hello everybody,
regarding doing a spinal/epidural/nerve block outside the operating room,in mumbai where is the space for an extra room?The nursing homes are congested,ill equipped and is it medico-legally safe to do this?

Friends,
I would like to know the experiences of my colleagues who have used clonidine.

Dear Colleagues,
Recently i had the good opportunity to go for a short visit to Tata memorial Hospital in Mumbai where the annual ARC(Anaesthesia review course) was being conducted.A common feature witnessed by me was that EMO,Flagg's can,Vapourisers,Boyle's machine were being taught to the student delegates who were seeing these old instruments for the first time!!! A young delegate was clicking photos of the EMO on his mobile camera!!!
This made me happy that at least we old timers are used to all these so called antiques in anaesthesia.
Another thought that came to my mind was that there should be a refresher course for the private practising anaesthesiologists who need to be updated with the newer anaesthesia machines,drugs etc to update our knowledge.This is indeed the need of the hour.
This should be made mandatory to all the practising anaesthesiologists.
I would like my fellow colleagues who are seniors in this field, to express their valuable suggestions and opinions about this topic without any bias.

Dear Yogen,Our ENT colleagues still prefer to do Tympanoplasty under local and sedation.Are these patients fasting pre-operatively?As you have mentioned there is no standard combination which will keep the patient well sedated.Each patient is different and u can never predict how he will behave during surgery.As you have mentioned we do have some of our younger surgical colleagues do take hours and hours to do a tympanoplasty.These are the cases where all the problem starts.Basically a full bladder does make the patient extremely restless.If the surgeon is slow,can the surgery not be done under General Anaesthesia?How long and how much will you keep on topping up the sedation?

Dear Yogen,I totally agree with jaffo's reply and your rejoinder to it.Dont you think we can still do something to revolutionise this branch of ours i.e. Anaesthesiology?
It is high time we seniors and even juniors opened up,accept our faults and errors and narrate our tales of trials and tribulations,which will be an eye opener to our fraternity members.
Let us all come under one platform in mumbai and stand united.It will send shivers down the spine of several of our colleagues from various other branches.
Are you game for it yogen?

Regarding an anaesthesiologist irrespective of whether he is senior or junior can go to help his colleague in times of distress as a good samaritan.This has been told by Dr.Gopinath shenoy repeatedly.Remember the case which was discussed at the ISA conference,where the second anaesthesiologist who went to help her colleague was also implicated in the medico legal case.As you have said, we have to make it 100% sure from various senior colleagues and medico legal experts regarding the good samiratans role in case the patient dies.Our colleagues from abroad should enlighten us aboput this.

Many new anaesthetic drugs are being launched by many pharma companies in the market.Many of us may not have used the new drug at all.just reading the literature or getting information from the websites is not enough.I personally feel we should get proper information of the newer drugs from experienced people who have used a particular drug for a reasonable time.Their good/bad experiences will definitely be an eye opener to all of us.
I welcome all members to express their views on the newer drugs in markets with no proper informations.

Dear Yogen,
I agree with your diagnosis.Anything and everything happening under the sun during any surgery,is always blamed on the anaesthesiologists.We are tuned into accepting everything due to our fault.Why?to please the surgeon?At what cost?
Overdose of anaesthesia is another loose and fancy word used by our surgical colleagues to explain any intra or post operative problem while explaining things to the patients relatives or the media.

yogen, i already had CABG as you are aware of it.I think we are very slow in going in for any change.See the municipal hospitals where the OT conditions are pathetic.Of course you always say"I have my juniors working there"so you may not feel the pinch.I still go to municip[al maternity homes and i know the problems!!!
There is only an outdated Boyle's machine with everything missing.You try giving full fledged GA and You had it.
payments are made after ages.
Madhav

I am happy to read your reply.Whatever you have written is 100% true.We are made to compromise on the working conditions,patients safety and our paltry remuneration.No wonder,many of the anaesthesiologists are ending with CABG(including myself in 2005).
I feel we should blame our forefathers for the present state of our branch.They should have drilled the idea into their student's head that they are qualified dignigied doctors and should behave like one.Instead we were led to believe that we are bonded labourers and be satisfied with whatever is thrown at us.
The word UNITY never exists among the anaesthesiologists.I have been fighting for the anaesthesiologists for the last 30 years but have not fully succeeded.
I have been labelled as an aggressive anaesthesiologist!!!!

Hello everybody,
Many of us are still using the old and outdated boyle's machine for delivering general anaesthesia.As a result we are compromising on the patient's safety and our own safety medico legally.Every Boyle's machine is treated as junk after 15 years and if not serviced regularly.The vaporisers in these old machines are meant for ether and trilene.Goldman vaporiser is used for halothane.It is shocking to note that Halothane which is banned in USA and UK and several countries is still being used in India.
This problem can be solved if we instruct the nursing home owners to go in for the newer machines with vaporisers for isoflurane and sevoflurane.In anesthesia,the dictum"old is gold" does not hold true.When surgeons are going in for newer techniques and instruments,why is it that we anesthesiologists are afraid to open our mouths and demand for newer things?
A gynaecologist in India has spent around Rs.50 lakhs for interrior decoration of his house with an inbuilt swimming pool,but in his own OT,fish tank is used for delivering oxygen to the patient!!!!
I would like all viewers of gasbag to read this article and send in their vciews,opinions and experiences.   

nemaa
NEMAACON 2008
NEMAACON 2008-International Conference
NEMAACON 2008 presents the first International conference of practising Anaesthesiologists on the 18th&19th october 2008 at mumbai.We have confirmed National and international Faculty.Dr.Bhavani Shankar Kodali from USA,Dr.Ram Kumar from Manipal and Dr.Ramesh from Chennai are the star attractions.We will be having 6 workshops,lectures,debates,pro&con,Poster presentation etc.
We also have "Young Achiever's Award" to promote young talent.
Our website is:nemaacon2008.org
You could also contact Dr.R.madhav Rao,the president of the conference on madhav.1949@gmail.com
Avail the early bird registration.
People wishing to participate in this conference may write to us at;nemaacon2008@gmail.com

As we are in the 21st century and seeing tremendous changes in the field of anaesthesiology,why do you beg for the old dusty stethoscopes which have been discarded by our physician friends?o wonder,people like you are resposnsible for making the Anaesthesia fraternity a laughinh lot and also making a fool of yourself

Hello everybody,
I am a consultant anesthesiologist practising in the metropolis city Mumbai in India.We have a very funny system of anesthesiologist's charges.The surgeon fixes the anesthesia charges and we usually get anywhere between 15-20-30-33% of the surgeon's charges.Many of our own colleagues resort to the practice of Undercutting their anesthesia fees to survive in this terrible rat race to earn some paltry sum of money.
I would like to know the state of affairs in other parts of the world.