The Department provides anaesthesia services for both paediatric (child) and adult patients undergoing surgical and interventional procedures. More than 26,000 anaesthetic sessions were performed by the department every year.
Our subspecialty services include:
- Paediatric and neonatal anaesthesia
- Cardiothoracic and vascular anaesthesia
- Anaesthesia for organ transplant surgery
- Anaesthesia and analgesia for gynaecological-obstetric services, including fetoscopic surgeries and EXIT (Ex Utero Intrapartum Treatment) procedures
- Anaesthesia for orthopaedic, spine and trauma surgery
- Anaesthesia for neurosurgical procedures, including awake craniotomies and neurointerventional radiological procedures
- Anaesthesia for otorhinolaryngology, eye, plastics and dental surgeries
- Anaesthesia for cancer surgery
- Surgical Intensive Care
- Pain management
- Perioperative medicine
Life expectancy is increasing. With increasing average age of the population, the volume of surgical procedures performed each year continues to rise. Commonly, patients presenting for surgery have multiple medical issues and medications. Surgical procedures and techniques are also constantly developing and evolving. These factors contribute to increasing complexity in the provision of anaesthesia to facilitate treatment.
Peri-operative care bridges the periods before, during and after surgery. In the 16a Anaesthesia, Pain Management and Acupuncture Clinic; outpatients planning for elective surgery are assessed and counselled on what to expect during the procedure, anaesthesia options and preferences, and risks involved. Inpatients and patients who require emergency procedures are similarly evaluated and prepared by our on-call specialists. When appropriate, pre-existing conditions are optimised to reduce the risk of complications arising from them in the peri-operative period.
Through gathering and provision of information, we aim to empower patients and their families to better understand the medical condition, treatments required and risks involved. We tailor the anaesthesia and analgesia (pain relief) plan to each individual patient taking into account their needs and preferences. This encompasses the management of maternal labour pain and options available during delivery.
For procedures requiring extra coordination, we engage in multi-disciplinary discussions to formulate a cohesive management plan. These include coordination with the doctors performing the procedure and nursing staff to determine appropriate pre-, post-op and discharge care.
Surgical Intensive Care Unit
The Surgical Intensive Care Unit (SICU) is a 15-bed facility providing advanced critical care to adult patients who have undergone major surgical procedures and require close monitoring and organ support to help them recover. The unit is managed by dually-accredited anaesthesia and intensive care physicians together with a multi-disciplinary team including pharmacists, respiratory therapists, physiotherapists, speech therapists, dietitians and medical social workers. Together, we aspire to deliver compassionate bedside care, driven by evidence-based practices.
The surgical disciplines serviced by the unit include neurosurgery, general surgery, otorhinolaryngology (ENT), urology, orthopaedics, obstetrics and gynaecology, trauma, and solid organ transplants such as liver and kidney.
To complement our clinical work, the SICU team places an emphasis on continued education and research. We train critical care Advanced Practice Nurses (APNs) and are an accredited centre for SICM (Society of Intensive Care Medicine) fellowship training of postgraduate doctors. Ongoing involvement in research and quality improvement projects enables us to improve patient care and clinical outcomes.
Our dedicated team provides patient-centric care for critically-ill patients in a dignified manner and endeavours to provide support to patients' families during this period of stress and tension.
Pain Management Unit
Pain is a sensation that can cause significant discomfort and distress in patients. When pain is not addressed and treated, it interferes with recovery and rehabilitation.
Persistent pain can interfere with the way we think and function, gets in the way of everyday activities and affects work and relationships with family and friends. It reduces one's quality of life, and can eventually spiral down to needless suffering and depression.
The Pain Management Unit of the Department of Anaesthesia comprises a team of doctors and nurses working in tandem with other allied health professionals (including physiotherapists and psychologists) to holistically manage patients' pain experience and alleviate suffering.
The Acute Pain Service manages pain associated with trauma or post-surgery, and acute medical conditions such as mucositis and sickle cell crisis. Using a wide range of treatment modalities from oral painkillers and intravenous patient controlled analgesia, to epidurals and peripheral nerve block infusions, the service provides 24/7 care during the most critical periods of a patient's recovery.
The Chronic Pain Service similarly employs a comprehensive spectrum of strategies to address a wide variety of persistently painful conditions, ranging from non-malignant conditions such as low back pain and trigeminal neuralgia, to recalcitrant cancer pain in both adult and paediatric patients.
Some of the techniques used regularly include:
- Non-invasive techniques based on psychology
- Pharmacological agents (oral and injection medications)
- Interventional pain procedures such as nerve blocks and radiofrequency ablation.
Our Pain Service is co-located within the 16a Anaesthesia, Pain Management and Acupuncture Clinic at the NUH Medical Centre, level 16.