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  1. About Us
  2. Department Activity
  3. Education & Courses
  4. Patient Information
  5. Contact Us

The Department of Anaesthesia comprises of the Anaesthesia Service, the Intensive Care Unit and the Pain Service managed by fifteen consultant anaesthetists and over 40 residents including post graduate students. Our involvement supports our belief that the responsibility for anaesthetic management entails patient care throughout the peri-operative period.

The Department is affiliated to the Homi Bhabha National Institute (Deemed University) and has MCI recognised postgraduate diploma (D.A) and degree courses (M.D.) in Anesthesia Seven staff members are recognised teachers for the above courses.

Several members of the department are specialists in their respective field. The department is recognised nationwide for it's expertise in the anesthetic management of surgical, diagnostic and therapeutic procedures, pre- and post operative care including pain therapy and intensive care of cancer patients .The department attracts several qualified anesthetist from different parts of the country who wish to undergo advanced training in different areas.

The Department has a strong academic inclination. Many members of the department have acquired foreign qualifications or have received specialisation training abroad and have varied research interests. Members have made important contributions in prestigious national and international journals. The Department also boasts of an excellent annual postgraduate teaching program in anesthesia (Anesthesia Review Course) for students from various parts of the country and also holds in house bi-weekly academic meets.

Intensive Care Unit

The Intensive Care Unit consists of an 11 bedded critical care area and a 22 bedded recovery room/step down unit. The unit has 24 hour coverage by a consultant and junior medical staff. Several consultants of the department rotate in the ICU on a monthly basis, many of whom have received specialisation training in intensive care at various centers abroad. The unit aims at providing high quality intensive care for the critically ill cancer patients.

Patients include critically ill surgical patients, patients with acute medical illness, co-morbid conditions and patients with hematological malignancies, neutropenia and chemotherapy related complications. These patients have complex problems like Sepsis, ARDS, and multi-organ failure, many having acute haemodynamic, respiratory and metabolic derangements.

On an average the ICU receives over 650 critically ill patients every year with a mean APACHE II Score of 15. The mortality is about 35% with an SMR (Standardised Mortality Ratio) of 1.4 (2005 figures)

The unit is equipped with well trained intensivists and state of the art amenities to provide the entire range of intensive care services including airway management, mechanical ventilation, circulatory support including advanced haemodynamic monitoring, renal support with dialysis or hemofiltration, enteral /parenteral nutrition, blood component therapy, sedation, pain relief and other supportive measures.

Emphasis is given to the importance of a multidisciplinary approach to critical care The unit has a team of specialised nurses, physiotherapists, dieticians, technical and paramedical staff who are actively involved in the supportive care of the patients. The ICU also takes consults from various services as and when required.

The ICU has several quality assurance programmes and ongoing audits. Severity scoring of patients is done using APACHE II, SAP II, Groegar and SOFA scores and entered into a database. On going collection and analysis of microbiology culture data is used to identify ICU infection patterns. Various protocols and audits including one for airway accidents and outcome of patients with haematological malignancies have been implemented to evaluate and improve the quality of care in the ICU.

The ICU runs a Cardiac Arrest Team that was started in the hospital in December 2002. The team is actively involved in the resuscitation of all in hospital cardiac arrests. Systematic reporting of all cardiac arrests, crash cart inspections and on going training of hospital medical and paramedical staff are other activities of the ICU team.

Anesthesia Service

The Anesthesia service is involved with the peri-operative management of patients undergoing cancer surgery in the operation theatre complex for routine and emergency procedures, as well as in peripheral areas including paediatric radiotherapy, brachytherapy, endoscopy and radiology.

Our operating rooms are arranged geographically by surgical subspecialty and include 11 theatres for major and 2 for minor surgical procedures including laser surgery. Excellence in clinical care has always been an essential mission of our service. A work environment of mutual trust, respect, understanding and appreciation of each others needs, between surgeons and anaesthetists is encouraged. In the year 2005, we administered anesthetics to over 6047 patients and this volume of patient care has continued.

Major surgeries at our center include pulmonary, oesophageal and mediastinal tumour surgery, liver resections, pancreatectomy, adrenalectomy, radical cystectomy and renal surgery. Hemipelvectomy and limb salvage surgery are the major orthopaedic surgeries performed. Major head and neck surgeries include laryngectomy, laryngopharygectomy with gastric transposition, composite resections and skull base surgery. Airway surgery includes laser surgery for laryngeal / bronchial lesions and tracheal resections. Complex micro vascular reconstructive surgeries are also undertaken and a growing number of minimally invasive procedures like laparoscopic APR, laparoscopic Wertheim's hysterectomy, laparoscopic nephrectomy / cystectomy, VATS (Video Assisted Thoracoscopic Surgery) etc. are being performed.

The anesthetic management of patients undergoing extensive cancer surgery offers challenging problems including the management of difficult airway, acute hemorrhage, massive blood transfusion, anesthesia for emergency surgery in patients with severe sepsis and hemorrhage. The immense clinical experience gained in administering anesthesia to these patients, monitored anesthesia care, performing invasive procedures and experience in invasive haemodynamic monitoring attracts qualified anesthetists from around the country to undergo specialisation training in anaesthesia at our center.

Recovery Room

( 24 hour service) All patients after major or minor surgical procedures are shifted to the recovery room for observation before being transferred home or to the ward. During this period they are monitored by a team of anaesthetists and nurses, who perform an initial post-operative evaluation, pain management, manage any acute post-operative event and also decide when the patient is ready for transfer.

Pre-operative Clinic

The department runs a clinic to conduct pre-operative anaesthetic evaluation of patients planned for surgery. A team of anaesthetists evaluate the patient's medical condition and formulate an anaesthetic plan, taking into account the patient's physical condition. This is then discussed with the patient, including the risks involved and details of any procedures likely to be performed in the peri-operative period.

General OPD (No. 178 GJB Bldg.)
Timing 9.15am - 1.30 pm (Monday to Friday)

Private OPD (No. 39 Main Bldg.)
Timing 9.15am - 1.30 pm (Monday to Friday)

Pain Service

The Pain Service looks after Acute Pain Management and Chronic Cancer Pain. Several consultants of the department are actively involved in pain management and rotate in the service on a monthly basis.

Acute Pain Service

The Acute pain service looks after post-operative pain after major surgeries and all other acute and acute on chronic pain conditions. Epidural analgesia and Patient Controlled Analgesia (PCA) are employed to relieve pain.

The Pain team consists of a pain consultant, a pain nurse and a pain resident. Pain medications are reviewed and readjusted accordingly, with the goal of keeping the pain scores below three. APS strives to reduce the incidence of severe pain to less than 10% in the ward. During 2006 about 1250 patients were treated by APS for post-operative pain using PCA, Epidurals etc.

The Pain Clinic

The Pain Clinic at TATA MEMORIAL HOSPITAL is one of the oldest pain clinics in the country. More than 1000 patients were managed in the pain clinic in the year 2006 with an over 800 patients follow up.

Chronic Cancer pain is managed using a multimodal approach, ranging from the use of oral analgesics including NSAIDs, co-analgesics, various forms of morphine, transdermal fentanyl patch to neurolytic nerve blocks given under fluoroscopic guidance.

The Pain Service actively supports and participates in the activities of the Palliative Care Clinic where treatment is offered for a variety of symptoms affecting those patients with advanced cancer.

Pain Clinic Timings
General OPD (No. 178 GJB Bldg.)
Timing 9.15am - 1.30 pm (Monday to Friday)

Private OPD (No. 39 Main Bldg.)
Timing 9.15am - 1.30 pm (Monday to Friday)

Post Graduation Education

Degree (M.D.) and Diploma (D.A.) Courses in Anaesthesia

The Department is affiliated to the Homi Bhabha National Institute (Deemed University) and is recognised for both postgraduate degree (M.D.) and diploma (D.A) courses in Anaesthesia (Formally affiliated to Maharashtra University of Health Sciences - MUHS). Seven staff members are recognized teachers for the above courses. The department receives seven M.D. (3 year course) and five D.A. (2 year course) students in anaesthesia every year. The designation of the post graduate student is 'Junior Registrar I, II or III' depending on the year of residency respectively.

Post Graduation Teachers

The following seven faculty members of the department are MCI recognised teachers for post-graduate diploma (D.A) and degree courses (M.D.) in Anaesthesia of the Homi Bhabha National Institute (Deemed University).

Dr. Raman Sareen M.D, D.A. Professor and Head of Department
Dr. Kailash Sharma M.D,D.A Professor
Dr. J.V Divatia M.D Professor and Officer in charge of ICU
Dr. R.P.Gehdoo M.D,D.A Professor
Dr. P.N.Jain M.D,MNAMS Professor
Dr. Vijaya Patil M.D,D.A.(CPS) Additional Professor
Dr. Atul Kulkarni M.D Additional Professor

Senior Registrar Posts

Eligibility and Application

Senior registrar (SR) posts are available for a minimum period of one year (2 posts of 6 month duration) to those who have an M.D. (Anaesthesia) and/or D.N.B. (Anaesthesia) qualification from an MCI recognised institute. Newspaper advertisements for these posts are made about 2-3 months prior to the selection. The term commences on the 1st of September and 1st of March every year .Candidates are selected for the post following an interview, based on their experience and merit. SR I, II or III designations are given to the senior registrars based on the number of years completed after MD/DNB.
(Respectively in our department). JR III post is available for candidates who have done MCI Recognised post graduate diploma in Anaesthesia (D.A.) Application for these posts should be forwarded to the hospital HRD department directly. Selected candidates will be under a bond for a minimum period of 6 months.

Post continuation

Continuation in the department as senior registrar after completing one year is subject to the discretion of the Head of the Department, based on the candidate's work and conduct during the one-year period. Those interested is continuing may apply to Head of the Department one month prior to post completion.

Locum Posts

Locum senior registrar posts, for a minimum period of one month may be available from time to time against resignation or long leave of the senior registrars. Applications for locum posts may be made directly in the Anaesthesia department office. Eligible candidates will be contacted by the department office, as and when a locum post is available. Continuation beyond the locum period up to the end of the term is subject to the requirement of the department and the discretion of the H.O.D. For continuation into the next term, fresh applications should be made for senior registrar post to the H.R.D. office as per the newspaper advertisement requirements.

Registrar Rotation

All senior and junior registrars follow a monthly rotation in various areas like major and minor operating rooms, pain, recovery room, pre-op clinic etc. This rotation usually includes an ICU posting once in 3 months. Residents may also be rotated for a month at ACTREC (Advanced Centre for Treatment, Research and Education in Cancer) at Kharghar, which is the satellite institution of TMC .

Working Hours

O.T. posting

Work in the O.T. begins at 8.30 am and continues till the last case is shifted to the recovery room in the evening (not earlier than 4.45 pm) from Monday to Friday and half day (not earlier than 1.45 pm) on alternate Saturdays. One weekend ICU shift is done by the O.T. anaesthetist per month.

ICU posting

Registrars are posted in ICU once in every 3 months. Registrars work in 2 shifts – The morning batch works from 8.30 am to 7.00 pm and the evening batch from 7.00 pm to 8.30 am (Monday to Friday) which is alternated every week. On weekends the ICU registrar is required to do any one shift as designated.

Emergency duties

Registrars posted in O.T. will be required to do approximately 3-4 emergency duties per month from 4.45 pm to 8.30 am in addition to their routine O.T. work.

Orientation Programme

An orientation programme is conducted by the department for all newly joined residents.

A 'Handbook for Anaesthesia Registrars' will be available in the department office after appointment for information Further information related to the registrar post, can be obtained from the hospital HRD section.

Courses Conducted by the Department

1. Anaesthesia Review Course (ARC)

Anaesthesia Review Course, now, popularly known as ARC, was started in 2004. We felt that there was a lack of a CME course for postgraduate students which will help them prepare for their postgraduate examination. The purpose of ARC is thus to prepare the postgraduate student to face the examination with confidence. The course material that is given to the delegates gives the students a sound base from which to embark on their further studies. The anaesthesia machine and instruments is another neglected area in postgraduate teaching, hence we always attempt to rectify that through a hands on workshop on these topics with eminent faculty to facilitate interaction between the delegates and faculty at the workstations, we limit the number of registrations. The response to this annual CME has been overwhelming and enthusiastic all these years. For further information, the students can contact:

Dr. Atul Kulkarni
Anaesthestist & Additional Professor
Dept. of Anaesthesiology, Critical Care & Pain
TATA MEMORIAL HOSPITAL, Parel
Mumbai - 400 012.
Phone no. 098690 77526 and 022 -24177049
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

2. THEMATICC -Tutorials in Haemodynamic Monitoring & Therapy in Critical Care

Haemodyanmic monitoring is an essential area in the management of patients under anaesthesia and intensive care. As there was no comprehensive course dealing with all aspects of haemodynamic monitoring, interpretation and appropriate therapeutic approach, we commenced this CME as a joint venture with the Mumbai Branch of Indian Society of Critical Care Medicine. During the workshop, through hands-on interactive sessions at the workstations with experienced faculty, we deal with both basic and advanced haemodynamic monitoring modalities. At the end of the course we expect the delegates to have learnt physiologic principles involved in monitoring modalities, understood role and limitations of different modalities of haemodynamic monitoring in different pathological conditions and to be able to formulate appropriate therapeutic strategies based on available monitoring. In order to facilitate maximum interaction between delegates and faculty, we usually limit the number of registrations to 60 each year.

Dr. Vijaya Patil
Anaesthestist & Additional Professor
Dept. of Anaesthesiology, Critical Care & Pain
TATA MEMORIAL HOSPITAL, Parel
Mumbai - 400 012.
Phone no. 098690 77526 and 022 -24177049
E-mail: This email address is being protected from spambots. You need JavaScript enabled to view it.

3. ICU Technician Course

Duration- One Year Certificate Course (starting in January each year)
No. of Seats – 10 seats
Eligibility- BSc. in Physics, Chemistry, Microbilogy, Zoology , Botany, other Life Sciences OR HSC with CMLT
Age Limit -35 years

Course Objectives - The course will provide an outline of, Anatomy, Physiology, Microbiology and training in electrical and electronics to improve the students understanding of the technical and diagnostic procedures used in ICU with special emphasis on applied aspects. There would be extensive coverage of theory as well as practical aspects in both basic life sciences as well as advanced technology used in modern ICUs.

Clinical Training – Students will be given training in the ICU under supervision where they would undertake graded responsibility of patient care. They would also be rotated through the operation theatre to understand airway management. The working of modern state of art equipments like ventilators, hemodynamic monitors etc. would be explained and taught by engineers working in the field.

* Age limit and Eligibility may be relaxed in case of departmental and sponsored candidates

For further information contact:

Dr. Vijaya Patil
Anaesthestist & Additional Professor
Dept. of Anaesthesiology, Critical Care & Pain
TATA MEMORIAL HOSPITAL, Parel
Mumbai - 400 012.
Phone no. 098690 77526 and 022 -24177049
E-mail:This email address is being protected from spambots. You need JavaScript enabled to view it.

In-House Teaching Programmes

Anaesthesia

  • 1Anaesthesia Post Graduate Teaching Programme – Case presentations,lectures,group discussions on topics related to post graduate training are taken under consultant supervision on Thursdays between 8.15 am to 9.00 am
  • 2Anaesthesia Clinics –Lectures on topic of clinical interest in Anaesthesia are taken for the residents by consultants on Wednesdays between 3.00 pm and 4.00 pm
  • 3Anaesthesia Journal Club – Interesting articles in Anasthesia are presented and discussed by department consultants on the 1st and 3rd Fridays of the month between 3.00 pm and 4.00 pm

Critical Care

  • 1Case Discussion - Interesting ICU cases are discussed in the ICU among department consultants and registrars working in the ICU on Mondays between 3.00 pm and 4.00 pm.
  • 2Journal Club – Interesting articles in critical care are presented and discussed among the consultants in the department on the 1st and 3rd Tuesday of the month between 3.00 pm and 4.00 pm.
  • 3Critical Care Clinics - Lectures on key topics in Intensive care are taken for the registrars by different consultants from the department on the 2nd,4th and 5th Tuesday of the month between 3.00 pm and 4.00 pm.

Pain

Acute /Chronic Pain Clinics -lectures are taken for residents on pain topics ranging from assessment to treatment using all specialised techniques by consultants interested in pain management every Thursday between 3.00 pm - 4.00pm

ISCCM Post Graduate Diploma in Critical Care Medicine

The ICU is a recognised training unit for the ISCCM Diploma in Critical Care Medicine ( One Year Course) for a period of Six months. Two seats are available in the months of february and August each year. Applications for the post should be addressed to the Head of Department and sent in by the first week of January and July respectively.

Details about the ISCCM Diploma course are available on the following website.

http://www.isccm.org/ISCCM/Certificatecourse.aspx

YOUR ANESTHESIA EXPLAINED

This booklet provides some information about anesthesia & may answer a few queries regarding anesthesia. If you have any further questions, we would be happy to answer them.

What is anesthesia

Anesthesia is given so that you do not feel pain or other sensations during an operation.

Types of Anesthesia

Anesthesia can be given in various ways and does not always make you unconscious.

Local anesthesia is given in the form of an injection that numbs a small part of your body. You remain conscious but free from pain.

Regional anesthesia: A local anesthetic is used to numb a larger or deeper part of your body, for example an arm or a leg. The common regional anesthetics are spinal and epidural anesthesia. They involve injections in the back to remove feeling from the waist downwards. You stay conscious but free from pain. Epidurals may be used during and/or after surgery for pain relief.

General anesthesia: You are unconscious and will feel nothing for the duration of your operation.

Sedation is the use of small amounts of medication to produce a 'sleep-like' state.

Sedation relaxes you during an investigation or procedure which may be unpleasant or painful (such as an endoscopy) but where your co-operation is needed. You may remember very little or nothing at all of the procedure. If you are having a regional or local anesthetic, you may be given some sedation as well.

Combining types of anesthesia

Anesthetic drugs and techniques are often combined so as to make you comfortable during an operation .e.g;

  • Regional anesthesia may be given along with general anesthesia to provide pain relief during & after the operation.
  • Sedation may be used with regional anesthesia. The regional anesthesia prevents you from feeling pain, and the sedation makes you feel drowsy and relaxed during the operation.

Anesthetists are doctors who have had specialized training in

  • providing anesthesia
  • treatment of pain
  • care of very ill patients (intensive care), and
  • emergency care

Your anesthetist is responsible for:

  • your wellbeing and safety throughout your surgery
  • giving your anesthesia
  • planning your pain relief
  • managing any blood transfusions you may need during an operation

Before admission to the hospital for an operation you need to know the following things before your operation. If you smoke, stop smoking several weeks before the operation. The longer you can give up the better. Smoking reduces the amount of oxygen in your blood and increases the risk of breathing problems during and after an operation. If you have loose or broken teeth, or crowns/caps that are not secure, they may be further damaged during the anesthesia If you have a long-standing medical problem such as diabetes, asthma, hypertension, thyroid problems or epilepsy, you may need to undergo some checkups to ensure that they are under control.

The anesthetist and the team

Anesthetists work closely with surgeons and other theatre staff. Operation theatre staff helps the anesthetist and take part in your care. Trained staff in the recovery room will take care of you after your operation until you are ready to go back to your ward.

The pre-assessment clinic (PAC)/ Health check-up before your anesthesia

Is managed by the Department of Anesthesia, Critical Care & Pain & attended by an Anesthesia Consultant & a junior doctor. You will be asked a number of questions to check your health before your operation. The questions will be about:

  • your general health and fitness
  • any serious illnesses you have had in the past
  • any problems with previous anesthesia
  • whether you know of any family members who have had problems with anesthesia
  • any pains in your chest
  • any shortness of breath
  • any heartburn/acidity/reflux
  • any pains you have which would make lying in one position uncomfortable
  • any medicines you are taking, including herbal remedies and supplements you may have been prescribed
  • any allergies you have
  • any loose teeth, caps, crowns
  • whether you smoke/ drink alcohol or chew tobacco

If you are taking any pills, medicines, herbal remedies or supplements, please bring these with you to the PAC. It will be helpful to your anesthetist.

If you have any allergies, kindly inform the doctor

You may require more tests/ investigations after your checkup and may have to return to the pre-assessment clinic once again with the results of the tests asked for.

The pre-assessment clinic is the right place to ask questions about the anesthesia and discuss your worries regarding the same (if you have any).

On the day of your operation

  • Nothing to eat or drink – fasting ('Nil by mouth'/ NBM)

You must follow the instructions about fasting. If there is any food or liquid in your stomach during your anesthesia, it could come up into your throat and go into your lungs. This could cause choking, or serious damage to your lungs.

  • Your normal medicines

You should continue to take your normal medicines up to and including the day of surgery, unless your anesthetist or surgeon has asked you not to. There are exceptions. For example, if you take drugs to stop blood clotting (anticoagulants), aspirin, and drugs for diabetes or herbal remedies, you will need specific instructions. If you are not sure, kindly ask your anesthetist or surgeon & they will advise you accordingly.

The choice of anesthesia depends on:

  • your operation
  • your physical condition

Premedication

Medication which is sometimes given before an anesthetic, May be a tablet or an injection. It helps to;

  • reduce or relieve anxiety

A premedication may make you drowsy after the operation.

Blood transfusion

During an operation, you may lose some blood. Your anesthetist can usually make up for this blood loss by giving you other types of fluid (saline) into a vein through a drip.

You will be given a blood transfusion only if your anesthetist thinks it necessary. You will be informed by your doctor about the possibility of a blood transfusion & you must ensure the presence of donors (relatives) prior to the operation.

Why does the anesthetist postpone some operations?

Occasionally, your anesthetist might find something about your general health that could increase the risks of your anesthesia or operation. It might then be better to delay your operation until the problem has been reviewed. This would be less likely if you have been to a pre-assessment clinic. The reasons for any delay would always be discussed with you at the time.

Your anesthetist's main concern is your safety.

Getting ready for 'Operation theatre'

Here are some of the things that you may be asked to do to get yourself ready for your operation

  • Bath or shower: before your operation will clean your skin and reduce the risk of infection.
  • Do not use any makeup, body lotion or cream as they prevent dressings from sticking to your skin properly.
  • Remove any nail polish and jewellery (bangles, ear-rings, toe/finger rings) that you may have on you. If you cannot remove your jewellery, it will need to be covered with tape to prevent damage to it or to your skin.
  • You will be asked to remove all your undergarments and wear the hospital gown given to you.

You can wear your glasses, hearing aids and dentures to go to the operating theatre. If you are having a general anesthesia, you will need to remove them in the anesthetic room to make sure they are not damaged or dislodged while you are anaesthetized. They will be handed over to your relatives outside the operation theatre. If you are not having a general anesthesia, you can keep them in place.

When you are called for your operation

You will be taken to the operation theatre on a patient trolley by a ward boy. One of your relatives may accompany you to the main door of the operation theatre complex.

The operating theatre complex

The operating department includes waiting area, operating theatres and a recovery room. Operating theatres are brightly lit and may have no natural light. The theatres may also be quite cold.

The waiting area

You will now be asked to get onto a theatre trolley. Theatre staff will check your identity, your name and date of birth, and will ask you about other details in your medical records

The operation room

This is often a busy place, with staff bustling to get ready for your surgery and noises echoing around. Music may be playing. You will be moved from your trolley onto the operation table.
It is here that your anesthetist will prepare you for your anesthetic. All the checks you have just been through will be repeated once again.
If you are having a general anesthesia, you will now need to remove your glasses, hearing aids and dentures to keep them safe
To monitor you during your operation, your anesthetist will attach you to machines to watch:

  • your heart: sticky patches will be placed on your chest (electrocardiogram or ECG)
  • your blood pressure: a blood-pressure cuff will be placed on your arm
  • the oxygen level in your blood: a clip will be placed on your finger (pulse oximeter).
More monitoring may be needed for major operations

IV cannula

Your anesthetist will need to give you medications & saline into a vein. A needle will be used to put a thin plastic tube (a 'cannula') into a vein in the back of your hand or arm. Sometimes, it can take more than one attempt to insert the cannula. Saline will be given through a drip into your cannula during your operation. If you need blood during the operation it will be given to you through the cannula.
Regional anesthesia (Spinal/Epidural/Nerve blocks)
Spinals or epidurals, the most common regional blocks, are used for operations on the lower half of your body.
Spinals are single injections which take only a few minutes to work and last about two hours.

Epidurals can take up to half an hour to work but can be used to relieve pain for hours and sometimes days after your operation.
Your anesthetist will explain the procedure of a regional anesthetic to you prior to your anesthesia.
Local anesthesia will be given to help reduce the discomfort of the injection for the block. It can take more than one attempt to get the needle in the right place so that the area is properly numbed. Your anesthetist will ask you to keep quite still so he or she can give you your local or regional anesthetic block. If you move during the block, you may make it difficult for your anesthetist. You are requested to kindly co-operate with your anesthetist. You may notice a warm tingling feeling as the anesthetic begins to take effect. It is common to feel as though the part of your body which is anaesthetized does not belong to you. Your operation will go ahead once the area is numbed.
Local and regional anesthetics are usually given to you while you are conscious. You can

  • help your anesthetist get you into the correct position
  • tell your anesthetist if the needle causes pain
  • tell your anesthetist when the anesthetic is taking effect.
The type and place of a local or regional anesthetic injection will depend on the operation you are having and the pain relief you will need afterwards.

General anesthesia

There are two ways of starting a general anesthesia;

  • anesthetic drugs may be given through the cannula (this is generally used for adults); or
  • you can breathe anesthetic gases and oxygen through a mask, which you may hold if you prefer.

You may have a light-headed feeling and will lose consciousness within a minute or so. It might hurt when anesthetic drugs are given through your cannula.

After your operation

You will be moved from the operation room to the recovery area by your anesthetist. Recovery staff will continue to monitor your blood pressure, oxygen levels and pulse rate. Here;

You may have a tube in your nose (if you have undergone some operation on your head or neck) to help you breathe. This tube stays in place till the next morning, when it is removed.

  • Oxygen will be given through a lightweight clear-plastic mask, which covers your mouth and nose.
  • If you feel any pain, let the staff in the recovery know so that they can give you some pain killers.
  • If you feel sick, you may be given drugs which will help this.
  • Depending on the operation you have had, you may have a urine catheter. This is a thin soft tube put temporarily into the bladder to drain it.

If you have had a local or regional anesthesia

It will take some hours for feeling to return to the area of your body that was numb. You may feel a tingling sensation as the feeling returns. Until the block wears off you will feel fine, but once it wears off you will start to feel the pain.

Let the recovery staff know if you are feeling any pain, so they can provide the necessary pain killers

High Dependency Unit (HDU) or the Intensive Care Unit (ICU)

After a major operation, you may be taken to the HDU or ICU. If this is planned, it will be discussed with you beforehand. You may remember little about your stay in ICU. This is because you will be receiving sedation and other medicines to help you recover.

Back to the ward

Once the recovery staff is satisfied that you have safely recovered from your anesthetic, and all your observations (such as blood pressure and pulse) are stable, you will be sent to your ward.

It is important that you ask for help:

  • when you first get out of bed (although you may feel fine lying in the bed, you may feel faint or sick when you first get up)
  • if you have had a spinal or epidural, as your legs may still be weak or numb for some hours. They may not regain their full strength for about 12 hours. Kindly do not get out of your bed without assistance.

Pain relief

Good pain relief is important.

  • It avoids the suffering
  • helps you recover more quickly.
  • helps prevent complications (chest infection & blood clots in veins)

If you can breathe deeply and cough easily after your operation, you are less likely to develop a chest infection.

If you can move around freely, you are less likely to get blood clots (deep-vein thrombosis or DVT) in your legs.
It is much easier to relieve pain if it is dealt with before it gets bad. So, ask for help as soon as you feel pain, and continue the treatment regularly.

Pain relief can be given in the following way:

  • Tablets or liquids to swallow

These are used for all types of pain. They take at least half an hour to work and should be taken regularly. You need to be able to eat, drink and not feel sick for these to work.

  • Injections

These are often needed, and are given either into a vein for immediate effect, or into your leg or buttock muscle which may take up to 20 minutes to work.

  • Patient-controlled analgesia (PCA)

This is a method using a machine that allows you to control your pain relief yourself. It has a pump which contains a pain killer (medicine). The pump is linked to a handset which has a button. When you press the button, you receive a small dose of the medicine painlessly into your cannula. Ask your anesthetist for more information.

  • Local anesthetics and regional blocks

These types of anesthesia can be very useful for relieving pain after surgery.

Pain killers (Medications)

  • Opiates: These are the medications often used for severe pain. They include morphine, codeine and pethidine. They may be given by tablets, injections or patient-controlled analgesia. They may also be added to a spinal or epidural to give longer and better pain relief. Some people have side effects the most common include nausea (sickening feel), vomiting, constipation, and drowsiness. Larger doses can produce breathing problems and low blood pressure (hypotension).The nursing staff will watch you closely for these.
  • Other pain killers (analgesics): such as diclofenac, ibuprofen or paracetamol may be given during anesthesia or afterwards as injections or tablets. They must be used carefully by people with asthma, kidney disease, and heartburn or stomach ulcers. If you are allergic to these or have had any problems with these medications you must inform your anesthetist about it.

Acute Pain Service team (set up exclusively for the perioperative period)

The team comprises of an anesthetist and a nurse (who specialize in pain relief after surgery) to provide you pain relief or regulate your pain relief once you are in the ward.
They will meet you on the ward after your surgery and provide you pain relief or regulate your pain relief to suit you and keep you as comfortable as is possible. They will meet you regularly for the first 2-3 days after your operation depending on your need. Feel free to discuss with them any aspect of pain relief that you would want to know. Your queries are welcome

If you feel that you are in pain you must let the nurse or doctor know so that appropriate measures can be taken to control your pain satisfactorily.

Risks & benefits of Anesthesia

Anesthesia has made much of today's surgery possible, and has brought great benefit.
Anesthesia removes pain and any sensation during an operation. This benefit needs to be weighed against the risks of the anesthetic procedure and the medications used. This will vary from person to person. With modern anesthesia, serious problems are uncommon. Risk cannot however be removed completely, though modern equipment, training and drugs have made it a much safer procedure.
The risk to you as an individual will depend on:

  • Whether you have any other illness
  • Personal factors, such as smoking or being overweight
  • Surgery which is complicated, long or carried out as an emergency.

Side effects of anesthesia

The incidence of these side effects varies from person to person. It may be possible that you have none of these problems after you have had your anesthesia.
The following table below will give you an idea of the possibility of side effects after anesthesia.

The incidence is as follows;

Common
(Incidence: 1 in 100)

General Anesthesia

Regional Anesthesia

Vomiting after surgery

ü

ü

Sore throat

ü

Î

Dizziness, blurred vision

ü

ü

Headache

ü

ü

Itching

ü

ü

Bodyache, pain & backache

ü

ü

Bruising & soreness

ü

ü

Confusion & memory loss

ü

Î

 

Uncommon
(Incidence: 1 in 1000)

General Anesthesia

Regional Anesthesia

Chest infection

ü

Î

Bladder problems

ü

ü

Muscle pains

ü

Î

Breathing problems

ü

ü

Damage to lips, teeth & tongue

ü

Î

Awareness

ü

Î

 

The department secretary will be available during working hours (8.30 am to 5.30 pm Mon-Friday and 8.30 am to 1.30 pm on Saturdays) in the department office for any general assistance/information required.

Phone: Department Office Number: (+9122) 24177000 Ext.No. 6026

Address: Department of Anaesthesia, Basement, Homi Bhabha Block

TATA MEMORIAL HOSPITAL, Dr.E.Borges Road, Parel, Mumbai - 400-012

Maharashtra, India

Fax: Hospital Fax Number: (+9122) 24146937

Email-id: Email-id: This email address is being protected from spambots. You need JavaScript enabled to view it.

Contact Us

TATA MEMORIAL HOSPITAL
Dr. E Borges Road, Parel, Mumbai - 400 012 India
Phone: +91-22- 24177000, 24146750 - 55
Fax: +91-22-24146937
E-mail : This email address is being protected from spambots. You need JavaScript enabled to view it.