The Department of Anaesthesia and Pain Management is a 24-hour perioperative service that encompasses pre-anaesthesia assessment, intraoperative anaesthesia and physiologic monitoring, anaesthesia for areas outside of the operating suite, acute post-operative pain management, sub-acute and chronic pain management, and tertiary trauma care.
The department is committed to evidence-based best practice and continuous quality improvement. It is also committed to the academic pursuits of clinical and laboratory research, training and continuing medical education to ensure its knowledge, skills and abilities meet its stakeholders' requirements.
Perioperative Medicine and Theatre Management
The department has been very active in improving operating room systems. One initiative, the Electronic Theatre Booking System, has significantly changed the way emergency theatres cases are booked. This intranet-based system is available to all medical staff and it encourages timely, definitive surgical care. A dedicated 23 hour unit is about to be constructed to improve patient flow and throughput.
There is a well organised preadmission clinic with all attending patients being seen by an anaesthetist. About two thirds of elective day of surgery admission patients will have been seen preoperatively by an anaesthetist. This improves patient education and assessment, reduces day of surgery cancellations and enhances anaesthetic involvement in perioperative medicine.
Dr Malcolm Hogg, anaesthetist and pain specialist, continues to improve pain services across Melbourne Health. There are comprehensive acute and chronic pain services with a focus on early access to chronic pain services for patients with difficult to manage acute pain. The deparment is approved for Faculty of Pain Medicine training.
Education and Training
Department members continue to be heavily involved in education and training. Simulation and team training courses continue, and Dr Reny Segal has convened several highly successful fibre-optic intubation skills workshops including the National Airway Training Course for Anaesthetic Trainees. Associate Professor Daryl Williams has been instrumental in bringing the Advanced Life Support (ALS) course to RMH and Victoria and the department is involved in convening and running a number of courses a year. Dr Irene Ng maintains an interest in regional anaesthesia and ultrasound and organises courses for trainees in this area. The department holds an Annual Refresher Course meeting that attracts more than 150 anaesthetists from around Australia.
Dr Robyn Gillies has helped to establish the Australian and New Zealand Malignant Hyperthermia Group. The group has developed the MH resource kit which is available on their website www.malignanthyperthermia.com.au. The group is participating in clinical genetics and has worked collaboratively to discover new malignant hyperthermia mutations over the past 12 months. Dr Gillies coordinates in-vitro contracture testing for malignant hyperthermia for Victoria and these are performed in the departmental laboratory.
Anaesthesia is provided for over 600 cardiac operations a year – the largest number at a single centre in Victoria. Cardiac anaesthetists perform transoesophageal echocardiography for all these procedures and the department has two 3D toe probes and is rapidly increasing its experience in this exciting area of intraoperative cardiac imaging and monitoring. Associate Professor Colin Royse has driven the development of the Melbourne University Postgraduate Diploma of Perioperative and Critical Care Echocardiography which has now been extended to become a three stage postgraduate Certificate, Diploma and Masters in Clinical Ultrasound. He also runs a number of practical workshops in ultrasound and echocardiography (see www.heartweb.com.au).
Director - Associate Professor Daryl Williams
Deputy Director - Dr Elizabeth Pemberton
Nurse Unit Manager - Mr Chris Taylor