The Department of Anesthesia and Pain medicine is a vital part of the patient services provided by NRCH. It provides round-the-clock consultant-supervised anaesthesia services for all incoming elective/ emergency surgeries. Anesthesia is provided for a very wide variety of cases including Surgical [thoracic /gastrointestinal /urologic /oncological /minimal access interventions]; Orthopaedic [Major joint replacements, arthroscopies, spine surgeries]; Complex Gynaecological and Obstetric; ENT and Ophthalmological cases.
There are currently five dedicated operation theatres (OTs) in the operation theatre complex - 3 of which are modular. All OTís are fully-equipped with advanced equipment. In addition there is a 12 bedded, well equipped, immediate-postoperative care recovery room within the OT complex. The department has been in the forefront in providing advanced technology/aids to bolster routine clinical anaesthesia for a very wide variety of complex surgical procedures and it has always had a history of early adoption of new technologies including the use of Ultrasound in anesthesia; Advanced Airway fibrescopes and laryngoscopes; non-invasive monitoring devices; Low flow anesthesia; BIS and NMT.
The department is also providing pain management for a variety of acute and chronic pain conditions. All perioperative cases get the best possible pain management techniques with a great emphasis on regional blocks thus ensuring quick recovery and increased patient satisfaction following surgery. Chronic pain conditions are also dealt with through a variety of ways using conventional, as well as, alternative techniques like acupuncture.
The Department is headed by Dr A K Sharma ACHD/ANESTH who has nearly 30 years of experience in the speciality; in addition there are 4 other Consultants, 3 of whom have over 20 years of experience after post-graduation. Both, faculty members as well as residents attend seminars, conferences and workshops to update their skills and to keep abreast of latest techniques.
Apart from the provision of routine clinical Anesthesia, the department is a recognised Post Graduate Training Centre affiliated to National Board of Examinations, New Delhi and has been imparting postgraduate Training DNB (Anesthesiology) since 2009, with an intake of 2 Trainees per year, with an excellent academic track record. The Department has been conducting the FAT Examination for the DNB and this year (2018) it was also the centre of the Final DNB exit examination (Practical and Viva). In addition there is an ongoing training OT staff (nurses as well as OT technicians), on a regular basis and new MBBS-graduates under the Rotatory Internship programme receive their first exposure to the speciality.
What procedure do patients follow before surgery?
A few days or weeks before surgery; the doctor who will perform the surgery (or a member of that team) will ask you (the patient) questions, examine you physically and order tests like blood, x-rays etc. After the test results are available you will be referred to the PA clinic where you will be seen by an anesthesiologist. The anesthesiologist will fill a form, ask you some more questions; and may order more tests if required.
Why is this pre-operative process so long?
The conduct of anesthesia and surgery today has been made very safe overall. However, ensuring this safety requires very careful examination and testing, sometimes repeatedly. Thus it is necessary to see more than one doctor [sometimes on many occasions] as well as to do several tests, in order to make the procedure as safe as possible. In emergency cases a less detailed (and quicker) evaluation is done. However all such emergency cases carry a greater risk of complications and side effects compared to non-emergency (also called elective cases).
What happens after my surgery?
After surgery you will be taken to the post-operative ward, where you will be given oxygen /fluids (glucose) /drugs etc. as decided by your doctor. Your vitals like Heart rate /BP etc. will be monitored by use of machines and the on-duty nurse will keep a watch over these parameters. In addition, residents will also monitor you at intervals and will keep your consultant/s apprised of your condition.
Who is an anesthesiologist? What does he do?
An anesthesiologist is a physician who has taken additional training in this speciality of medicine. After passing medical college [MBBS degree], the physician completes a post-graduation in anesthesiology (usually 3 years) before he practises independently. He /she will administer anesthesia and monitor you throughout the period of your operation. Even after the operation you will continue under his/her care for at least the first 24 hours after your surgery.
Will I be in pain during or after surgery?
You will not feel any significant pain during surgery whether you are awake or asleep.
After the operation there is often mild pain, but you will be provided pain relief for the expected duration, after surgery. If you feel the need, you can inform the nurse on duty; he/she will provide further medicines for pain relief if required.
Is it always necessary to be asleep during my surgery?
Most operations will require you to be under general anesthesia which resembles sleep but is more complex than normal sleep (eg. unlike normal sleep your breathing is controlled by your doctor usually with the help of a ventilator-a machine that provides you with breath). But there are also many operations in which it is preferable for you to be awake during surgery. In any case your anesthesiologist will ensure that whether awake or asleep your pain level is at a minimum. You can discuss this when you meet your anesthesiologist at the first visit in the P A clinic. He /she will advise you whether it is possible and/or advisable to keep you awake during your operation.
What is the usual advice /instructions given to patients before any surgery?
Each patient will have slightly different instructions depending on the kind of surgery and the disease and medicines the patient is taking. These instructions are written down by your doctor in your case sheet and also explained to you before surgery. However in all elective cases a fasting period of 8 hours is usually advised unless the case is an acute emergency. You will also have to remove all jewellery, dentures and wear the required dress for the OT which the nurse in the ward will provide to you.
Dr. A K Sharma ACHD HOD
Dr. Mamta Chadha ACHD
Dr. Sushil Krishnan SR DMO
Dr. Rakesh Kumar SR DMO
Dr. Ashok Bansal ADMO