Anaesthesiology & Intensive Care

 

About the Department:

Anaesthesiology & Intensive Care is a major clinical department rendering services with safety to all medical, surgical and the critically ill patients. Started as an independent department in 1986 anaesthetizing around 1800 patients annually, the department has since evolved dramatically, and made a mark in the country now anaesthetizing 18,000 patients annually and providing Critical Care to about 1000 patients in the 10 bedded state of the art RICU (Respiratory Intensive Care Unit).  A number of patients are referred to our intensive care unit from other hospitals in and around the city and from different parts of the State The ABG (Arterial Blood Gas) Lab provides round the clock service for the entire hospital. Extending pain relief beyond the confines of the operating room is our conviction, which led us to start “Acute Pain Services”. “Chronic pain services” are provided for specially referred patients

Anaesthesia outside the operating theatre has become the hallmark of this department.  Involvement for challenging procedures in Interventional Radiology, Cardiology, Neurology, Gastroenterology and Radiation Oncology are a few to name.  The department is actively consulted by all for Respiratory assessment, ventilator management and invasive monitoring.

In addition to active service being rendered, we have a good academic record in teaching & training our students. Our students have received a number of best paper awards and won first places in several quiz competitions. The prestigious MD (Anaesthesia) degree course and the 1 year Post Doctoral Course in Cardiac & Neuro Anaesthesia and 1 ½ year fellowship in criti cal care medicine are acclaimed as one of the best in the country. Paramedical courses for Anaesthesia technicians and Respiratory therapy are also popular.

Inspite of busy work and teaching schedules, the department has published about 150 papers in national & international journals. Out of the international publications in the core journals of “Anaesthesia and Analgesia” and “Anaesthesia” five are very well cited.  The department has the credit of having conducted several seminars, CMEs, Workshops and national and international conferences.  The Department has been involved in a few multicentre trials too.  Awareness programmes like CPR, Pre-hospital care are conducted. The Department has developed its own software for a comprehensive ICU and anaesthesia database including nutrition and drug therapy.

With anesthesiologists being peri-operative Physicians and also intensives in the ICU, it stands to reason to refer to “Anaesthesia” as an independent clinical specialty imparting quality patient care and maintaining the highest possible standards in safety. 

Faculty:

1)            Dr. R. Gopinath                   Professor & HOD

2)            Dr. Mantha Srinivas             Professor

3)            Dr. K. Dilip Kumar              Professor

4)            Dr. T. Suhasini                     Additional Professor

5)            Dr. D. Padmaja                    Associate Professor

6)            Dr. Radha Rani                    Assistant Professor

7)            Dr. Rajiv Gambhir                Assistant Professor

8)            Dr. B. Malleswar                 Assistant Professor

9)            Dr. Madhavi Singh               Assistant Professor

10)        Dr. Ashima Sharma             Assistant Professor

11)        Dr. Nirmala                         Assistant Professor

12)        Dr. Srilatha                          Assistant Professor

13)        Dr. Narmada Padhy            Assistant Professor

14)        Dr. Kanithi Geetha              Assistant Professor

15)        Dr. Indira Gurajala              Assistant Professor

16)        Dr. Zahid Saleem Khan       Assistant Professor 

 

Residents (23)

Post Doctoral Fellows (7)

Technicians (17)

Secretarial Assts. (2) 

Courses Offered:

 a)Post –graduate (Medical)  

1)         3 years post-graduate course in M.D. Anaesthesiology

2)         1 Year post doctoral certificate course (PDCC) in cardiac and neuro-anaesthesia

3)         1 ½ year Post Doctoral course in Critical Care

 b)Paramedical

1)         Two year Diploma Training in Anaesthesia Technician Course

2)         Two year Postgraduate course in Respiratory Therapy Technology

 

Major State of Art equipment:    BIS

Research Projects/Drug trials

1.      “A Multicentre, Randomised, Single – blind comparison of mortality in post surgical adult patients sedated in intensive care with Diprivan 1% versus ZD0859# 1 1%” in association with Quintiles Spectral, Mumbai.

2.      “A prospective randomised multicentric open label study to compare the efficacy and safety of propofol lipid-free as an I.V. anaesthetic agent with a marketed formulation in long duration surgeries”  in association with SIRO Clinpharm Pvt. Ltd., Mumbai.

3.      Clinical Trial of “Dipeptiven” with Fresenius Kabi, Pune.

4.      Efficacy and Safety of Drotrecogin alfa (Activated) in Adult patients with early stage severe sepsis with Eli Lilly Company (India) Pvt. Ltd, Gurgaon, Haryana. Large multicentre, International double blind placebo controlled randomised study.

5.      F1K-MC-EVBJ is an international, noninterventional, multicenter, prospective observational study of patients with severe sepsis world wide. This study is web-based and will use the most current information technology available, including provisions for secure access and transmission of data.   For this study Eli Lilly and Company (India) Pvt., Ltd has selected our institute as one of the sites.  This has been submitted for Ethical Committee approval.

6.      Pressure control ventilators and evaluation by cytokines

7.      Comparison of melatonin and diazepam for premedication in adult patients undergoing CABG

8.      Melatonin as premedication in elderly orthopedic patients – Evaluation of sedative and psychomotor performance

9.      Influence of the CZ/C6 Hydroxyethylation of Hydroxyethyl starch on Hemorheology Coagulation and Elimination kinetics.

Patient Services:

I.  Anaesthesia for different surgical specialties

Cardiothoracic Surgery: Including open heart surgeries like CABG, valve replacement surgeries and complicated paediatric and adult congenital heart surgeries. 

Orthopedic Surgery: Including trauma, joint replacement (knee & hip),arthroscopies and spinal corrective surgeries 

Neuro Surgery: Including neurotrauma, intracranial tumors, aneurysms and special surgeries like rhizotomies and deep brain stimulations. 

Vascular Surgery: Including aortic aneurysms, aorto-femoral bypass, embolectomies and endovascular stents. 

Plastic Surgery: All major trauma and cosmetic surgeries including – microvascular surgery, craniofacial, facio maxillary and reimplantation of severed extremities.   

Urology: Laproscopic, endoscopic procedures and renal transplantation (Cadaveric transplantations) 

Surgical Gastroenterology: GI emergencies, liver resections, Whipples procedure, portal hypertension, endocrine tumors and laproscopic surgeries. 

Surgical Oncology: Faciomaxillary tumors, major abdominal malignancies and thoracoscopic surgeries.

 II. Intensive Care Unit

10 bedded Respiratory Intensive Care catering to both surgical and medical specialities.

Medical Cases

Including poisonings requiring ventilatory support

Pneumonia

Ventilatory failure with COPD

Neuromuscular weakness, GB Syndromes

Sepsis & MOSF – Renal failure 

 

Surgical Cases

Post operative elective ventilation

Post operative Analgesia

Post operative Sepsis 

 

Trauma Cases

Fat embolism

Chest injuries

Head & Spine injuries

Abdominal trauma

Crush Injuries

Anaesthesia for patients in remote locations

BRACHYTHERAPY

MRI

CT

Cardiac Catheterization

DSA (Digital Subtraction Angiography)

Children for Radiotherapy

 

Academic Achievements – Awards Received:

·        Best paper Award – International Congress of Anaesthesiology 1991 -“Infections in ICU” - Prof. S.Manimala Rao 

·        3rd prize Dundee presentation – for work on sevoflourane, Northern Ireland, U.K.,     1996 - Dr. R.Gopinath 

·        International man of the year 1997 – Dr. Mantha Srinivas 

·        Best paper award – 2nd Annual conference of IACTA, Mumbai, 1998- “Role of free radical scavengers in attenuation of reperfusion injury following aortic cross changing, comparison of allopurinol, trimetazine and combination of. both”-            Dr. Padmaja / Dr. R.Gopinath 

·        Appreciation award for NIMSET  Convenor  - Dr. Mantha Srinivas 

·        Best paper award  -  Xth  ISA Annual Conference of A.P. Chapter, Vijayawada 2000-“Prediction of outcome in Organo Phosphorus Poisoning in ICU - Dr. Kalyan Rao / Prof. S. Manimala Rao

·        Padmabhushan Dr. P.Siva Reddy Endowment Award & Honouring of Distinguished Medical men / Women, 2000 - Prof. S.Manimla Rao

·        Best paper award for a paper on “a software on Total parenteral  Nutririon”  Crirical  care conference Jan   2000. – Dr. Dilip Kumar 

·        Best paper in KOPs Award session – 49th Annual Conference of ISA, Ahmedabad, 2001 – “Comparison of cervical movements during intubation using laryngoscopy and ILMA.- Dr. D.Raja / Prof S.Manimala Rao/Dr. Padmaja 

·        Best paper Award – 3rd National Conference of Indian Society of    Neuroanaesthe-     siology & Critical Care at Bombay, 2001- Anesthetic consideration for deep brain stinulation -Dr. D. Padmaja / Dr. S. Manimala Rao 

·        Best poster presentation Award – 3rd National Conference of Indian Society of      Neuroanaesthesiology & Critical Care at Bombay, 2001- ILMA – a bridge to FOB – Rule of ILMA in intubation of cervical pathology with difficult intubation – study of 150 patients - Dr. Jatin / Dr. D.Padmaja/ Dr. S. Manimala Rao

·        Best paper award for paper on “kratschmer’s reflex during rhinoplasty- a case report” at XI annual conference of A.P. Chapter of Indian Society of Anaesethesiologist (ISA) Warangal –2001 – Dr. Nirmala. J/ Dr. Dilip kumar 

·        The team from Department of Anaesthesiology has won the IInd prize in the Quiz     competition in HYCOME I.S.A. 2002 CME held at Owaisi Hospital & Research      Centre, Hyderabad, July 20 – 21, 2002. 

·        Best Poster Award for “Topical Anaesthesia for Chest Drain Removal” at the RSACP meet held at Mumbai from 14.08.04 to 18.08.04. Dr. Madhavi Singh/ Dr. Dilip Kumar/ Dr. Gopinath 

·        Won the KOPS Award for “Comparison of neuromuscular junction monitoring in healthy and paretic limbs in paraplegic patients” at ISACON–04 Conference held at Bhopal from 27th-30th December, 04., Dr. M. Srilata,/ Dr. Padmaja/Dr. Gopinath 

·        Won T.N.JHA Memorial Award for “Evaluation of caudal analgesia for lower lumbar laminectomies” at ISACON – 04 Conference held at Bhopal from 27th – 30th December, 05., Dr. J. Veerendra/ Dr. Padmaja 

·        Best paper award paper titled “Comparative study of I. V. butorphenol, pericoxib, tramadol and pethidine for post operative pain relief” at south zone, kakinada 2004., Dr. Ramesh / Dr. Dilip Kumar/Dr. Rajiv 

·        HYCOME 2005 Hyderabad – P.G.QUIZ 1st prize–Dr.Veerendra.J&Dr. Sudhakar, 2nd Prize – Dr.Kaleem & Dr.Lakshmi Narasimhulu.K,

Dr.Shravan& Dr.Bhanukumar,  Dr.Shyam&Dr.Sathish.  

*     Dr. Narendra.D & Dr. Lakshmi Narasimhulu (P.G.s) 1st prize in QUIZ in ISA 

APCON-2005 held at Amalapuram Sep 2005. 

*    Dr.Kaleem & Dr.K.V.L.Suneetha (P.G.s) 1st prize in QUIZ in ISACON-2005 held at Kolkata Dec 2005 

*    2nd best poster in ISACON – Kolkata 2005-“Anesthetic consideration for intra operative EEG recording during seizure surgery / Dr. Padmaja / Dr. Gopinath 

*    Simple bed side additive score for prediction of ventilation and In-hospital mortality in cervical spine injury –1st Best poster in ISNACC-2006 held at Mumbai Jan2006. Dr. Padmaja/ Dr. M. Srinivas/Dr. Gopinath 

*    QT interval and hemodynamic changes with phenytoin and fosphenytoin during Propofol and Isoflurane anaesthesia –is there is any interaction –2nd Best poster in ISNACC-2006 held at Mumbai Jan 2006. Dr.Srinivas Reddy/ Dr. Padmaja/Dr. Dilip/ Dr. Gopinath 

*    Anesthetic management of surgery on pituitary gland NIMS experience with 250cases –3rd Best poster in ISNACC-2006 held at Mumbai Jan 2006, Dr. Sujeet kumar /Dr. Padmaja/ Dr. Gopinath 

*    Perioperative management of giant intracranial aneurysms NIMS experience –Best paper award in ISNACC-2006 held at Mumbai Jan 2006 Dr.Vibhavari Naik /Dr. Padmaja/Dr. Dilip Kumar/Dr. Gopinath 

CMEs Conducted:

·        CME for twin city Anaesthesiologists, on Cardiovascular Anaesthesia Oct. ’87,

      organizer: Prof. S. M.Rao 

·        CME symposium-cum-workshop on ABG, Sep. ’92, Dr. Gopinath

·        CME on Pain management, Nov. ’98, Organizing Secretary : Dr. Dilip Kulkarni

·        HYCOME ISA City Branch 2002, Organizing Secretary : Dr. Suhasini

Conferences:                                                                                          

·        3rd Annual conference of ISA (Indian Society of Anaesthesia), A.P. chapter, Nov. ’88, Dr. S. Manimala. Rao 

·        Vth Annual conference of RSACP (Research Society of Anaesthesiologist and clinical pharmiology), Oct. ’90, Dr. R. Gopinath 

·        39th Annual conference of ISCTS (Indian Society Cardiac Thoracic Surgery), Feb. ’93, Dr. S. Manimala Rao 

·        X LIV Annual & National conference, ISA(Indian Society of Anaesthesia), Dec. ’96, Anaesthesia Chapter, Dr. S. Manimala Rao 

·        IVth Annual conference of IACTA (Indian Associate of Cardiac Thoracic Anaesthesia, Nov. 2000 Dr. Gopinath 

Workshops:

Airway workshop, Jan. 2000 – Organizing Secretary, Dr. S. M. Rao

Workshop on Airway Management was organized in the Learning Center, NIMS, ISA (Indian Society of Anaesthesia) organizing Secretary Dr. Padmaja, 2005 

Publications:

1.      Anaesthetic management for cervical laminectomy in patients of skeletal flurosis. Journal of Anaesthesiology Clinical Pharmacology, Oct 1987, vol 3: No.4., Dr. S. Manimala Rao

2.      Anaesthetic management of combined cardiac and non-cardiac surgery. Journal of Anaesthesiology-clinical Pharmacology, April 1988, vol 4., Dr. S. Manimala Rao

3.      Is Laryngotracheal lignocaine necessary?  Indian Journal of Anaesthesia, April 1989, vol 37: page 78-83. Dr. S. Manimala Rao

4.      Minitracheostomy - a modified technique Journal of Anaesthesiology Clinical Pharmacology, Oct. 1989, vol 5: No.4. Dr. S. Manimala Rao

5.      Non Cardiogenic Pulmonary odema following suicidal hanging. Anaesthesia 45, Nov, 1990.Dr.S. Mantha / Dr. S. Manimala Rao

6.      Editorial: Pregnancy cardiac disease and role of anaesthesiologist. J.I.M.A. Vol 89: No.9 1991.

7.      T-wave changes in controlled hypertensive patients undergoing general anaesthesia. Journal of Anaesthesiology-Clinical Pharmacology, vol 8: Page 17-20, 1992.

8.      Microbiological profile of tracheal aspirates in patients on long term ventilation. Journal of Anaesthesiology-Clinical Pharmacology, Vol. 8 No.2, p 125-129 April 1992.

9.      Evaluation of ARDS by expanded definition. Journal of Anaesthesiology & Clinical Pharmacology, 9: 25-28, 1993.

10.  Pharmacokinetics of Intravenous Lignocaine and its Correlation with Haemodynamic responses to Tracheal Intubation. Journal Anaesthesia. Clinical Pharmacology. 11: 199-202, July 1995.

11.  Inspiratory Collapse of Alae nasi causing variable extra thoracic airway obstruction”. Anaesthesia & Analgesia, 1998: 86:294-296.

12.   Oxidant Stress and essential fatty acids in patients with risk of established ARDS. Clinica Chimica Acta 298 (2000) 111-120.

13.   "INTRAVENOUS REGIONAL ANAESTHESIA WITH DIFFERENT DRUG COMBINATIONS : A COMPARATIVE STUDY" Ind. J. Anaesth, 41, 114-121. 1993.

14.   "ANAESTHETIC MANAGEMENT OF SURGICAL REMOVAL OF INSULINOMA"The Clinical Proceedings of NIMS, 9 : 3, 64-66, 1994.

15.   "INTRACTABLE BRONCHOSPASM DURING WEANING FROM CARDIOPULMONARY BYPASS" J. Anaesth Clin. Pharmacol 8. 153-155. 1991.

16.   "ANAESTHESIA FOR TEMPOROMANDIBULAR JOINT SURGERY:A REVIVED TECHNIQUE" Ind. J. Anaesth. 39. 105-108. 1991.

17.   "CHANGES IN SERUM OSMOLARITY AND SERUM ELECTROLYTES DURING PERCUTANEOUS NEPHROLITHOTOMY" J. Anaesth Clin. Pharmacol 10. 199-201. 1994.

18.   “FIBEROPTIC NASAL INTUBATION FOR TEMPOROMANDIBULAR JOINT ANKYOSIS : OUR EXPERIENCE” The Clinical Proceedings of NIMS, 12:4. Oct 1997.

19.   “ONE LUNG VENTILATION IN A CHILD - A MODIFIED TECHNIQUE” The Clinical Proceedings of NIMS, 12:4. Oct 1997.

20.   SPINAL ANAESTHESIA FOR AN MRI PROCEDURE” The Clinical Proceedings of NIMS, 12:3. July 1997.

21.   “EXPERIENCE IN FIBREOPTIC NASAL INTUBATION FOR TEMPOROMANDI- BULAR  JOINT ANKYLOSIS” Ind. J.Anaesth  43,26 1999.

22.   RADIOLOGICAL ASSESSMENT OF DIFFICULT AIRWAY WITH CLINICAL CORRELATION: A prospective study. Indian Journal of Anaesthesia, February, 2001 Vol. 45 .

23.   LOW BACKAHE-A CLINICAL PROBLEM” in a book “Musculo skeletal system imaging and management by NIMS,publisher Kala jyothi process ltd, 1998.

24.   “ANAESTHETIC MANAGEMENT OF GOLDENHAR’S SYNDROME” published in NIMS Clinical Proceedings.15:1,2000.

25. ”BLOOD SUGAR LEVELS AFTER ADMINISTRATION OF 6% PENTASTARCH-  COMPARISON OF TWO VOLUME LOADS, HETASTARCH AND NORMAL  SALINE” NIMS Clinical Proceedings 15:1.2000.

26.  “NON-VENTILATORY STRATEGIES IN ACUTE LUNG INJURY” J. Anaesth Clin. Pharmacol , vol.16 :4,oct 2000.

27.  “ANAESTHETIC MANAGEMENT FOR THE PATIENTS OF POLYMYOSITIS: TWO CASE REPORTS” NIMS Clinical proceedings 16:2.sept.2001.

28.  Dr. V. Nagendra Nath: “Microbiological Profile of Tracheal Aspirates in patients on long term ventilation” Journal of Anaesthesiology – Clinical Pharmacology vol 8 No.2 pp 125 – 129, April – June, 1992.

29.  S. Manimala Rao, V.Nagendra Nath: “Arterial Blood Gas Monitoring” Indian Journal of Anaesthesia, August , 2002, Vol 46 pages  289 – 297.

30.  Dr. V. Nagendra Nath: Complications of General and Regional Anaesthesia. In  “Obstetric  Anaesthesia” Arya Publications,  First Edition, 2004.

31.  Suhasini T, Prabhakar Reddy, Jyostna Madduri, Manimala Rao S. An unsual method of fibreoptic guided endotracheal intubation.  Journal of Anaesthesiology and Clinical Pharmacology 1999;15:105-107.

32.  Suhasini T, Pratap M, Srinivas M, Rajender Y, Manimala Rao S. Evaluation of Collateral circulation in the foot by pulse oximetry.  Journal of anaesthesiology and Clinical Pharmacology 1997; 13:149-150.

33.  Suhasini T, Murthy NVSS, Rao S.M. Nasogastric tube as a tracheal tube introducer. (Letter) Anmaesthesia 1995 ;50:270.

34.  Gokhale AGK, Suhasini T, Saraswati V et al.  Cold agglutinins and warm heart surgery (Letter).  The Journal of Thoracic and Cardiovascular Surgery 1993; 105:557.

35.  Mantha S, Manimala Rao S, Suhasini T. Use of double lumen endotracheal tube for nonthoracic surgery.  Journal of Anaesthesiology and Clinical Pharmacology 1992;8:163-5.

36.  Suhasini T, Manimala Rao S, Satyanarayana PV. Heparin resistance during cardiopulmonary bypass: A case report.  Clinical Proceedings of Nizam’s Institute of Medical Sciences.

37.  Mantha S, Suhasini T, Manimala Rao S et al.  MgSO4 in phaeochromocytoma surgery.  Journal of Anaesthesiology and Clinical Pharmacology 1990; 6:251-4.]

38.  Mantha S, Suhasini T, Manimala Rao S et al. Anaesthesia for renal transplantation.  Clinical Proceedings of Nizam’s Institute of Medical Sciences.

39.  Manimala Rao S, Suhasini T, Srikanth T etal Serum Cholinesterase levels in Organocompound pesticide poisoning – correlation with the type of compound, morbidity and mortality – to be published in Indian Journal of Critical Care Medicine.

40.  Nifedepine to obtund cardiovascular responses to Intubation.  R. Gopinath et al. J. Anaesth .Clin.Pharmacol.5, 205 (1989).                          

41.  Implications of Combined Calcium & Beta-adrenergic Blockade in cardiac anaesthesia.  ( As co-author). J. Anaesth Clin, Pharmac. 5, 205; (1989).

42.  Profound Beta blockade following neostigmine in a patient on Atenolol.  R.Gopinath et.al.  J. Anaesth. Clin. Pharmacol, 5, 225 ; (1989).

43.  Changes in EF during induction of anaesthesia with two different iv techniques. (As Co-author). Acta Anesthesiol Scand. 1991 Jan; 35 (1): 91-2.

44.  Venous sequelae after i.v. diclofenac.  R. Gopinath  ( C.)  Br.J.Anaesth.,1991 Dec .67(6) ;803 91.

45.  Anaesthesia for Temporomandibular Joint Surgery – A revived technique.  R. Gopinath. Et. al. Ind . J. Anaes.   Dec 1991.

46.  Venous sequelae of diclofenac. R.Gopinath (C) Br.J.Anaesth. 69,332(1992).

47.  Intractable bronchospasm during cardiopulmonary bypass R.Gopinath. et. al. J. of Anaes. Clin. Pharmacol . (April 1992)

48.  Recovery after induction and maintenance of anaesthesia with Sevoflurane /Oxygen in adult outpatients.  A comparison with Propofol / Sevoflurane / Oxygen.  R. Gopinath.  et. al.   Br. J. Anaesth. , 78 ; 461 P,  (1997).

49.  Intractable ventricular fibrillation following aortic cross clamp removal: Intra-aortic Magnesium, a saviour. R.Gopinath et al.  J Cardiothoracic Vasc Anesth. 1999 Dec; 13 (6): 801-2.

50.  Percutaneous tracheostomy and Murphy’s law; an eye for trouble. R.Gopinath et al.  Anesth Analg.1999 Sept; 89 (3) : 670-1.

51.  Pathophysiology of Acute Lung Injury- Symposium On Acute Lung Injury. Proceedings of the Annual Conference of the R.S.A.CP. J. Anaesth. Clin. Pharmacol . Oct  2000.

52.  Topical analgesia for chest drain removal in Cardiac Patients.  Madhavi Singh, R. Gopinath, J Cardiothoracic Vasc Anesth. 2005, Dec.

Public Awareness programmes

CPR for school children                                    -           Oct 16 1992

CPR programme at Gulbarga                            -           Oct 16 1994

CPR for Bank employees                                 -           Oct 16 1996

CPR for paramedical personnel & nurses          -           Oct 16 1998

Ambulance drivers training                                -           Oct 16 2000

Training for Emergency Medicine technicians     -           Oct 2004