Anesthesia History

Anesthesia History

Established in the Year: 1927

Memorable Details of History about the Institute

• The department of anaesthesia started functioning as a separate unit in year 1927 and Dr. Francis DARCS was the first Professor of the Department of Anaesthesiology. He held the chair for 12 years from 1927-1939.
• It was during the tenure of Prof. V. Rajagopalan, FFARCS,(1953-1974), that the department of anaesthesia developed academically with the starting of Diploma in Anaesthesiology in the year 1959 and Master Degree in Anaesthesiology in the year 1966.
• Earlier there was only one surgical block in the old building with general surgical theatres and as the surgical specialities and techniques developed, so did anaesthesia. In the old building there were 6 operation theatres, 2 theatres per floor. Each theatre had around 4 operating tables. Altogether there were around 24-26 operating tables in the old block. OT1 was emergency theatre, OT2 - ortho theatre, OT3 - general surgery, OT4 - surgical gastroenterology, OT5 – plastic surgery, surgical endocrinology & general surgery, OT6 -ENT.
• Currently The Department efficiently manages 15 operation theatres catering to
  • General Surgery
  • Orthopaedic Surgery
  • Vascular Surgery
  • Cardiothoracic Surgery
  • Neuro Surgery
  • ENT Surgery

  • Plastic Surgery
  • Urological Surgery
  • Gastro intestinal Surgery
  • Endocrine Surgery
  • Geriatric Surgery

  and round the clock functioning Emergency theatre., Post Anaesthesia care Unit (PACU)

Cardiothoracic, Neuro, and Specialty Theatres

• The Cardiothoracic theatre was started in year 1954-55 and the first successful open heart procedure was done in the year 1974 under the leadership of Dr.A.Venkatasamy.
• Later on this took a higher stride under Dr.Kabeer and Dr.Janakiraman, then Dr.D.B.Reddy, Dr.Lalitha and then for almost a decade from 1989, under the guidance of Dr.R.Rajendran the anaesthetic management of cardiac and thoracic cases took a turn for the better as it was during this period that all cases were invasively monitored, thanks to the efforts of Dr. Vijayashankaran, cardiothoracic surgeon who was instrumental in procuring the multipara monitors.
• Neurosurgery as a specialty started in the year 1950 and the present block with the neuro theatre was started in the year 1969.
• Under the leadership of Dr.L.Appasamy as the chief neuro anaesthetist, and ably assisted by Dr.S.V.Soundappan, Dr.N.Sambandhan, Dr.A.Thiruchelvan,and Dr.S.Vasudevan, neuroanaesthesia blossomed into a fine art. Later, Dr.R.Chandrasekaran was instrumental in procuring the multipara monitors and in refining neuroanaesthesia
• Specialty theatre (OT 12) was started in the year 1983. The first renal transplant was done in 1987., under the guidance of Dr.T.A.Thirumalai. Dr.S.P.Ramachandran and Dr.Manonmani underwent training in renal transplant and under their guidance and support, Dr . Ganapathy Asokan who was there for 17 years took OT12 to an exalted status, under the leadership of Dr.K. Balakrishnan.
• Major vascular procedures (both elective and emergency), and the maximum number of renal transplants were done during that period. We still follow the protocol devised by them for anaesthesia for renal transplant.

Emergency OT

• The emergency theatre in the ground floor catered mainly to general surgical cases and occasionally to plastic surgery cases .The Orthopaedic emergencies were done in OT 7. Neurosurgical emergencies were done in the neurosurgery theatre and in the mid 1990°s in a small operating room within the head injury ward(N1 ward). Cardiothoracic emergencies were done in the cardiothoracic theatre.

Evolution of New Theatre Complexes

• The new theatre complexes in Tower II were started in 2005 during the tenure of Dr.G.Sivarajan. The Department became an Institute in year 2010 and Dr. C.R. Kanyakumari was the First Director of IACC. Now, we have 62 operating tables, out of which 35 tables are in Tower block —II .
• Here we have state of the art facilities like stainless steel wall cladding, advanced OT lights, movable anaesthesia gas delivery pendants, anaesthesia workstation, multipara monitors and defibrillators..
• Situated in the East wing of the sixth floor is our General surgery theatre which has 14 tables in 7 theatre suites,out of which two OT tables are exclusively utilized for Interventional Pain management.
• Other than general surgical cases, cadaver organ retrieval is also done in general surgical theatre at all hours of the day.
• The west wing of the sixth floor of Tower —II has 8 operation tables catering to Orthopedic surgery, Trauma, Spine surgery, Geriatric surgery, Oral and Maxillofacial surgery and Surgical Oncology.
• The west wing of fifth floor Tower II has 8 operating tables catering to Surgical Gastroenterology, Surgical Endocrinology and ENT.
• In the east wing of the fifth floor is the Post Anaesthesia Care Unit which started functioning in 2005, under the guidance of Dr.T. Venkatachalam. We have 8 beds for Post anaesthesia cases and 2 beds for brain dead patients. It is well equipped with multi para monitors, ventilators, ABGA machine, ECG machine, defibrillator and syringe infusion pumps.
• The Emergency theatre is in the ground floor Tower block II and has 5 operation tables in two theatre suites catering to General surgical, Neurosurgical, Orthopedic, Vascular, Plastic and all other specialities. This theatre is in close proximity to casualty and trauma ward to ensure Zero delay service.
• Our Cardiothoracic theatre complex is still functioning in seventh floor of Cardiology block and has 4 operating tables
• OT 12 is in the sixth floor of the specialty block where Urosurgical , Renal and Cadaver transplants, Vascular and Plastic surgical procedures are done. It has 5 operating tables. We also have an Endovascular suite opposite to the main theatre complex. Earlier this was functioning as our classroom.
• Infected and Septic cases are done in MOT situated in the first floor of the old surgical building (earlier OT 3). There are 5 operating tables and we offer 24 hours anaesthesia services here.
• There is a central sterile supply department that functions from the basement of Tower II. It has 10 big steam autoclaves and one state of the art ethylene oxide sterilizer.

Central Assessment Room

• Earlier the concept of Central Assessment Room did not exist and anaesthetic assessments were done in the respective theatres. It was during the tenure of Dr .C.T..Santhanalakshmi (1994-1996) that Dr. Thiruchelvan along with Dr.Durairaj formed a protocol for anaesthesia assessments and the concept of Central Assessment Room was borne. Now the Central Assessment room is in the 2nd floor, Tower II.
• There was’nt a separate Chief anaesthetist room . The Chief Anaesthetist would function rom a small room within OT 3. It was during the tenure of Dr .V.Kanagaraj (1996-2000) that a room for chief anaesthetist was obtained iust outside and adjacent to OT1 in the ground floor of the old block.
• Earlier, anaesthesia charts were Noseworthy charts and were put only for high risk patients. The present system of charting was initially done only in OT12 by Dr.Ganapathy Asokan for renal transplants and vascular cases.
• I found this chart to be more informative than our earlier charting and started to follow this way of documenting our anaesthetic management. This was slowly followed in other theatres as it was appreciated by the surgeons and it was very informative and useful during mortality meetings.

Transplants

• Cadaver transplant was not new to our department as we have been doing it in OT12 since 1996. The first cadaver renal transplant was done on 19.01.1996, when Dr.K. Balakrishnan was the chief in OT12. I was in OT12 for almost a decade and I am proud to say that along with Dr.Ganapathy Asokan, and during the tenure of Dr.M.R.Vasanthan, we did around 10-15 cadaver renal transplants per year, quite a number in those days. Both organ retrieval and cadaver transplant were done in OT 12 itself.
• At that time there was not much awareness about cadaver transplants. Dr.M.R.Vasanthan was instrumental in documenting all the work done in OT12 at that period. Now, we have the Organ retrieval and Cadaver Transplant programme since 2009.
• Dr.T.Venkatachalam played an active role in the success of this programme So, not only do we give anaesthesia for cadaver transplant but we are also involved with the preoperative workup of the brain dead patients for organ retrieval. This includes preoperative hemodynamic and metabolic optimization of these patients followed by breath apnoea testing, which is done in our Post Anaesthesia Care Unit.

Trauma Care

• Trauma ward has around 15 ventilators and under the guidance of a senior anaesthesiologist we have 2-4 anaesthesia postgraduates exclusively doing intensive care and critical care work around the clock.

Pain Clinic

• Initially Pain Clinic was not a separate entity. Dr. Azhar Hussain, Dr. M.M.K Pashah, and later Dr.Silamban were involved with Pain management. Chronic Pain Management Clinic was officially inaugurated in Sept. 2013 due to the efforts of Dr.GK.Kumar and under the guidance of Dr.B.Kala.
• This clinic functions on all weekdays and interventional pain procedures. It has its own exclusive High end Ultrasound- Thanks to our directors Dr.Sugantharaj Anuradha and Dr. Murugan and our MMC Dean.

NORA (Non-Operating Room Anaesthesia)

• Our services are also extended in the form of NON OPERATING ROOM ANAESTHESIA (NORA) to
  • Interventional Cardiology
  • Interventional Radiology
  • MRI, CT Scan, GI Scopies
  • Radiotherapy
  • Trauma care & Critical care

Our Extensions

• The other Institutes affiliated to the Institute of Anaesthesia, Madras Medical College are the Anaesthesia Departments in the
• Institute of Child Health – Egmore
• Institute of Obstetrics & Gynaecology – Egmore
• Institute of Ophthalmology – Egmore
• Kasturba Gandhi Hospital – Triplicane
• Institute of Mental Health – Kilpauk

Classroom and Academics

• The classroom for post graduate teaching was earlier in the ground floor adjacent to OT1 in old building. When this was converted into the Central Assessment Room, it was shifted to the sixth floor in Specialty block opposite to OT12.
• This has now been converted to Endovascular suite and our classroom is in Tower II since 2005. Our classroom is well equipped for teaching and presentations and it was in January 2014 that we added a smart board for teaching purpose.
• As anaesthetic techniques and newer surgical procedures were evolving, the academic activities were erratic and postgraduates had to literally hang on to the words from their teacher's mouth, During this period, Dr.Narayanasamy evinced keen interest in teaching and took classes on instruments, anaesthesia machine and anaesthetic techniques.
• Later, Dr. Janakiraman followed his footsteps and though classes were taken regularly by our teachers,it was only around 2001-2002, that academic activities took shape in the form of MACME and yearly Teaching Programme. MACME was started in 2001 by Dr.R.Chandrasekar, neuroanaesthesia chief, when Dr.Balamani Mukilan was the HOD. Since then we have been having regular teaching programme, CME , symposium, clinical discussion, and journal club.
• Earlier there were six MD and ten DA postgraduates. Then there are 18 MD and 15 DA postgraduates and our total strength of anaesthesia students is 81.
• Now we have 37 MD seats per year with 111 postgraduates in total guided by 10 professors , 9 Associate professor, 23 Assistant professors, 7 Senior residents . We also train anaesthesia technicians.
• So, over the years we have metamorphosed from Department of Anaesthesiology to Institute of Anaesthesiology and Critical Care, thanks to all the efforts and hardwork of our predecessors and teachers.
• From being within the walls of the operation theatre we have now spread our wings to outside the operating room as well. For this we, the faculty of IACC, Madras Medical College, immensely thank all our teachers who have made this possible.

Our Emblem depicts our motto

• Acquire Knowledge
• Alleviate Pain
• Assure Life