Our study demonstrates that although partial awareness regarding anaesthesia techniques exists among patients and attendants, significant gaps remain in understanding the comprehensive role of anaesthesiologists, particularly beyond the operation theatre. Knowledge deficits were notable regarding complications and perioperative responsibilities. Encouragingly, most participants expressed willingness to receive detailed information before surgery. Strengthening preoperative counselling, improving public education through digital and print media, and enhancing direct communication by anaesthesiologists may improve patient awareness, reduce anxiety, and promote shared decision-making.

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