Hanaoka Seishū (1760–1835) - Osaka. A Japanese surgeon of Edo period with knowledge of Chinese herbal medicine and Western surgical techniques. In 1785, Hanaoka re-created a compound similar to Hua Tuo's mafeisan. After years of research and experimentation, he finally developed a formula which he named tsūsensan (mafutsu-san) - a compound composed of extracts of several different plants. The active ingredients in tsūsensan were scopolamine, hyoscyamine, atropine, aconitine and angelicotoxin - consumed in sufficient quantity, produced general anesthesia and skeletal muscle paralysis.
Message of the Chair:
The department of Anaesthesiology was started in the year 1965 with only 2 anaesthesiologists. Now it has grown to a major & vital department in the hospital and the southern districts of Tamilnadu with 28 faculty, 40 other nursing, paramedical and office staff. We have recognized MD postgraduate residency program with an annual intake of 4 graduates per year. Our hospital being a tertiary referral centre, I take pride of being here.
SUCCESSION OF HEADS
|Dr. Krishnan MD DA||1968||1975|
|Dr. Ian Sundararajan MD DA||1975||1976|
|Dr. Madanagopal MD DA||1976||1977|
|Dr. Mohan Roy MD DA||1979||1981|
|Dr. Sambandham MD DA||1981||1984|
|Dr. Prema MD DA||1987||1991|
|Dr, Rathnam MD DA||1991||1992|
|Dr. Parthasarathy MD DA||1992||1993|
|Dr. Ranganath MD DA||1993||1998|
|Dr. Balasubramanian MD DA||1998||2005|
|Dr. Kannan MD DA||2005||2012|
|Dr. A.Thavamani MD DA||2012||Till Date|
STATISTICS OF THE DEPARTMENT
|Year||Major Surgeries||OG||Minor Surgeries||Total|
The Postgraduate Department of Anesthesiology Department at the TVMCH specializes in anaesthesia support for general surgery, orthopedics & traumatology, obstetrics and gynecology, otorhinolaryngology, ophthalmology, plastic surgery, genitourinary surgery, pediatric surgery, cardiothoracic surgery, neurosurgery and spinal surgery. The Department also specializes in Acute and Critical Care & Pain and Palliative Care. The Department has a Post-Anesthetic Critical Care Unit.
The Anesthesiology Department meets the needs of several medical procedures. Our anesthesiologists handle both elective and emergency cases on a daily basis. Every patient is given an assessment before anaesthesia is administered. The department provides as a routine General Anesthesia, Short GA, Localized & Special Anesthesia for
- Orthopedics, Plastic & Reconstruction Surgeries, and Genito-Urinary procedures such as trauma, tumor and spine surgeries.
- Pediatric Anaesthesia Procedures that involve children requiring special care,
- Specialized procedures involving airway and oto-rhino-laryngological procedures and Ophthalmic surgery
- Critical and Anesthetic Assistance in the management of ventilation, in trauma, post-operative management of patients in the surgical ICU and Critical care support in IMCU. IRCU and ICCU at the TVMCH.
- Intrapartum Anesthetic Support is one of the best in our region to offer round-the-clock continuous labour analgesia and operative pain services.
- Cardiac Anaesthesia, which encompasses a wide range of cardiac surgery from newborn surgery to adult. We provide Intra operative and post-operative intensive care to the patients. The cardiac surgical intensive care unit is a 8-bedded unit with sophisticated monitoring facilities.
- Neuro Surgical in neuro-surgical trauma and tumour surgery.
The Department has 12 operation theatres with a total of 26 operating rooms. These complexes spread over 9 buildings are grouped into three units under a professor each. The department also supports critical services in 8 intensive care units with 105 beds. Of these, besides the post-surgical intensive care unit, is a 8-bedded multi disciplinary unit directly under anaesthesia care. The Anaesthesia services are provided round-the-clock, seven days a week with daily outpatient services for assessment and weekly pain care service.
CONFERENCES & CME
Tirunelveli Update of Anaesthesia. This CME, was conducted in the year 2005. The one day CME had 12 lectures by eminent faculties. All the topics were on current trends which were helpful for all the 150 delegates to provide better health care to their patients.
NELCON 2007 (State ISA Conference)
It was the annual conference of Indian Society of Anaesthesiologists held in the year 2007 at Tirunelveli Medical College campus. It was a 2 day conference, with a theme “Target zero accident”, was attended by 450 delegates from all over Tamilnadu and from neighbouring states. 28 lectures by faculties and 40 free papers by Post graduates were presented. Two workshops one on Fiber optic intubation and another on Central venous assess were organized.
Tirunelveli ISA Ventilator Agglomeration (TIVA 2011) was an ISA sponsored, one day CME, organized by the Department of Anaesthesiology, TVMCH. The CME comprised of a series of lectures covering 8 topics, starting from the basics of ventilation to the newest modalities in ventilator therapy. The lectures were conducted by eminent speakers from within the state as well as outside the state. The lectures were followed by a workshop/ hands-on training on ventilators. The CME and workshop were accredited for 10 points under category 3, by the ‘Tamilnadu Dr. MGR Medical University’. The CME was specially designed to Review the basic concepts on ventilator management, inculcate greater knowledge on ventilators, provide a comprehensive skill in the intensive care practices, deal with the problems and complications associated with the patient, update the practising anaesthesiologist and physicians on the recent modalities of ventilation and ventilator management. The WORKSHOP was specially devised to Improve CRRIs and PGs participation with the ventilator management by removing the hesitation to operate the ventilator, Improve intensive care physicians participation, Trouble-shoot minor problems arising from the ventilator, Prudently identify and understand the priority alarms on the ventilator and setting it right as necessitated, Promptly identify disastrous events such as mechanical failure, disconnection of circuits, kinked/ blocked endotracheal tube etc.& Promote a synergistic and co-ordinated activity in the intensive care unit
PRIZE EXAMINATION FOR INTERNS
A medal exam is held for CRRIs (a pioneer endeavor among the anaesthesia departments in the TN). Interns take an examination of MCQs. 6 are short listed for the final evaluation which comprised of clinical, reasoning and skills in anesthesiology as an OSCE. Ms. Parimala Devi, was awarded the Gold Medal for the year 2010-2011(sponsored by Indian Society of Anaesthesiologists (ISA), Tirunelveli chapter.
Academic Program—Graduate The graduate training is placed on a broad objective that at the end of the training, the student should be able to
- perform cardio-pulmonary resuscitation with the available resources and transfer the patient to a bigger hospital for advanced life support.
- Set up intravenous infusion.
- Clear and maintain airway in an unconscious patient.
- Administer oxygen correctly.
- Perform simple nerve block procedures.
- Exhibit awareness of the principles of administration of general and local anaesthetics.
He should know the principles of and the processes of
- Cardiopulmonary resuscitation (C.P.R.) – basic and advanced, including use of simple ventilators.
- Anatomy of upper airway; sites of respiratory obstruction and management of airway in an unconscious patient.
- The pharmacology of local anaesthetics, their use and how to perform simple nerve blocks like,
- Infiltration anaesthesia.
- Digital block, Ankle block, Pudendal and paracervical blocks.
He should have fair knowledge of
- Various methods of oxygen therapy and its indications.
- Management of complication of regional anaesthesia.
- The principles of administration of general anaesthetics.
- Start a intravenous line and infusion in adults, children and neonates.
- Do a venous cutdown.
- Insert and manage a Centrla Line.
- Conduct C.P.R. ( Cardiopulmonary resuscitation ) and first aid in newborns, children and adults including endotracheal intubation.
- Do lumbar puncture.
- Perform nerve blocks like infiltration, digital, pudendal, paracervical and field block.
- Administer O2 by mask, catheter and O2 tent and be able to handle O2 wall units and cylinders
The Resident in our department goes through a strict routine of postings in various OT rooms and spaces. Genera! Surgery, Orthopaedic Theatre, Cardiothoracic Theatre, Neuro Surgical Theatre, Urology, Plastic & facio - maxillary, Paediatrics, Obstetrics & Gynoecology Theatre & E.N.T. Theatre. The residents also receive formal teaching schedules with Basic Sciences Departments for discussions in topics related to anaesthesia including anatomy, physiology, Pharmacology, Biochemistry, Physics including electronics, computers and lasers. The residents undertake pre anaesthetic evaluation and preparation including pre, per and post operative care. The residents receive hands on training in different methods of Anaesthetic Techniques. Regional anaesthesia including, spinal, epidural and caudal etc, Local anaesthesia including nerve blocks, management of chronic pain. They are trained in blood transfusion - Fluid and electrolyte balance, Theatre sterilization procedures, Oxygen therapy and Management of both acute and chronic respiratory insufficiencies, and ventilator committments in I.C.U and ritical care Anaesthesiology.
Hospital Services Photos
OT AND ANAESTHESIA TECHNICIANS TRAINING PROGRAMME
These technicians are trained in the OT complexes for a period of 1 year. Basic sciences are also taught to them to equip themselves better inside the OT atmosphere. The training is focused on Operation Theatre maintenance sterilization procedure. Understanding the basic principles of anesthesia equipments and circuits. Assisting the anesthesiologists in all anesthestic procedures inside the Operation Theatre.
- Nutrition in critical care: Kannan M, et al Indian journal of Anaesthesia (IJA):2008
- Mitral stenosis and pregnancy: Current concepts in anaesthetic practice. Kannan M, Vijayanand G. Indian J Anaesth 2010;54:439-44
- Differential blockade to assess surgical repair by intraoperative active mobilization in knee injuries-
- Beyond labour analgesia; Vijayanand G, Kannan M, Palaramakrishnan D. Indian J Anaesth 2011;55:181-3
- Effects of dexmedetomidine added to caudal ropivacaine in paediatric lower abdominal surgeries. Vijayanand G, Kannan M, Thavamani A, Bridgit MJ. Indian J Anaesth 2011;55:340-6.
- Comparison of subarachnoid blockade in pre-eclampsia patients and normal pregnant patients coming for caesarean section
- Effect of dexmedetomidine added to ropivacaine in paediatric day care surgeries
- Effect of intravenous paracetamol for post-operative pain relief following tonsillectomy
- Effect of intra-thecal clonidine on post-operative analgesia in pregnant patients undergoing lower segment caesarean section.
- Comparison of Buprenorphine and clonidine as adjuvants in supraclavicular brachial plexus blockade.
- Comparative study between epidural magnesium sulphate with ropivacaine and ropivacaine in lower limb surgeries.
- Comparative study of three different doses of dexmedetomidine added to hyperbaric bupivacaine for infra umblical surgeries.
- Comparison of three supraglottic airway devices – Proseal LMA, LMA supreme and I-gel in anaesthetized non-paralyzed patients.
- A study of lignocaine with dexmedetomidine for intra-venous regional analgesia.
- A comparative study of intra-thecal clonidine and fentanyl added to hyperbaric bupivacaine for lower segment caesarean section.
OUT REACH TRAINING PROGRAMME IN RURAL ANESTHESIA (6 MONTH COURSE)
PHC doctors are posted under RCH program for a period of 6 months in-house training. They are trained appropriately to manage the operation theatres in the PHCs’, and to manage obstetric emergencies that would require the intervention of an anesthesiologist with special focus on fundamental principles of GA & RA, CPR, BLS and ACLS; Emergency airway management; Operation Theatre sterilization procedure and maintenance; Management of Obstetric emergencies.