ANAESTHESIA

The specialty caters to all the demands of surgical oncology to undertake major surgeries with  best care and includes a range of anaesthetic, critical care, acute pain and  interventional pain management.

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Introduction and History

The department of anaesthesia at the Cancer Institute (W.I.A) was established in the initial decade of the inception of the institute. Over the last six decades the department has evolved from single anesthetist manned solitary Operation theatre to state of the art eight major multispecialty theatres with specific intraoperative radiotherapy theatre, paediatric procedure room apart from minor theatres.  We provide a range of anaesthetic, critical care, acute pain interventional pain management and palliative care services to patients.

Department Vision

To provide excellent perioperative care to all patients in line with the institute’s motto of “Service to all”.

Department Mission

To deliver evidence-based safe and comprehensive anesthesia care to all the patients through inter-professional education and advanced research activities.

Our Priorites

  1. Patient safety- This is ensured by following the standards of care in patient monitoring and anaesthetic management. Infection control practices are strictly adhered to.

  2. Pain management– All post-surgical patients have a well-planned pain management plan which is reviewed on daily basis and modified as appropriate.

  3. Early post-operative recovery and management of complications- patients are cared for in specialized settings post-surgery depending on their surgical severity and patient illness. Early chest physiotherapy, patient mobilsation and resumption of enteral nutrition are ensured. Patients are monitored with standardized scoring system and timely intervention is done in the event of any complication. Patients are managed by the intensivist  in consultation with the cardiologists, nephrologists and pulmonologists as needed , to provide comprehensive and exemplary care until discharge to home.

Emergency Cases

Please feel welcome to contact our friendly reception staff with any general or medical enquiry call us.

Opening Hours

Monday – Friday :  8.00 am – 7:00 pm
Saturday : 9.00 am – 8.00 pm
Sunday : 10.00 am – 9.00 pm

Registration Time

Monday – Sunday : 7.00 am – 11.00 am

Visiting Hours

Monday – Sunday : 4.00 PM – 6.00 PM

Clinical Services

  1. Preoperative patient assessment and optimization of comorbidities alongside prehabilitation before surgery.

  2. Anaesthetic management of oncological surgeries- open, laparoscopic and robotic.

  3. We manage surgeries in the sub-specialities of head and neck cancer, lung and mediastinal tumours, gastrointestinal tumours, adrenal and urologic cancers, gynecological cancers, bone and soft tissue cancers and tumours of the brain and spine.

  4. We provide procedural sedation for interventional and diagnostic endoscopic, pulmonary and radiological procedures (CT, MRI, Radio frequency and micro wave ablation), brachytherapy.

  5. We provide sedation for pediatric patients planned for bone marrow studies, central line placement and radiotherapy.

  6. Interventional pain management such as celiac plexus block ganglion impar block, epidural steroid injections, to name a few, and central desensitization for patients with severe pain.

  7. Intensive care and postoperative management for surgical patients.
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Facilities and Equipments

  1. Eight major operating rooms and three procedural rooms with the latest anesthesia workstation, advanced monitoring and patient warming devices.

  2. 15 bedded ICU with a fulltime intensivist, advanced monitors with central monitoring console, 6 ventilators capable of invasive and non-invasive ventilation and two Bipap machines, transport ventilators, three high flow oxygen therapy, facilities for haemo dialysis, plasma exchange and two intermittent pneumatic compression pumps. ICU has a dedicated ultrasound machine for point of care critical care sonography.

  3. Oxygen generator which provides oxygen supply to the entire hospital.

  4. Advanced hemodynamic monitoring equipment which help monitor cardiac function and fluid status.

  5. Target controlled infusion pumps, bispectral index and entropy monitoring which provide total intravenous anesthesia to facilitate intraoperative monitoring during brain and spine surgeries.

  6. CT –guided robotic positioning system which enables accuracy in performance of interventional pain procedures.

  7. Patient controlled analgesia pump which gives patients the ability to titrate the analgesic medications to achieve adequate pain relief.

  8. Adequate numbers of infusion pumps to ensure epidural analgesia for pain relief for abdominal, thoracic and lower limb surgeries intra-operatively and upto 3 days postoperatively.

  9. Point of care arterial blood gas analysis to measure the oxygenation and perfusion status of patients during surgery.

  10. Three Ultrasound machines which are used for patient side evaluation of cardiac function, for central venous access and nerve block procedures.

  11. Advanced airway equipments to manage difficult intubations which includes fiberoptic bronchoscopes-adult and pediatric, video laryngoscope, jet ventilator and EZ bronchial blockers.

  12. State of the art sterilization equipments for autoclaving, plasma and ethylene oxide sterilization of various hospital equipment’s and premium indicators to monitor the efficacy of sterilization process.

Statistics

Research Activities

1. Effects of anaesthetic agents on natural killer cells and biomarker release during Stage 3 Epithelial ovarian cancer surgery: A prospective pharmacodynamic cohort study.

2. Prospective randomised study to assess the feasibility of performing opiod free anesthesia with ketamine for elective modified radical mastectomy.

3. Effect of intraoperative coeliac plexus block on postoperative analgesia in major upper abdominal surgeries.
1. OASyS- An onco-anesthesia synopsis and symposium 24th September 2022 at Cancer Institute

2. Fellowship in onco anesthesia – we are in the process of initiating two year fellowship program for practicing anesthesiologists (awaiting accreditation from Dr MGR medical university).

3. Observership- 1 month programme for final year MD anesthesiology students from other institutions.

List of staff members

The department comprises of experienced anesthesiologists, who have special training in providing perioperative care for high risk patients and complex surgeries.

Dr. Kalpana Balakrishnan
Professor & HOD

Dr. Punitha
Associate Professor

Dr.Nivedhyaa. S
Associate Professor

Dr. Prasanna Vani.V
Assistant Professor

Dr. Radhika Dash
Associate Professor

Dr. Aishwarya Ramakrishnan
Associate Professor

Dr. Mani Raj
Assistant Professor

Dr.Nairita
Associate Professor

Dr. Sahithya Sriman
Associate Professor

Dr. H S Subramanian
Assistant Professor

Dr. Pritha Raj
Associate Professor

Dr.Vallary Reshmikanth Modh
Associate Professor

Dr. Poorna M S
Assistant Professor

Dr. Aravind Narayanan
Associate Professor

Dr. Hariesh A
Associate Professor

Dr. Pavithra A S
Assistant Professor

S.No

Name

Designation

1

Dr. Kalpana Balakrishnan

Professor & HOD

2

Dr. Punitha

Associate Professor

3

Dr.Nivedhyaa. S

Associate Professor

4

Dr. Prasanna Vani.V

Assistant Professor

5

Dr. Radhika Dash

Assistant Professor

6

Dr. Aishwarya Ramakrishnan

Assistant Professor

7

Dr. Mani Raj

Assistant Professor

8

Dr.Nairita

Assistant Professor

9

Dr. Sahithya Sriman

Assistant Professor

10

Dr. H S Subramanian

Associate Professor

11

Dr. Pritha Raj

Assistant Professor

12

Dr.Vallary Reshmikanth Modh

Assistant Professor

13

Dr. Poorna M S

Assistant Professor

14

Dr. Aravind Narayanan

Associate Professor

15

Dr. Hariesh A

Assistant Professor

16

Dr. Pavithra A S

Assistant Professor

Recent Publications

  1. Jain P, Balkrishanan K, Nayak S, Gupta N, Shah S. Onco-anaesthesiology and palliative medicine: Opportunities and challenges. Indian J Anaesth 2021;65:29-34

2. Bhandoria, Geetu, Solanki, Sohan Lal, Bhavsar, Mrugank, Balakrishnan, Kalpana,Bapuji, Cherukuri, Bhorkar, Nitin, Bhandarkar, Prashant, Bhosale, Sameer, Divatia, Jigeeshu V., Ghosh, Anik, Mahajan, Vikas, Peedicayil, Abraham, Nath, Praveen, Sinukumar, Snita, Thambudorai, Robin, Seshadri, Ramakrishnan Ayloor and Bhatt, Aditi. “Enhanced recovery after surgery (ERAS) in cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC): a cross-sectional survey” Pleura and Peritoneum, 2021, pp. 000010151520210117. https://doi.org/10.1515/pp-2021-0117

3. Balakrishnan K,Chockalingam P. Specifying perioperative nonsteroidal anti-inflammatory drug use in trials of the effect of anaesthetic technique on oncologic outcomes. Comment on Br J Anaesth 2021; 127: 65–74. Published online: September01,2021.https://doi.org/10.1016/j.bja.2021.07.028

4. Nivedhyaa Srinivasaraghavan, Nairita Das, Kalpana Balakrishnan & Swaminathan Rajaram (2021): Effect of Whey Protein Supplementation on Perioperative Outcomes in Patients with Cancer—A Systematic Review and Meta-Analysis (PROSPERO 2020: CRD42020188666), Nutrition and Cancer.

5. Vanamail PV, Dash R, Balakrishnan K. A retrospective analysis of the presentation, outcomes and detrminants of severity of postoperative pneumonia in upper abdominal oncological surgeries. Indian J Respir Care 2020;9:52-7

6. Prasanna Vani Vanamail, Radhika Dash, Kalpana Balakrishnan, & Thendral (2021). Recurrent pulmonary thromboembolism during radical cystectomy:
A case report. Indian Journal of Case Reports, 260-262.

7. Vanamail PV, Balakrishnan K, Prahlad S, Chockalingam P, Dash R, Soundararajan DK. Ultrasonographic Assessment of Diaphragmatic Inspiratory Amplitude and Its Association with Postoperative Pulmonary Complications in Upper Abdominal Surgery: A Prospective, Longitudinal, Observational Study. Indian J Crit Care Med 2021; 25 (9):1031-1039.

8. Anaesthetic management of a super obese patient posted for Abdominoplasty-Venkatachalam T, Nivedhyaa- Med ej – the e journal of the Tamil Nadu Dr. Medical University(2013)

9. Venketeswaran MV, Srinivasaraghavan N, Balakrishnan K, Seshadri RA, Sriman S. Intubation outcomes using the aerosol box during the COVID-19 pandemic: A prospective, observational study. Indian J Anaesth 2021;65:221-8.

10. Srinivasaraghavan N, Balakrishnan K, Venketeswaran MV, Chockalingam P. Unusual Echocardiographic Diagnosis of a Metastatic Thrombus – A Case Report. J Indian Acad Echocardiogr Cardiovasc Imaging 2021;5:75-7

11. Balakrishnan K, Srinivasaraghavan N, Venketeswaran MV, Ramasamy T, Seshadri RA, Raj E H. Perioperative factors predicting delayed enteral resumption and hospital length of stay in cytoreductive surgery with hyperthermic intraperitoneal chemotherapy: Retrospective cohort analysis from a single centre in India. Indian J Anaesth 2020;64:1025-31

12. Bhattacharya, S., Srinivasaraghavan, N. Nasogastric Tube Knotting Around the Nasotracheal Tube in a Patient with Oral Cancer and Trismus. Indian J Surg (2021). https://doi.org/10.1007/s12262-021-03000-z (Corresponding author)

13. Srinivasaraghavan N, Das N, Balakrishnan K, Rajaram S. Effect of Whey Protein Supplementation on Perioperative Outcomes in Patients with Cancer-A Systematic Review and Meta-Analysis (PROSPERO 2020: CRD42020188666). Nutr Cancer. 2021 Dec 28:1-14. doi: 10.1080/01635581.2021.2020302. Epub ahead of print. PMID: 34961401.

Scientific Meetings

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