Department of Anesthesiology

Hiroyuki Yamamoto, Aiko Ohshita, Reiko Sato, Kazuaki Hiraga

Introduction

The Department of Anesthesiology consists of four staff members (two Fellows of the Japanese Sociery of Anesthesiologists (JSA) and two JSA Board Certified Anesthesiologists) and two or three rotating residents. Each year, we provide more than 2,700 anesthesia services in eight operating rooms. A large number of operations in the Department of Head and Neck Surgery and procedures involving a thoracotomy for lung and esophageal cancer are one of the features of this hospital. Accordingly, a special anesthesia induction method for difficult airways and use of the one-lung ventilation technique for thoracotomy are often necessary. Recently, complex procedures are increasing on more seriously ill patients with coronary disease, chronic obstructive pulmonary disease (COPD), neurological disorders, and so on. In postanesthesia care for such patients, the Intensive Care Unit (ICU) plays an important role. Therefore we manage the operating room in close cooperation with the Department of Intensive Care Medicine. The goals of the Department of Anesthesiology are to provide anesthetic care to patients, with their safety being the highest priority.

Our team and what we do

Four staff members (three full-time and a visiting anesthesiologist), two or three rotating residents, and 12 part-time anesthesiologists cover eight operating rooms. A preanesthesia case presentation is held every morning to examine the case of the day and discuss the anesthesia problem and strategy for patients with various complications. In 2016, we provided 2,756 anesthesia services (Table 1).

Education

Our department has no resident. For rotating residents from other surgical departments. we provide opportunities of epidural anesthesia, one-lung ventilation technique for thoracotomy, and difficult airway management including fiberoptic intubation. We are convinced that these experiences are useful for the management of postoperative patients in the ward or the ICU. A Journal club is also held once a week in addition to the everyday morning conference. We support residents who hope to obtain the qualification of Registered Anesthesiologist or JSA Qualified Anesthesiologist during rotation periods.

Future prospects

In 2017, the Center for Developing Next-generation Endoscopic-surgical Treatment (NEXT) will be completed. For the NEXT building, which has 12 operating rooms, we are planning to increase the number of anesthesia cases from 10% to 20%. This goal is expected to be achieved with the addition of four or five part-time anesthesiologists, and for further operations the increase of regular staff members is essential.