Anaesthesiology

The Department of Anaesthesiology was established in the year 1988 in Sri Devaraj Urs Medical College, Kolar as part of the R L Jalappa Hospital and Research Centre.
Surgery and critical illness are events that are taxing and disturbing to the patients and the entire family. Even as one may have minimal interaction with an anaesthesiologist during surgery, his/her role is pivotal in providing a safe surgical environment. Anesthesiologists constantly strive behind the scenes to make sure that the patients get the best of care during these stressful situations and accelerate their recovery and return to normalcy.
The health care facilities available at RLJH are sophisticated and state of the art. The Operation Theatre complex of RLJH is equipped with 17 major, 2 minor operation theatres and caters to a comprehensive list of specialities that include General surgery , Obstretics, ENT, Orthopaedic and Ophthalmic surgeries and also for super speciality surgical branches such as Neurosurgery, Urology, Pediatric Surgery, Plastic Surgery, Facio-Maxillary Surgery, Joint Replacement Surgeries, Head Neck and General Oncosurgery.
The department also extends its services to the Adult Critical Care unit which comprises of a 36 bedded Intensive Care Unit, which includes 3 isolation cubicles. The unit is well equipped to handle critically ill patients of all specialties.
Our team of anesthesiologists provide a comprehensive and versatile range of services which includes providing anaesthesia, intensive care management, code blue team, labour analgesia, sedation for CT/MRI, transport of critically ill patients and pain management. This is possible only because of a team of highly motivated, skilled, dedicated and experienced team of doctors, nurses and paramedical staff. Hence, we have played a significant role in achieving the goal of RLJH, which is to provide quality tertiary healthcare to the rural population.
Together we work round the clock to provide make sure that we have left no stone unturned in providing the best of care for our patients.

Head of department’s message


Anaesthesiologists are peri-operative physicians and their duty is not only to provide anesthesia inside the operating room, but actually help the surgical team in the process of decision making about the feasibility of operation depending upon the pre-existing medical problems of the patient and the nature of the operation that is planned. Anesthetist optimises the organ function before the operation, maintains the function during the surgical procedure and supports the organs as per requirement after the operation. Broad based knowledge and expertise of different medical specialities apart from anaesthesia, medicine and pain is required to effectively contribute for holistic management of the patient.
Critical care is an emerging super speciality for managing patients who are seriously ill and are in need of sophisticated life support system to salvage them from critical illness.In most intensive care units, anaesthesiologists not only manage patients in ICU but also get involved in ICU administration.
Anaesthesiologists are important members of resuscitation team, attending emergencies, including cardiac arrest and also training medical, paramedical staff and the public in basic and advanced life support (BLS & ACLS). The anaesthetists role is therefore not only vital inside the theatres but, outside the operation theatres as well.
Anaesthetic team of RLJH are striving round the clock to ensure that quality anaesthetic services are provided to all the patients.

Our Services

Anaesthetic Services

Pre- Anaesthetic Services: Our team is intimated well in advance for when a patient is posted for a surgery. We conduct a thorough pre- anaesthetic evaluation and formulate a suitable plan of anaesthesia based on the condition of the patient. The various anaesthetic options available include, but are not limited to General anaesthesia, Neuraxial anaesthesia (spinal and epidural anaesthesia) and Regional blocks (nerve, plexus and fascial plane blocks).The entire process is greatly expedited in case of emergency surgery such as in trauma and caesarean section.
Intra-operative Care: We aim to provide a stable and safe surgical environment along with the surgical team. This is possible with the help of vigilant and sophisticated monitoring of the vital signs. In addition administer a carefully planned combination of drugs and nerve blocks to ensure that you do not have awareness or pain during surgery. In addition we used advanced monitoring using ultrasonography to do FAST scans in emergency, for assessment of fluid status, transthoracic ECHO, in case of difficult neuraxial anatomy and for securing vascular access and invasive blood pressure monitoring.
Post-operative Services:
Our care continues into the post- operative period to ensure a speedy and pain free recovery period. The regional blocks and epidural catheters are used in the post- operative period to provide good pain relief, with minimal adverse effects of pain medications. We also care for high risk post-operative patients in the ICU, ensuring physiotherapy and nutritional support to enhance recovery.

Critical care

The department also extends its services to the Adult Critical Care unit. Currently, RLJH is running 36 bedded state of the art, critical care unit which includes 3 isolation cubicles. The unit is well equipped to handle critically ill patients of all specialties. Facilities for invasive and non-invasive mechanical ventilation, invasive and non-invasive monitoring, in-house haemodialysis facility for 4 ICU beds are available. There is a facility for nurse call system and central monitoring system in the ICU. Initial assessment and re-assessment of critically ill patients with point of care Ultrasonography. Ultrasound guided central venous, arterial catheterization and regional nerve blocks are done in the unit. Other facilities in unit include ABG, portable x-ray, ECG, ECHO. Medical imaging and laboratory information can be digitally accessed using PACS (Picture Archiving Communication System) and LIS (Lab Information System). We are honoured to be a part of fighting the COVID 19 pandemic as this unit was dedicated to the care of critically ill COVID-19 patients and another 14 bedded non- COVID ICU was established for the other patients.

Pain and Palliative Care

Apart from catering to services in the OT & ICU, we also offer Pain & Palliative Care for in – patients. Labor analgesia for the parturient, epidural steroid injections for backache are provided. Ultrsonography or Fluoroscopy guided regional nerve blocks are provided for pain management. Transdermal opioid patches are also available for pain control. RLJH has a well-established oncosurgery team caring for a good number of cancer patients. We are also actively involved in cancer pain management, providing post- operative pain relief and palliative pain relief through enteral and parenteral opoids.

Cardio-pulmonary resuscitation

We are trained and active members of the code Blue team and are available 24x7 to resuscitate patients in the hospital. Two of our team members are AHA certified BLS/ACLS instructors and are actively involved in training the students. Our team members are involved in supervision and auditing of the code Blue process, ensuring participation at all levels.

  • In the operation theatre, we have
    • State-of-the-Art Anaesthesia work stations
    • Paediatric and adult flexible fibre-optic bronchoscopes
    • Video laryngoscopes
    • Ultrasonography machine for peripheral nerve blocks
    • Automated Gas Scavenging System
    • Automated External defibrillators in all Operation Theatres and ICU
  • In the ICU, we have
    • Ventilators with newer modes of ventilation
    • Blood Gas Analyser
    • Haemodialysis in ICU
    • High Flow Nasal Oxygen therapy (HFNO)
    • Negative Pressure Isolation Cubicles
    • Point of care ultrasonography in ICU

Faculties

DR SURESH KUMAR .N MBBS, MD. IDCCM Professor & HOD
Dr Dinesh K MBBS, MD, MNAMS Professor
DR RAVI M MBBS, DA, DNB, MNAMS, FIMSA Professor
Dr. KIRAN. N MBBS, DA, MD Professor
Dr. SUJATHA M P MBBS, DA, MD, DNB Professor
Dr. LAVANYA KAPARTI MBBS, DA, MD Professor
Dr. VISHNU VARDHAN V MBBS, MD Associate Professor
Dr. SUMANTH T MBBS, MD Associate Professor
Dr. Abhinaya Manem MBBS, MD Assistant Professor
Dr. Ankitha Sunand MBBS, MD Assistant Professor
Dr Amulya N MBBS, MD Assistant Professor
Dr. Huchappa K. V. MBBS, DA Senior Resident
Dr. Vidyashree C MBBS, MD Senior Resident
Dr. Dhanalakshmi M MBBS, MD Senior Resident
Dr. G. Sai Yashaswini MBBS, MD Senior Resident
Dr. Yashwanth P MBBS, MD Senior Resident
Dr. Gagan M MBBS, MD Senior Resident

Break through cases

Pre- operative picture of patient showing the deranged airway anatomy of patient and fiberoptic view of the glottis showing airway edema

FAQs
What is anaesthesia?
Anaesthesia stops you feeling pain and unpleasant sensations. It can be given in various ways and does not always need to make you unconscious
Why is pre-anaesthetic check (PAC) required? Do you give the patient a trial of anesthesia during PAC?
Anesthesia can thus be a complex combination of many medical activities being done at the same time. It is very important to know before hand, the patient’s general medical condition before an operation is done. It is important to know the risks to the patients’ health (& life) that can threaten him during and after the operation. This knowledge's are acquired by anesthesiologist by doing examination & testing of the patient, before he is actually anesthetized. PAC is a detailed medical, surgical, laboratory & radiological evaluation of patient’s condition. No trial of anesthesia is given during the PAC.
Do I have to come with an empty stomach for PAC check, what I need to bring to facilitate PAC?
There is no need to come fasting for PAC. You must take morning dose of all prescribed medications.
What do you do to give anesthesia ?
Depending upon the needs of operation to be done, general (full) or regional (in the area to be operated) anesthesia can be given.
What do I need to know about general anesthesia?
General anesthesia usually acts on the brain leading to overall relaxation of the body. Anesthetic drugs will either be given through an intravenous line which will be put just before you’re taken for surgery or through inhalation i.e by breathing in the anesthetic gases.
Would I feel any pain during surgery with General anesthesia?
No, you will not feel any pain during the entire surgery.
Why is there a risk even in otherwise healthy people?
The drugs used in anaesthesia potentially do have some side effects. Moreover, the human body reacts differently to different drugs and procedures in spite of using them in optimal doses. Hence, there is an inherent risk associated with anaesthesia.
What is the intensive care unit?
The intensive care unit (ICU) is a special part of the hospital that provides care to patients with severe, life-threatening injuries or illnesses. ICUs have higher nurse-to-patient ratios than other parts of the hospital. They also can provide specialized treatments, such as life support.
It is a special area of the hospital where the focus is on intense observation and treatment with increased staff and resources. This helps respond immediately to emergency conditions. The trained nurses and doctors with the help of a multidisciplinary team ensure that the critical patient rapidly recovers and goes home to their family.
What kinds of illness require critical care?
Any illness that threatens life requires critical care. Poisoning, surgical problems, and premature birth are a few causes of critical illness. Critical illness includes:
  • Illness that affects the heart and all of the vessels that carries blood to the body, such as:
    • Myocardial infarction (heart attack)
    • Shock
    • Arrhythmia
    • Congestive heart failure
  • Illness that affects the lungs and the muscles used for breathing, such as:
    • Respiratory failure
    • Pneumonia
    • Pulmonary embolus
  • Illness that affects the kidneys, such as:
    • Kidney failure
  • Illness that affects the mouth, esophagus, stomach, intestines, and other parts of the body that carry food, such as:
    • Bleeding
    • Malnutrition
  • Illness that affects the brain and the spinal cord and nerves that connect the brain to the arms, legs, and other organs, such as:
    • Stroke
    • Encephalopathy
  • Infection caused by a virus, bacteria, or fungus, such as:
    • Sepsis
    • Ventilator-associated pneumonia
    • Catheter-related infection
    • Drug-resistant infection
  • A serious injury also requires critical care, whether the result of:
    • A car crash
    • A gunshot or stabbing wound
    • A fall
    • Burns
What sort of medical care happens in the ICU?
Patients in the ICU are very sick. They are often connected to many monitors that allow healthcare professionals to monitor their vital signs on a minute-to-minute basis. Patients often have intravenous tubes (IVs) in their arms and neck so that medications and fluids can be delivered directly into their veins. They often have a tube placed into the body to drain and collect urine. Some patients are also connected to life support machines, such as breathing machines or dialysis machines. Patients may also have a tube through their nose or mouth to deliver liquid food directly into the stomach. In order to tolerate the tubes, IVs, and life support, many patients receive sedating medications.
Who needs to be treated in an ICU ?
Any patient who needs close monitoring and treatment needs to be admitted to an intensive care unit. Anyone with breathing difficulty requiring the use of special machines called ventilators , patients with low blood pressure needing medicine to treat it, infections causing septic shock as well as patients who need close observation after certain surgeries like heart bypass, trauma surgery and brain surgery are some examples.
What is life support?
Life support refers to various therapies that help keep patients alive when vital organs are failing.
Most often, when people say “life support,” they are referring to a mechanical ventilator, which is also known as a “breathing machine.” Mechanical ventilation helps patients breathe by pushing air into their lungs. The mechanical ventilator is connected to the patient by a tube that goes through the mouth and into the windpipe. Patients who need less lung support than mechanical ventilation may simply have a mask over their mouths and nose to deliver oxygen.
Dialysis is another form of life support; it filters toxins from the blood when kidneys are failing.

Patient Education material - Click Here