Surgery is the pride of Allopathic Medicine and other systems of medicine, such as Ayurveda, Unani and Homeopathy, cannot make this claim.

Surgery is a team work, where the involvement of every member should be cent percent. A single error by one person may end up in unnecessary morbidity or mortality.

It is like a bicycle chain with hundred links. If one link fails, not only the chain fails but also the whole bicycle fails in performing its function. No one could put forward a democratic argument of 99% success.

Dr S Ahanatha Pillai is a good assessor and meticulous in his job. He keeps everybody, including surgeons, on their toes, when he is in the operating theater.

I still remember a case of tuberculosis (TB) of spine in an elderly lady, elder sister of a leading surgeon, on whom we were planning to do surgery; and we were pessimistic about the outcome. Dr Pillai gave the green signal and we did the surgery confidently and the end result was excellent.

He has covered the subject in an elaborate way and this book will be a useful reference book in every operating theater.

The book will be useful not only for the Theater Assistants (Anesthesia Technicians), Technicians but also for nurses and junior level doctors.

I wish the readers of this book will have more knowledge on this new essential subject.

In the past, for many decades, it is worldwide well recognized and established that a Theater Technician is one among the essential technical personnel necessary in the operating department for its efficient functioning.

Unfortunately, his vital role and contribution for the successful outcome of the surgical work is often underestimated and is not well realized by many, including medical professionals.

I had the fortune of entering into the specialty of Anesthesiology in 1971 as a beginner in Madurai Medical College and Government Erskine Hospital (presently Rajaji Hospital) Madurai, Tamil Nadu, India, when there were many well-trained, senior and skillful Theater Assistants working in that hospital.

I have always been experiencing and enjoying the warmth of the skillful assistance given to me by the Theater Assistants during my work for past 35 years and more, and I wish every anesthesiologist must enjoy such an assistance.

However, in the recent days, the number of adequately trained Theater Assistants are very few. If available, most of them are self-trained and have very little knowledge of the scientific background of their work.

The presence of an efficient assistant makes a big difference in the overall safety of the conduct of anesthesia. That is the reason why the Ten Golden Rules for Safe Anesthesia proposed by the world authorities state that always have someone in the room who can apply cricoid pressure effectively, and it will be useful in an emergency.

Similarly, the Governing Council of Indian Society of Anaesthesiologists recommended certain minimum requirements for safe anesthetic practice on the 20th of October 1990 at its meeting at Chennai, Tamil Nadu, India. Two recommendations proposed in that, regarding staffing are:

In fact, the second recommendation has to be modified, as the assistant has to be by the side of the anesthesiologist to help him starting from the time of giving premedication to the time of conclusion of the operating list of the day. That is how developed countries have considered the role of the Theater Technicians very seriously.

I strongly believe that an anesthesiologist will be able to tackle the most critical and difficult situation during anesthesia very easily, if an efficient and intelligent Theater Assistant helps him during the times of crisis.

Many developed countries conduct structured training courses for Theater Technicians. The syllabus is quite elaborate. One has to take examinations to get qualified to work as Theater Technicians. Unfortunately, this aspect of training is neglected and not given due importance in our country. Such courses are not conducted by many universities of our country.

Recently, such paramedical courses are conducted by some universities and the Government of Tamil Nadu has introduced a program to train youngsters who have completed their schooling, and has started short-term training courses for Theater Assistants as Anesthesia Technician Paramedical Course in all the teaching medical institutions and prescribed the syllabus for that. It is a welcome change in our atmosphere.

However, there is no comprehensive, simple book available on this subject, simple enough for them to understand. As I have been giving training to Theater Assistants for the past few decades, many of my younger colleagues wanted me to write a book for them. This prompted me to present a simple book with all the necessary details in simple language for them with adequate illustrations. It will give them a better understanding of the technical background of their work. I have strived much to present the script in a very simple language which is easy for any one to understand. The illustrations provided will make the understanding still easier.10

The students may find it difficult to understand the meaning of the medical and technical terms used in the book. Quite obviously, any beginner will be unfamiliar with such terms. Hence, the students are advised to keep a small medical dictionary to look for the meaning of these terms.

I have purposely provided the essential information which may be a little more than what is needed for the examination of Theater Technicians course (e.g. Anatomy, Physiology, Theater atmosphere, Ventilation, etc.). The students are, therefore, advised to get suitable guidance from the anesthesiologist who train them as to what extent they have to know.

I always sincerely feel the need for an efficient Theater Assistant by my side for safe conduct of anesthesia.

I hope that this small work will serve the purpose for which it is meant.

I earnestly wish to have suggestions and criticisms for the improvement of the book from all quarters.

My loving students, both undergraduates and postgraduates, consistently inspired me to continue teaching for more than three and a half decades. I am grateful to them for their love to me.

Very sincerely, I express my gratitude to all my Anesthesia Technicians (Theater Assistants), who have worked with me in the past and working presently. By their priceless contribution and support, they always make my work safe.

I am extremely grateful to Professor A Subramaniam [MS, MS (Ortho)], Former Professor and Head, Department of Orthopedics, Madurai Medical College and Deputy Superintendent, Government Rajaji Hospital, Madurai, Tamil Nadu, India, for being kind enough to go through this book and for writing a foreword.

A lot of gratitude is due to my dear wife, Mrs Neelam, and my children for the loving care and the support, they give me in ventures like this.

My dear younger colleague, Dr G Saravana Kumar (MBBS, DA, MS), helped me in every step of this work. He did the proof correction very meticulously. Particularly, his contributions have made the book more easier to read for the technicians.

I owe deep gratitude to my dear colleague, Prof Dr A Paramarivan (MD, DA), Professor of Anesthesiology, Madurai Medical College and Government Rajaji Hospital, Madurai, Tamil Nadu, India, for the inimitable support he gave me in executing this project.

I am always very grateful to all my patients, for all that they taught me during the past four decades.

My profound gratitude is due to M/s Anesthetics India Pvt Ltd, Mumbai, Maharashtra, India, pioneer manufacturers of anesthetic equipment for more than 60 years, for permitting me to use the pictures of equipment in the book.

My very sincere gratitude is due to Mr R Jayanandan, Senior Commissioning Editor, M/s Jaypee Brothers Medical Publishers, Chennai, Tamil Nadu, India, for the excellent and encouraging coordinating work, he did with regard to this book as he did with my earlier three publications.

I sincerely thank Shri Jitendar P Vij (Group Chairman), Mr Ankit Vij (Managing Director) and Mr Tarun Duneja (Director-Publishing) of M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India, particularly for the inimitable interest shown and the support they rendered in bringing out the book in a very presentable form in a short time.12