AIIMS Neuroanaesthesia Update 2015

Third annual, All India Institutes of Medical Sciences (AIIMS) Neuroanaesthesia Update held at Jawaharlal Nehru Auditorium, AIIMS, New Delhi was organised by the Department of Neuroanaesthesiology and Critical Care, on August 26 and 27, 2015. Under the proficient guidance of Prof. Parmod Bithal (Professor and Head Department of Neuroanaesthesiology and Critical Care, AIIMS, New Delhi), Dr. Girija Prasad Rath (Additional Professor, AIIMS, New Delhi) was the organising secretary for the event. The scientific meet was a huge success and was graced by reputed national and international faculty and attended by over 170 national and foreign delegates. The meeting was an excellent concoction of live demonstration of anaesthetic management, monitoring workshop, and scientific deliberations by eminent speakers. Activities such as quiz and interactive case discussions were among other highlights for the trainee residents.

The update lasted for period of 2 days. The theme for the 1^st day was based on monitoring. It started with live audiovisual relay of anaesthetic procedures and advanced monitoring based management of three elective neurosurgical procedures in operation rooms (ORs) to the auditorium. The expert panel in the OR for discussion and interaction included Prof. Parmod Bithal, Prof. Deepak Sharma (Professor and Chief, Division of Neuroanaesthesia and Perioperative Medicine, Harborview Medical Centre, Seattle), Prof. Sergio Bergese (Associate Professor and Division Chief Neuroanaesthesia, The Ohio State University, Columbus) and Dr. Radhakrishnan M (Additional Professor, National Institute of Mental Health and Neuro Sciences, Bengaluru). The audience moderator (auditorium) was Dr. Hemanat Bhagat (Additional Professor, PGIMER, Chandigarh), while Dr. Ashish Bindra (Assistant Professor, AIIMS, New Delhi) co-ordinated the workshop from OR. Dr. Bhavna Hooda (Army Base Hospital, New Delhi) and Dr. Nidhi Gupta (Indraprastha Apollo Hospital, New Delhi) facilitated interactive discussion between the audience and experts in the auditorium. Dr. Gyaninder Pal Singh, Dr. Keshav Goyal, Dr. Niraj Kumar, Dr. Charu Mahajan and Dr. Indu (AIIMS, New Delhi) managed, demonstrated and facilitated the intraoperative anaesthetic procedure. The first case was clipping of a middle cerebral artery bifurcation aneurysm. There was an excellent demonstration of retrograde cannulation of the jugular vein for SjVO₂ monitoring by Prof. Deepak Sharma while Dr. Prassana Bidkar (JIPMER, Puducherry) highlighted the theoretical aspect of the same. There were an interesting keynote presentation and demonstration of non-invasive cardiac output monitoring by Dr. Navdeep Sokhal (AIIMS, New Delhi) for fluid management in this case.

The second case was excision of the thoracic intradural extramedullary tumour. The method and interpretation of evoked potential monitoring were depicted by Prof. Ashok Jariyal (Prof. Physiology, AIIMS, New Delhi) and a keynote presentation on the same was given by Dr. Manish Marda (New Delhi) from the auditorium. Dr. Keshav Goyal depicted the use of Masimo monitor in neuroanaesthetic procedures.

The third case was awake craniotomy for excision of frontal glioma. Elaborate demonstration of scalp blocks was given by Dr. Gyaninder and Dr. Charu. Keynote lecture on the depth of anaesthesia monitoring was given by Dr. Surya Kumar Dube (AIIMS, New Delhi) and Dr. Pallav Kumar (New Delhi) talked on intraoperative electrocorticography monitoring. The session was a huge success and witnessed excellent scientific interaction between expert panel in OR and the participants in auditorium.

The post lunch session moderated by Dr. Jayashree Sood (Sir Ganga Ram Hospital, New Delhi) and Dr. Rajendra S. Chouhan (AIIMS, New Delhi) focussed on detailed lectures and demonstration of important neuromonitors like ultrasound for optic nerve sheath diameter (Dr. Renu Bala, PGI Rohtak and Dr. Niraj Kumar, AIIMS, New Delhi), Transcranial Doppler (Prof. Deepak Sharma, supported by Dr. Sujoy Banik, AIIMS, New Delhi), monitors of cerebral oxygenation (Dr. Virendra Jain, Fortis Memorial Research Institute, Gurgaon) and Microdialysis (Dr. Nidhi Gupta, Indraprastha Apollo Hospital, New Delhi).

Thereafter the update was inaugurated by Prof. M.C. Misra, Director AIIMS, New Delhi, in presence Prof. N.K. Mishra (Cheif, Neurosciences Centre, AIIMS), Prof. P.K. Bithal (Organising Chairman), Dr. R.S. Chouhan (Organising Vice Chairman) Dr. Girija Prasad Rath (Organising Secretary), Prof. H.L. Kaul (Former Head, Department of Anaesthesiology, AIIMS, New Delhi) and Dr. Rashmi Madan (Former Professor, Anaesthesiology, AIIMS). Prof. Kaul and Prof. Madan were felicitated on this occasion for their contribution to the development of field of Anaesthesiology. After a formal lamp lighting, the gathering was addressed by the dignitaries on dias. Dr. Rath delivered the vote of thanks.

The last session of the day was a quiz, in which three teams; AIIMS, New Delhi, Max Super Speciality Hospital, New Delhi, Sawai ManSingh Medical College, Jaipur participated. The quiz was moderated by Dr. Hemant Bhagat, Dr. Charu Mahahjan and Dr. Ankur Luthra (Medanta, New Delhi). The team from Max Super Speciality (Dr. Sarika Juneja, Dr. Binesh Badyal) won the quiz and team from AIIMS, New Delhi (Dr. Sujoy Banik, Dr. Vikas Chauhan) scored the second position. It was followed by gala dinner at faculty lawns, AIIMS.

The 2^nd day academic activities began in JLN auditorium, AIIMS, with a session chaired by Prof. Sergio Bergese and Dr. KJ Choudhury (Indraprastha Apollo Hospital, New Delhi). Prof. H.H. Dash (Director, Anaesthesia and Pain Management, Fortis Memorial Hospital, Gurgaon) delivered a talk on “Indian Perspective of research in Neuro anaesthesia and Neurocritical Care.” Other scientific talks in the session were “Biomarkers of cellular injury and death in acute brain injury” by Dr. Hemanshu Prabhakar (AIIMS, New Delhi), “Postoperative delirium, cognitive dysfunction” by Prof. Sergio Bergese and “Myths and misunderstandings in Neuroanaesthesia” by Prof. Mihir Prakash Pandia (Prof. Neuroanaesthesiology and Critical Care, AIIMS, New Delhi). After this an interesting panel discussion on “Intensive Care for Ischemic Stroke: Time to redefine stroke programme in India,” was moderated by Prof. Rajiv Chawla (Prof. Anaesthesia, GB Pant Hospital, New Delhi). The panelist included Prof. Padma Srivastva (Neurology, AIIMS, New Delhi), Prof. Shailesh Gaikwad (Interventional Neuroradiologist, AIIMS, New Delhi), Prof. Deepak Sharma and Dr. V. Pooniah (Global Hospitals, Chennai). The post-tea session was on crisis management in neuroanaesthesia and was chaired by Prof. Shobha Purohit (Anaesthesia, Swai Man Singh Medical College, Jaipur) and Prof. Nidhi Panda (PGIMER, Chandigarh). The speakers Dr. Radhakrishnan M., Prof. Deepak Sharma and Dr. H.K. Venkatesh elaborated on “Anticoagulants and Antiplatelets for Neurosurgery and Neuroradiological interventions,” “How can the anaesthesiologists contribute to improving the outcomes of TBI” and “Fluids during elective Neurosurgery - What fluid, how much and how to titrate,” respectively.

An award poster session was held during lunch break, a total of 10 presenters elaborated their original work in the field of Neuroanaesthesia and Critical Care. The judges Prof. P.K. Bithal, Prof. Dilip Kulkarni (NIMS, Hyderabad) and Prof. Pragati Ganjoo (GB Pant Hospital, New Delhi) awarded Dr. Sujoy Banik (AIIMS, New Delhi), Dr. Saurabh Kansal (Subharti Medical College, Meerut) first and second position respectively while the third prize was a tie between Dr. Ajay Prasad Hrishi P. (SCTIMST, Trivandrum) and Dr. Sikha Bansal (GB Pant Hospital, New Delhi).

Post lunch session was a clinical scenario based interactive discussion between the presenters (Dr. Sujoy and Dr. Vikas, AIIMS), the experts Prof. Manikandan S. (Sree Chitra Tirunal Institute of Medical Sciences and Technology, Trivandrum), Prof. Monica Tandon (GB Pant Hospital, New Delhi) moderator (Dr. Ashish Bindra) and audience. The clinical cases discussed were “Acromegalic with difficult airway, hypertension and diabetes to undergo pituitary surgery” and “A patient with pheochromocytoma undergoing emergency intracranial aneurysm clipping.”

During the post tea session, brain death and organ donation were discussed. The session was chaired by Prof. M.K. Arora (Head, Departement of Anaesthesiology, Critical Care and Pain Medicine, AIIMS, New Delhi) and Dr. Aarti Vij (Chief, ORBO, AIIMS, New Delhi). Among the narrators were Dr. Surya Kumar Dube, Dr. Prasanna Bidkar and Dr. Sanjeev Lalwani, who elaborated on “Diagnosing Brain Death,” “Caring for brain dead organ donors” and “Brain death and organ donation: Legal issues, respectively.”

The last scientific session was chaired by Dr. Harsh Sapra (Medanta: The Medicity, Gurgaon) and Dr. Mukul Jain (Institute of Human Behavior and Allied Sciences, New Delhi) and interesting topics like “Contrast use in Neurosurgery and Neuroradiology: Remembering complications” by Dr. Rahul Yadav (New Delhi), “Anaesthesia in Brain Suite” by Dr. Saurabh Anand (Medanta, Medicity) and “Managing ARDS in neurologically injured patients” by Dr. Kapil Dev Soni (AIIMS, New Delhi) were presented.

The scientific meeting ended with a valedictory function, where awards were distributed to winners of award paper and quiz. Participant faculty and delegates shared their views and gave valuable feedback. Organisers thanked the delegates for their active involvement. At last, everyone posed for the camera and the wait for next meet starts!