The Department of Anesthesiology is one of the largest departments of the G.B. Pant hospital. The department was set up in 1964 with just 2 faculty members. It has grown over the years under the dynamic leadership of various heads of departments. The department has kept pace with the progress in medical sciences and has set up its own high standards in patient care, education and research. All clinical departments are anchored to this specialty.

In the early 80’s the faculty strength was increased to 4 and there were 2 operation theaters (each with 2 operating rooms) for cardiothoracic surgery and neurosurgery.  With increasing workload and hospital expansion, a new operation theatre with two operating rooms was commissioned for Gastrointestinal surgery and in early 1990’s, there were a total of 6 faculty members in the department. At present, there are 12 operation rooms with the faculty strength of18.  There are a total of 35 senior residents and 3 junior residents.  In addition to the patient care inside the operation theatres, the department provides care to the critically ill patients in the General Intensive Care unit and surgical intensive care units. Anaesthesia services are also provided in the Cardiac Catheterization Laboratories, ECT room, MRI as well as CT scan suites and endoscopy suites.

1. Nature of services:

The principal job of the department is to cater to the operation theatres and provide anaesthesia services of high quality to patients undergoing all types of surgical procedures. The department strives hard to provide a high quality care that ensures a painless experience to the patient with minimal risk during the entire peri-operative period. The following types of surgical procedures are commonly performed in the hospital:

Cardiothoracic surgery:

·         open heart surgery

·         off-pump coronary artery bypass surgery

·         repair of congenital heart defects

·         all types of valve surgery

·         Thoracic surgery

·         Vascular surgery

Neurosurgery

·         Craniotomies for benign and malignant intracranial masses

·         Spine surgery (including endoscopic spine surgery)

·         Awake craniotomies

·         Aneurysm surgery ((clipping and coiling)

·          Stereotactic neuro-surgery ( to be introduced soon)

Gastrointestinal surgery

·         Cholecystectomies

o    Conventional

o    Endoscopic

·         Intraabdominal cancer surgery

·         Liver resection

·         Liver transplant (to be introduced soon)

While providing the anaesthetic care of the highest order to these patients, the department resorts to the state of art monitoring techniques that include invasive pressure monitoring such as arterial pressure, central venous pressure, pulmonary artery and wedge pressures. In addition, advanced monitoring such as cardiac output and calculated haemodynamic parameters; transoesophageal echocardiography and BIS monitoring , neuro-muscular block monitoring, intra-operative EEG monitoring are routinely performed to ensure the anaesthetic care of the highest order and safety of patients during major surgical procedures.

Special clinics:

PAC clinic:

Pre-anaesthetic check-up (PAC) clinic: The department runs PAC clinic on a daily basis from 8 am to 3 pm. The indoor and outdoor patients who are scheduled for surgical or interventional procedures are screened here for their fitness and suitability to undergo surgical or interventional procedure.

Pain clinic:

The department runs a pain clinic on a weekly basis on each Saturday from 8 am to 1 pm. Patients suffering from chronic pain are examined here and advised appropriate treatment. Over 150 patients attend this clinic each year. Many of these patients are administered blocks for the relief of pain. The facility of radiofrequency coagulation and ultra sound guided blocks are being introduced as a step towards upgradation of the pain clinic facilities.

General Intensive Care unit:

The department has a 7 bedded state of art mixed medical-surgical Intensive Care Unit (ICU). Critically ill patients are admitted in the General ICU from both within and outside the hospital. The ICU is equipped with best ventilators and monitoringgadgets with adequate facilities for bedside procedures and point-of-care tests. A team of dedicated intensivists provide round-the-clock critical care services to the admitted patients. The expansion of General ICU to 15 beds with starting of continuous renal replacement therapy and bedside ultrasonography is in the pipeline. The Department also intends to start postgraduate courses in Critical care medicine very soon.

The Red alert area:

This is a multi-disciplinary facility in the hospital to provide emergency cover to the VVIPs. It is presently under charge of the department of anaesthesiology, and is kept in state of readiness for emergency health cover to visiting national and international VVIPs. The department also provides cover to all the VVIPs attending public functions / ceremonies and mass public rally(s) at ‘Ramlila Maiden’ which is just across the hospital campus. One of the senior faculty members is a nodal officer for the recently created Emergency Services Wing which will cater to critically sick patients of “Brain Attack and Heart Attack “(Stroke and Myocardial ischemia)

ACLS training laboratory: The department has set up a laboratory with an intubation trainer and a mannequin that is used to train the basic and advanced life support manouvres to the entire hospital staff.

Some other responsibilities of the department include Central Sterile Services Department and Pipeline Services. When Master Amir Chand (MAC) Block was made functional, a separate Central Sterile Services Department and Pipeline Service dedicated to that building was also started. Liquid Oxygen Tanks have also been installed, one each for “A” block and Master Amir ChandBlock to ensure uninterrupted’ oxygen supply to the various operation theatres and Intensive are Units. A new state of art CSSD facility is presently under construction.

Day-care Ward: A 10 bedded day care ward in the new EDP block has been sanctioned and will be commissioned soon.

2. Documents required for the services: The investigation reports and the OPD/ admission slip from the respective departments

3. Required fee, if any: No fee

4. Location of the office for these services:

Cardiothoracic operation theatres

·         2^nd floor MAC block

·         7^th floor MAC block

Neurosurgical operation theatres

·         1^st floor, block A ( three OTs)

·         2^nd floor block A (three OTs)

Gastrointestinal operation theatres

·         4^th floor MAC block

PAC clinic:

·         Room adjacent to ward 9, first floor, block A
( This facility will soon be shifting to the new OPD building (Block D) on 4^th floor)

General ICU:

·         First floor, block A (Ward 9)

Pain clinic:

New OPD building (Block D) on 4^th floor (Room no.419)

Faculty offices:

·         6^th floor Academic block

Timings:

Operation theatres:

9 am to 5 pm

PAC clinic:

8 am to 3.00 pm, Monday to Friday

8 am to 1 pm on Saturdays

Pain clinic:

9 am to 2 pm on all Saturdays

Academic activities:

The department provides a 3 years residency program to train all the senior residents in Anaesthesia& Intensive Care. They are posted in the Cardiothoracic surgery, Neurosurgery &Gastrointestional surgery OTs and General ICU on a rotational basis.

The department provides training in cardiac and neuroanaesthesiology to postgraduate students (M.D. And Diploma courses in anaesthesiology) of MaulanaAzadMedicalCollege and other Delhi government hospitals.

The department runs a 2 year post-doctoral fellowship programme (FNB) in cardiac anaesthesia under National Board of examinations.

The faculty and residents participate in the various state, national and international level conferences and contributescientific papers in research journals. On an average, the department presents 20-30 scientific papers and publishes around the same number of research papers each year.

The Department has the office of the Indian Society of Anaesthesiologists (Delhi chapter) for the year 2013-2015.

The department was the editorial office of the British Journal of Anaesthesia (Indian edition).

The department was the editorial office of the Annals of Cardiac Anaesthesia, the official publication of the Indian Association of Cardiovascular Thoracic Anaesthesiologists from 2002- 2007.

In job ICU training programme for staff nurses: Teaching and training programme for staff nurses was started for the nurses of the G.B.PantHospital. As the programme was a big success, it was extended to other Delhi Government hospitals. The programme aims to acquaint and upgrade the information of staff nurses on various practical procedures, which are of use in the intensive care unit while managing the critically sick patients.

In job training programme for OT technical staff is organized on a regular basis.

Awards and distinctions of the department:

Dr.RajeevUppal, Director Professor & HOD is the President of the Indian Society of Anaesthesiologists (Delhi chapter) for the period 2013-15. Dr.AkhileshTomar is the Vice President,Dr.Baljit Singh is the Organizing Secretary for ISACON (Delhi) 2013.

Dr.Rajeev Chawla is the President elect of the Indian Society of neuroanaesthesiology&neurocritical care (ISNACC) for 2013-14

Dr. Tomar and Dr. Vishnu Datt are on the Editorial Board of the “Annals of Cardiac Anaesthesia”

Dr. Baljit Singh is the co-editor of “Asian Archives of anaesthesiology and resuscitation”

Dr.AnirbanHomChoudhuri is the Executive Council Member of the Indian Society of Critical Care Medicine (Delhi & NCR) for the year 2013-15.

Dr.AnirbanHomChoudhuri has successfully completed Post Graduate Diploma in Medical law & Ethics (PGDMLE) from National Law School University, Bangalore

Future plans:

To expand the pain services by starting acute pain services and offering OPD services for patients with chronic pain.

To start postdoctoral courses in Critical care Medicine & Neuroanaesthesia.