Anesthesia

1. Goals

The goal of MD course in Anaesthesia is to produce a knowledgeable and skillful

anaesthesiologist who:

• Is competent to anaesthetize all categories of patients from ASA-I to V with medical problems for every type of elective and emergency surgery.
• Should be able to diagnose and treat acute and chronic pain conditions.
• Should be competent to manage critically ill patients in emergency and ICU requiring routine to advanced monitoring, mechanical ventilation and other interventions.
• Should be aware of the recent advances and developments in medical sciences as related to anaesthesia, analgesia and critical care.
• Should be oriented to principles of research methodology; and
• Is competent to teach acquired skills to medical and paramedical professionals.

2. Objectives

Department of anaesthesia makes sure that the candidate develops in all fronts

i.e. cognitive, affective and psychomotor domain as it is important for anaesthesiologist to work as member/ team leader in various clinical and critical situations in OR and outside OR. Candidate should be able to demonstrate following at the end of training.

• Demonstrate familiarity with diagnostic skills and laboratory procedures relevant to the diagnosis and evaluation of patients under Her / His care.
• Critically evaluate recent medical literature from journals, reference books: monographs update knowledge and adapt therapeutic procedures based on this appraisal.
• Manage administration of anaesthesia to patients of all grades of ASA risk grading and all types of surgical subspecialties both for elective and emergency procedures.
• Demonstrate aptitude and will to remain clear headed and act correctly when faced with critical incidence in the operating room and critical care units.
• Demonstrate the knowledge of ethics and medico legal aspects related to the practice of anaesthesiology and critical care.
• To work in a team and show leadership qualities in dealing with paramedics.

3.Facilities In The Department:-

Peri-operative anaesthesia care of all the patients who are operated at civil hospital including pre operative check up, pre-operative preparation of patient, intra-operative & postoperative anaesthesia care. We also provide our services for monitored anaesthesia care in radiology department & for ECT in psychiatry department. We also provide our services in various post operative ICU”s & medical ICU.

We also provide our services in PARAPLEGIA, DENTAL & OPTHALMOLOGY.

As such we do not have OPD days. In total we have 37 faculty members consisting of 4 Professors , 10 Associate Professors ,16 Assistant Professors and 7 Tutors who are working in various operation theatres in routine hours including DENTAL,PARAPLEGIA & OPTHALMOLOGY operation theatres

• Our Department has a total strength of 70 post graduate students out of which 15 third year resident, 27 second year resident & 28 first year residents who are working round the clock in the hospital under guidance of faculty members.
• Our Department is also providing training of ‘’Life saving Anaesthesia skill for Emergency Obstetrics Care ’’ for M.O. under RCH Project of Government Gujarat
• As such there is no separate ward for Anaesthesia Department in civil hospital in spite of that we provide Pre operative, intra operative & Post operative care
• In civil hospital total 9 Operation theatres & 28 operation tables on which we continuously provide routine & emergency perioperative care .
• We also provide our services for Resuscitation care in the wards & if required managing patient on supportive therapy (Intensive Care) including ventilators.
• We also provide services for various procedures like Central line insertion, RT insertion, IC insertion & Lumbar Puncture.
• Our Department also provides services for VVIP duties. In case of Natural Disasters, Men made Disasters like Floods, Earthquake, Terrorist attack & Bomb blast
• We have worked efficiently to meet the challenges.

4.SUBJECT CURRICULUM:-

• History of Anaesthesia
• Basic Sciences:

1. Respiratory System:

a) Anatomy of the upper airway – nose, pharynx, larynx, tracheso brachial segment.

b) Mechanics of respiration.

c) Physiology of respiration, ventilation/perfusion matching, lung volumes and capacitieschange with age.

d) Lung function Tests – Bedside / Laboratory for obstructive and restrictive lung diseases.

2. Cardiovascular System:

a) Heart and autonomic nervous system.

b) Maintenance of blood pressure

c) Microcirculation – starting forces/

3. Fluid and electrolyte Acid base balance/imbalance

4. Blood gases and acid – base balance

5. Haematology:- anaemia leukemia coagulopathy an Haemoglobuniopathid

6. Immunology related to anaesthesia.

7. Nervous System:-

a) Cranial nerves / nerve plexuses anatomy, special column

b) Physiology of sleep / Sleep disorders

c) Physiology & Pharmacology of pain

d) Physiology and pharmacology of neuromuscular junction.

e) Molecular basis of anaesthesia.

f) Autonomic nervous system – sympathetic and parasympathic

g) Thermo regulation.

8. Endocrinology as related to anaethesia:

a) Function of anterior / posterior pituitary dysfunction.

b) Hyper/Hypothyroidism/Para thyroid.

c) Diabetes mellitus-hypo / hyperglycemia, ketoacidosis, hyperosmolar honeketitic coma.

d) Adrenal cortex / medulla functions/disturbance

9. Pathophysiology of renal failure, renal function tests.

10. Pathophysiology of hepatic failure, renal function tests.

11. Physiology of Vomiting:

12. Pharmacology of anaesthesia drugs and adjutants.

a) Hypnotics, sedatives.

b) Anaethesics, antiemetics, anticonvulsants.

c) Inhabitional anaesthetic agents.

d) Intravenous anaesthetic agents.

e) Muscle relaxants and drug used for reversal.

f) Drugs acting on autonomic nervous system.

g) Local anaesthetics

h) Drugs used for respiratory, Cardiovascular and other diseases.

13. Physics – applied to anaesthesia:

a) Ventilators & Monitors, Gas laws

b) Medical gas supply.

c) Flow meters, vaporisors.

d) Breathing systems, carbon-dioxide absorbers.

e) Suction machines.

f) Electrical fore & explosion hazards.

h) Pollution in O.T.

14. Basic of research methodology and statistics.

· GENERAL ANAESTHESIA

1. Operating rooms complex, ICU design

2. Preanaesthetic preparation, concurrent drug, therapy and premedication.

3. Monitoring during anaesthesia.

4. Anaesthesia administration, endotracheal intubation.

5. Anaesthesia For:-

a) Cardiothoracic surgery ‘

b) Neurosurgery

c) Pediatruc surgery

d) E.N.T. and Ophthalmic surgery,

e) Dental Surgery

f) Outpatient / Daycare surgery

g) Orthopedic and Plastic Surgery,

h) Obstetric and Gynaecological surgery3

6. Emergency anaesthesia.

7. Anaesthesia for patients with:

a) Diabetes mellitus

b) Thyroid diseases

c) Inherited metabolic diseases

d) Obesity

e) Respiratory diseases

f) Cardiac disease

g) Renal disease

h) Geriatric problems

8. Complications of general anaesthesia morbidity and mortality mediolegal aspects

Regional anaesthesia

1. Subarachnaid and epidural anaesthesia, analgesia.

2. Plexus and nerve blocks for upper limb.

3. Plexus and nerve block for lower limb.

4. Nerve blocks for head and beck.

5. Regional anaesthesia for thorax abdomen

6. Surface anaesthesia, infiltration, field blocks.

Anaesthesia for Endoscopic Surgery & Laser Surgery

Management of Acute / Chronic Pain

1. Assessment of pain

2. Perioperative pain

3. Chronic pain syndrome-detection and prevention

4. WHO regime for Cancer pain

5. Acupuncture, tens, bahavioural therapy.

6. Ablative nerve block-desirable know

Intensive care

1. Principles of intensive care

2. Special needs of critically ill patients

3. Nosocomial infections prevention4

4. Nutrition

5. Psychological needs of personal

6. Psychological needs of patient family

7. Trauma care management

8. Basic and Advanced Life support

5.Examination Pattern:- _

Ratio of marks in theory and practical will be equal.

• The pass percentage will be 50%
• Candidate will have to pass theory and practical examinations separately.

A. Theory Examination (Total = 400)

Paper TITLE MARKS

Paper-I Basic Sciences as applied to Anaesthesiology 100

Paper-ll Clinical Sciences as applied to Anaesthesiology 100

Paper-III Principles and practice of Anaesthesiology 100

338

Paper-IV Recent advances in Anaesthesiology including principles 100

of Resuscitation and Intensive care Therapy.

B. Practical and viva voce Examination (Total=600)

Clinical/practical Cases

Long Case (1) 225

Short Cases (2) 150 + Spot Case 75

Oral Viva 2 tables -150

Four sets of stations. Each examiner to award marks out of 50 individually.

• Anaesthesia machine (knowledge of parts, Pre-anaesthesia checking,safety devices etc.) Identification and checking of Breathing Circuits, Ancillary anaesthesia instruments.
• Cardiopulmonary resuscitation
• Anaesthetic and Non-anaesthetic drugs
• Invesigations interpretation: EKG, X-rays (Chest, neck etc.), ABG and others.

6. TEACHING STAFF INFORMATION:-

Professors DR B J Shah (DEAN)

DR I A Chadha (HOD)

DR S K Shah

DR M H Shah

DR V B Rupakar

DR M I Shukla

DR T P Doctor

DR S R Engineer

DR A B Vyas 

Associate Professors DR T D Shah

DR S J Goswami

DR Ramila Jamalia

DR Bhavana Raval

DR Monal Ramani

Assisant Professors DR Anisha Chokshi

DR Naseer Shaikh

DR Seema Gandhi

DR J C Makwana

DR Nilesh Solanki

DR Chandresh Shah

DR Bharat Maheshwari

DR Chirag Patel

DR Kiran Patel

DR Dhara Patel

DR Asit Kothari

DR Tejal Shah

DR Jhanvi Patel

DR Siddarth Parmar

DR Mrunalani Patel

DR Shailesh Badla

DR Vaishali Gautam

DR Reema Vansola

Tutors DR Sonal Bhalwant

DR Sweta Jani

DR Sangita Parikh

DR Kajal Kakkad

DR Daxa Oza

Dr Vibhavi Patel

Dr Deepika Uttarkar

Dr Mahesh Patel

Dr Rajsri Buch

7. Non teaching Staff:-

8. OPD DAY & EMERGENCY DAYS:-

• As such we do not have OPD days. In total we have 37 faculty members consisting of 4 Professors , 10 Associate Professors ,16 Assistant Professors and 7 Tutors who are working in various operation theatres in routine hours including DENTAL,PARAPLEGIA & OPTHALMOLOGY operation theatres
• Our Department has a total strength of 70 post graduate students who are working round the clock in the hospital under guidance of faculty members.

EMERGENCY DUTIES:-