Pain medicine describes the work of specially qualified medical practitioners who undertake the comprehensive management of patients with acute, chronic and cancer pain using physical, pharmacological, interventional and psychological techniques in a multidisciplinary setting.
Acute pain management in surgical patients is a major role for the anaesthetists treating patients prior to surgery, during surgery and post-surgery. Chronic and cancer pain, on the other hand, is more specialised, therefore anaesthetists who treat chronic and cancer pain are specifically trained to do so.
In the anaesthesia training programme, all trainees receive training in acute pain at the basic level and acute and chronic pain at the intermediate level. For those trainees with an interest in pain medicine can specialise by completing pain medicine at the higher and advanced training levels. Advanced pain medicine includes the more specialised areas of:
- Spinal cord stimulation
- Paediatric pain medicine
- Cancer pain, and
- Intrathecal drug delivery
The Udai Omni department of anaesthesia and pain management is a 24-hour perioperative service encompassing pre-anaesthesia assessment, intraoperative anaesthesia, anaesthesia in areas outside of the operating suite, acute postoperative pain management, and tertiary trauma care.
The department is committed to evidence based best practice, continuous quality improvement, research and teaching. The hospital has 11 operating theatres, which cater for all major types of adult surgery with the exception of obstetrics and gynaecology. These include cardiothoracic surgery, neurosurgery, vascular surgery, urology and renal transplantation, plastic surgery, faciomaxillary surgery, Ent/head and neck surgery, orthopaedic surgery, ophthalmic surgery and general surgery.
Udai Omni hospital is a designated trauma hospital in the state of Telangana. Genetic testing is a recent addition to the service, which is opening up the possibility of interesting research and a complete understanding of this condition. The department has a well-coordinated acute pain service, with active research and education programs.
Anaesthesia and acute pain management
With full-time anaesthetists, part-time anaesthetists, visiting anaesthetists, registrars in training and support staff, currently staff the department of anaesthesia and pain management.
We provide anaesthesia services for all elective and emergency surgery at Udai Omni, conducting many procedures per year. We provide anaesthesia for the following specialities:
- Cardiac & thoracic surgery (including toe)
- Obstetrics & Gynaecology, including ~ 500 caesarean sections per year
- Paediatric surgery ~ 1500 procedures per year.
- Plastic surgery
- General surgery and endoscopy
- Vascular surgery
- Ent and maxillo-facial surgery
We perform approximately 10,000 general anaesthetics, 3,500 regional anaesthetics, 600 combined GA/regional anaesthetics and 3500 sedations per year. The recent introduction of ultrasound guidance for regional blockade has seen a significant increase in the number of regional blocks performed.
We provide anaesthesia for our operation theatres, as well as a delivery suite, radiology and cardiology. We also provide a support service for medical emergencies on the wards and the emergency department, including involvement in trauma calls and airway management in EMD and ICU.
The department also manages the acute and chronic pain services, and the pre-operative unit, including cardiopulmonary exercise testing (CPX) for pre-operative assessment of patients (see separate links).
The role of the anaesthetist
The anaesthetists at Udai Omni are highly trained medical specialists, who have training in anaesthesia, pain management, resuscitation and management of medical emergencies.
During your operation, they are responsible for all aspects of your well-being, including:
- General anaesthesia (fully asleep) and sedation (half asleep)
- Analgesia, or pain control, both during and after your operation
- Managing other medical conditions such as diabetes and heart problems
- Managing fluids and blood transfusions
- Monitoring and preventing complications of anaesthesia or surgery, and treating them if they do occur quickly and effectively.
The anaesthetist will see you before your operation to discuss different aspects of your anaesthetic. This may occur on the day of your operation, or earlier, in the pre-operative clinic, where further tests may be organised. They will ask you about:
- Any medical conditions or recent illnesses, particularly heart conditions, asthma or breathing difficulties, diabetes or other health concerns.
- The medication you take and any previous reactions to drugs or allergies.
- Any previous operations and particularly any problems arising from the anaesthetic.
- Your surgical condition, and the planned operation.
- Any dentures, loose teeth, caps or crowns.
They will also discuss with you the best type of anaesthetic for your operation. This may be:
- General anaesthesia – where you are unconscious during the operation
- Regional anaesthesia – where an injection of local anaesthetic makes the part of the body that is being operated on numb, allowing you to be awake during the operation, but pain-free.
- Local anaesthesia – where local anaesthetic is injected at the site of surgery to make just the area of the operation numb, supplemented with sedation.
You will be able to discuss the options with your anaesthetist to decide what’s best for you.
What is the post-operative service?
- Streamlines the process for elective surgery admissions, for all patients.
- Assesses how good a patient’s health is prior to their surgery and if necessary organises appointments with other specialists, further tests and investigations (including cardio-respiratory stress testing).
- Ensures that patients are in the best possible condition, both physically and mentally to undergo their anaesthetic and surgical procedure
- Provides patients with admission instructions and educational material prior to their surgery
- Admits elective surgery patients on the day of surgery, where they are prepared for theatre. The patient will meet pre-operative service nurses, their anaesthetic nurse, their anaesthetist and members of the surgical team prior to surgery.
The post-operative service also helps organise a patient’s discharge from hospital so that any help that may be required at home can be arranged as early as possible. If the patient will not be able to go straight home from the hospital, we will help to arrange alternative accommodation.
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