The Anaesthetic Department provides anaesthetic services for all orthopaedic surgical procedures being carried out in the hospital, the techniques used being general anaesthetic, regional anaesthetic and a combination of both.
In addition to general anaesthesia, the following techniques are widely used in the perioperative period:
- One lung ventilation
- Total intravenous anaesthesia
- Cell salvage (cell salvage is a process that collects blood from an operating site. This blood is then processed in a cell salvage machine and given back to the patient)
- Epidurals (thoracic, lumbar and caudal)
- Spinal anaesthetic
- Inter-pleural catheters (within the tissue of the chest wall)
- Continuous lumbar plexus infusion
- Brachial plexus blocks
- Intravenous regional anaesthesia.
The hospital has a well-established Nurse-led Pre-Operative Assessment Clinic which is also staffed by a consultant anaesthetist. There is a regular outpatient clinic conducted by a consultant physician, who is available to provide medical advice to the Anaesthetic Department.
Our 12 operating theatres are either new or recently upgraded. All operating theatres have modern anaesthetic machines and experienced operating department personnel. There are three ultrasound machines used for regional anaesthesia and vascular access, along with other state-of-the-art pieces of supplementary equipment.
The hospital has a well-equipped recovery area with a dedicated recovery staff, who work in close liaison with the acute pain team and the High-Dependency Unit (HDU).
The HDU has 6 beds where all major orthopaedic cases are recovered for the first 24 hours. It is equipped with invasive monitoring equipment and non-invasive ventilatory support, however elective post-operative ventilation is not carried out.
Any patient who requires post-operative ventilation is transferred to the parent unit from where the patient was referred. Careful assessment of cases reduces this to a minimum. Our spinal surgeons will sometimes carry out surgery in other hospitals if the condition of the patient demands elective post-operative ventilation. For this the anaesthetist and theatre team may travel with the surgical team.
The hospital has an acute pain service. Ward rounds are carried out daily and audit of the activity is recorded. The hospital has well-established protocols for management of acute pain. A teaching programme to educate the nursing and medical staff regarding management of pain is fully operational.
Our well-established pain management service is ran by a consultant anaesthetist with input from their multi-disciplinary team comprised of a psychologist, nurses, physiotherapists and occupational therapist. The team not only manages chronic pain but is also involved in active rehabilitation and functional restoration of chronic pain sufferers.