|
 |
 |
 |
|
| Dr. P. S. Garcha |
Dr. P. R. Musa |
Dr. (Mrs.) M.
Shinde Patil |
|
|
|
 |
 |
 |
|
| Dr. (Mrs.) Mamta
Sadre |
Dr. (Mrs.)Laxmi Manvikar
|
Dr.Bharti |
|
|
|
Department of anaesthesia is dedicated to the relief
of pain and total care of the surgical patients. The
spectrum of care includes the medical evaluation of the
patient before surgery, consulting with the surgical
team and providing pain support and control of life-functions
during surgery, supervising care during surgery, supervising
care after surgery, evaluating condition of the patient
at the time of discharge from a recovery unit.
|
|
We
are primarily physicians who administer anaesthesia to
alleviate pain and suppress consciousness of the patient
undergoing surgery. |
|
| Pre operative assessment |
|
The rationale of the
preoperative visit to the anaesthesiologist is to ensure
that your overall medical condition is the best it can
be prior to encountering the stress of anaesthesia and
surgery. The most common problems that need further medical
evaluation in surgical patients are cardiac (heart) and
pulmonary diseases. Specifically CAD (blocked blood vessels
of the heart) asthma and COPD are medical conditions
that most often require further testing or treatment
prior to elective surgery. Surgery and anaesthesia can
be very stressful and coupled with the above diseases,
can lead to adverse outcomes (for example : heart attack
after surgery) ; that can threaten patient’s
well-being or even their lives. Obviously, such patients
may still need surgeries. Thus, a major goal of the preoperative
anaesthesia assessment is to diagnose and treat any coexisting
medical condition, so as to minimize the risk to aforementioned
adverse
outcomes. Other diseases that may lead to adverse events
if not well-controlled at the time of surgery include:
disease of the liver, kidneys, nervous system, musculoskeletal
system, endocrine system (eg. Diabetes, thyroid disease)
and haematological (blood) system. Patient may need further
testing, Consultation and treatment in order to optimize
his / her condition in the preoperative period. If the
surgery is elective, it may be postponed so that patient’s
conditions can be better evaluated and treated. |
|
Another important aspect is the assessment
of the airway (i.e. mouth, throat, wind-pipe, neck movements)
and spine. |
|
It is crucial that we recognize any abnormalities
of these early and take measures to manage them intra-op
or even pre-operatively. This may decide the type of anaesthesia
to be given. In addition, you may have special questions
and concerns that are best addressed by an anaesthesiologist. |
|
| Anaesthesia Care |
|
In the operative room,
we are responsible for medical management and anaesthesia
care of the patient throughout the duration of surgery.
The anaesthesiologist must carefully match the anaesthetic
needs of each patient to that patient’s medical
condition, responses to anaesthesia and the requirement
of the surgery. The activity of the anaesthesiologist
is hardly seen by anyone outside the operation theatre,
even the patients themselves are unable to recall much
of their involvement with this vital specialist because
most of the anaesthesiologist work is done while patient
is anaesthetised ! The role of the anaesthesiologist
in the operation theatre is to. |
|
 |
Provide continual medical assessment of the patient. |
|
Monitor & control
patient's vital life functions, like Heart rate and
rhythm, breathing, BP, temp and body fluid balance. |
|
Control
of patient’s pain and level of unconsciousness
to make conditions ideal for a safe and successful
surgery. |
|
|
| Anaesthesia Techniques |
|
|
Local
Anaesthesia : Many procedures can be done with local
anaesthesia. Frequently some intravenously (IV) administered
sedation is given along with the local anaesthetic.
These medications will make you sleepy and reduce
pain. The same drugs can be used to cause brief periods
of deep sleep or unconsciousness for the most uncomfortable
parts of a procedure. |
|
General
Anaesthesia : Most of the major surgical procedures
are done under general anaesthesia especially surgeries
on upper limbs & faciomaxillary surgeries.
General anaesthesia is actually the reversible
loss of consciousness with the help of different
medicines & medical gases and inhalational
anaesthetic agents. Today is an era of ‘Balanced
anaesthesia’ where sedation, analgesia and
muscle- relaxation is achieved with different drugs
given in the optimum doses. |
|
Regional
Anaesthesia : It is the most frequently used technique
at our hospital. This techniques can be effectively
used for surgeries on extremities both upper and
lower. Major procedures like Total Knee Replacement
and Total Hip Replacement can also be comfortably
done under regional anaesthesia. Epidural anaesthesia
is a form of anaesthesia in which a tiny-tube (also
called a catheter) is placed in the epidural space
in your back. Anaesthesia medication is then injected
into the space via the catheter. An alternative to
the epidural technique is a ‘spinal anaesthesia’ which
is similar to an epidural anaesthesia. A thin needle
is inserted in the lower part of your back, and the
anaesthesia medication is injected through it. The
needle is then withdrawn. The effects of both are
very similar; they temporarily block the nerves,
so that pain is not felt. They, to a greater or lesser
extent, may decrease your ability to move your legs,
or even cause complete but temporary paralysis of
your lower body. As the medication wears off your
legs recover, both sensation and movement. In our
hospital, we practice ‘Combined spinal – epidural’ anaesthesia
where we try to achieve good effects of both the
techniques and also provide postoperative analgesia.
For upper limb surgery, we practice various techniques
of Brachial plexus blocks like supraclavicular or
axillary block, where only the relevant extremity
is rendered anaesthetised. |
|
This is usually
combined with light sedation. These methods are especially
good in vascular surgeries and may increase chances
of salvaging the limb. |
|
|
| Postanaesthesia Care Unit |
|
This is where patients are transferred after
surgeries, allowing them to emerge fully from the effects
of the anaesthesia under the watchful eyes of the nursing
staff with anaesthesiology consultation immediately available.
In most cases, the anaesthesiologist decides when the patient
has recovered enough to be sent home following out patient
surgeries or has been stabilized sufficiently to be moved
to a regular room or ward. |
|
| Pain Services |
|
In
addition to the patients pain being relieved or blocked
entirely during a surgical procedure, it is equally important
to provide adequate pain relief post operatively for
the patient’s comfort and well-being.
After surgery, we are involved in prescribing pain-relieving
medication and techniques that are best for each individual
patient to maintain a level of comfort and to follow proper
rest. |
|
| Critical Care and Trauma Medicine |
|
The role of anaesthesiologist
is to provide medical assessment, and diagnosis; and
respiratory and cardio-vascular support. Anaesthesiologists
have special training to deal with many emergency situations.
We provide airway management, cardiac & pulmonary
resuscitation; advanced life support and pain control.
As consultants, we play an active role in stabilizing
and preparing the patient for emergency surgeries. |
|
| Top |
|
|