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Department of Anesthesia

Team members includes 2 Doctor & 1 Technician

  • Dr. Sunita Wazira (M.D.) HOD
  • Dr. Pratibha Dubey (Panel Consultant Anaesthesia)
  • Mr. R.K. Tiwari, Head Technician

Introduction

Anaesthesiology is a branch of medicine that allows safe usage of medical drugs to induce a reversible state of total or partial lack of responsiveness to surgical procedures, so that they can be carried out smoothly, without causing any distress and inconvenience to the patient.

The Department of Anaesthesiology at MP BIRLA HOSPITAL uses the most advanced, safe and patient focused techniques in the delivery of anaesthetic care. We aim to provide optimum quality of patient care not only in the operation theatres but also beyond it by optimizing preoperative patient status and providing comprehensive patient care during the early post operative period.

Anesthesia Techniques include

  • General
  • Spinal
  • Epidural
  • Regional
  • Intravenous

General Anesthesia

Anesthesia is the combination of the endpoints (discussed above) which are reached by drugs acting on different but overlapping sites in the central nervous system. General anesthesia (as opposed to sedation or regional anesthesia) has three main goals: lack of movement (paralysis), unconsciousness, and blunting of the stress response. In the early days of anesthesia, anesthetics could reliably achieve the first two, allowing surgeons to perform necessary procedures, but many patients died because the extremes of blood pressure and pulse caused by the surgical insult were ultimately harmful. Eventually, the need for blunting of the surgical stress response was identified by Harvey Cushing, who injected local anesthetic prior to hernia repairs. This led to the development of other drugs that could blunt the response leading to lower surgical mortality rates.

Spinal & Epidural Anesthesia

Central neuraxial anesthesia is the injection of local aesthetic around the spinal cord to provide analgesia in the abdomen, pelvis or lower extremities. It is divided into either spinal (injection into the subarachnoid space), epidural (injection outside of the subarachnoid space into the epidural space) and caudal (injection into the cauda equina or tail end of the spinal cord). Spinal and epidural are the most commonly used forms of central neuraxial blockade.

Spinal anesthesia is a "one-shot" injection that provides rapid onset and profound sensory anesthesia with lower doses of anesthetic, and is usually associated withneuromuscular blockade (loss of muscle control). Epidural anesthesia uses larger doses of anesthetic infused through an indwelling catheter which allows the anesthetic to be augmented should the effects begin to dissipate. Epidural anesthesia does not typically affect muscle control.

Because central neuraxial blockade causes arterial and vasodilation, a drop in blood pressure is common. This drop is largely dictated by the venous side of the circulatory system which holds 75% of the circulating blood volume. The physiologic effects are much greater when the block is placed above the 5th thoracic vertebra. An ineffective block is most often due to inadequate anxiolysis or sedation rather than a failure of the block itself.

Regional Anesthesia

When pain is blocked from a part of the body using local anesthetics, it is generally referred to as regional anesthesia. There are many types of regional anesthesia either by injecting into the tissue itself, a vein that feeds the area or around a nerve trunk that supplies sensation to the area. The later are called nerve blocks and are divided into peripheral or central nerve blocks.

The following are the types of regional anesthesia:

  • Infiltrative anesthesia: a small amount of local anesthetic is injected in a small area to stop any sensation (such as during the closure of alaceration, as a continuous infusion or "freezing" a tooth). The effect is almost immediate.
  • Peripheral nerve block: local anesthetic is injected near a nerve that provides sensation to particular portion of the body. There is significant variation in the speed of onset and duration of anesthesia depending on the potency of the drug (e.g. Mandibular block).
  • Intravenous regional anesthesia (also called a Bier block): dilute local anesthetic is infused to a limb through a vein with a tourniquet placed to prevent the drug from diffusing out of the limb.
  • Central nerve blockade: Local anesthetic is injected or infused in or around a portion of the central nervous system (discussed in more detail below in Spinal, epidural and caudal anesthesia).
  • Topical anesthesia: local anesthetics that are specially formulated to diffuse through the mucous membranes or skin to give a thin layer of analgesia to an area (e.g. EMLA patches).
  • Tumescent anesthesia: a large amount of very dilute local anesthetics are injected into the subcutaneous tissues during liposuction.
  • Systemic local anesthetics: local anesthetics are given systemically (orally or intravenous) to relieve neuropathic pain

Intravenous Anesthesia

The core instrument in an inhalational anesthetic delivery system is an anesthetic machine. It has vaporizers, ventilators, an anesthetic breathing circuit, waste gas scavenging system and pressure gauges. The purpose of the anesthetic machine is to provide anesthetic gas at a constant pressure, oxygen for breathing and to remove carbon dioxide or other waste anesthetic gases. Since inhalational anesthetics are inflammable, various checklists have been developed to confirm that the machine is ready for use that the safety features are active and the electrical hazards are removed. Intravenous anesthetic is delivered either by bolus doses or an infusion pump. There are also many smaller instruments used in airway management and monitoring the patient. The common thread to modern machinery in this field is the use of fail-safe systems that decrease the odds of catastrophic misuse of the machine.

Anesthesia@MPBH: At a glance

Providing anesthesia for the following

  1. All type of general and cancer surgery.
  2. Thoracic surgery.
  3. Laparoscopic procedures.
  4. General orthopedic & implant surgery.
  5. All type of gynecological interventions & surgery.
  6. Maxillofacial & E.N.T. Surgery Including Functional Endoscopic Sinus Surgery (FESS)