Anaesthesia for the following surgeries

• Craniotomy for Brain tumours – gliomas, meningiomas, craniopharyngiomas, vestibular schwannomas, epidermoid, and intraventricular tumours.
• Anaesthesia for awake craniotomy.
• Complex skull base surgeries
• Anaesthesia for cerebrovascular disorder – Aneurysm clipping, AVM resection surgery, Dural AV fistula
• Epilepsy surgery
• Anaesthesia for craniotomy for infections such as pyogenic abscesses, tuberculosis, fungal infections and cysticercosis.
• Anaesthesia for functioning and non functioning Pituitary surgeries – TNTS, Combined transcranial and transnasal approach
• Anaesthesia for Spine surgery -Degenerative spine disorders, cervical, thoracic and lumbar laminectomy, instrumentation including minimally invasive and Endoscopic procedures.
• Anaesthesia for spinal dysraphism
• Congenital and acquired Craniovertebral junction anomalies
• Acute spine cord injury
• Anaesthesia for spinal cord tumours
• Anaesthesia for Scoliosis/Kyphosis surgery
• Anaesthesia for Paediatric neurosurgery – Supratentorial, infratentorial tumours, Anaesthesia for ST-MCA bypass and EDAS for Moya Moya disease, complex craniofacial reconstructive surgeries for craniosynostosis, Anaesthesia for Tethered cord release, Meningomyelocele excision, VP shunt/ VA shunt for Hydrocephalus.
• Anaesthesia for Neurotrauma – Decompression for Subdural/ Extradural haematoma/ contusion/DAI, Depressed skull fractures
• Functional Neurosurgery- Deep brain stimulation, Lesionings procedures, Stereotactic procedures
• Anaesthesia for Interventional Neuroradiology – Anaesthesia for AVM embolisation/ AV Fistula embolisation, Mechanical thrombectomy for arterial and venous stroke, Tumor embolisation, Aneurysm Coiling, Balloon Occlusion test, WADA procedure, Diagnostic/ Therapeutic angiogram, venous sinus pressure monitoring and stenting and MMA embolisation for chronic recurrent SDH.
• Anaesthesia for MRI for both children and adults.
• Anaesthesia for ECT

Pre Anaesthesia Facility

All patients undergoing Elective neurosurgical Procedures are seen in this clinic by a Consultant 1-5 days before surgery. Complex procedure are discussed in multidisciplinary meeting for better preop optimisation.

• Clinical neuromonitoring is done in our department
• Depth of anaesthesia monitoring – BIS/ Entropy/ PSI (Masimo)
• Cerebral Oximetry
• Neurophysiology monitoring – MEP (Transcranial, Direct cortical, subcortical and corticobulbar) , SSEP, Cranial nerve nucleus mapping, Cortical, Language and Cognitive Mapping, Facial and other cranial nerve monitoring in collaboration with the Neurophysiology department
• Transthoracic Echo – Basic skills
• Trans cranial Doppler
• POCUS

Procedures are done apart from the routine GA/ line placement

• Scalp block for all craniotomies
• Epidural Blood patch for spontaneous intracranial hypotension
• Lumbar drain placement for pituitary surgeries/brain relaxation/Complex skull based surgeries /treatment of intraprocedural/post procedural CSF leak.
• Quadratus Lumborum block for analgesia following anterior iliac bone graft harvest.
• ESP block, TLIP block, Superficial Cervical plexus block and different modalities of pain management following spine surgery.

DM in Neuroanaesthesia 

Duration of the Course: 3 years,  MCI Approved and affiliated to  “The Tamil Nadu Dr M.G.R   Medical University, TN.”                             

Eligibility: MD/DNB Anaesthesia. NEET Superspecialty Examination

No. of seats: Two 

Overview of Training Programmes

The Department of Neuroanaesthesia offers opportunities for those interested in advanced neuroanesthesia training. The Neurosciences department does about 3000 neurosurgical procedures per year with an extensive range of cases which include tumour surgery, seizure surgery, transnasal trans-sphenoidal pituitary surgery, intracranial aneurysms and other vascular procedures, spinal instrumentations, neuro-trauma, paediatric neurosurgery and awake craniotomy. The neurosciences department is the pioneer in the field of intraoperative neuromonitoring and evoked potential monitoring in India.

The three-year DM course in neuroanesthesia is open to those who have finished an M.D. or DNB in Anaesthesiology. This course involves training in the state-of-the-art newer techniques of anaesthesia and intraoperative neuro monitoring for neurosurgical procedures.

The trainees rotate through neurosurgery operation theatres, Neuro intensive care and Neurotrauma ICU. They are exposed to Neuro radiology and undergo a short training in intraoperative neuromonitoring. There is ample opportunity for hands-on training in procedures such as arterial cannulations, ultrasound and ECG-guided central venous cannulations, fibreoptic and video laryngoscopic intubations, Scalp block, Fascial plane blocks, and Lumbar drain insertion. Trainees are exposed to POCUS, Transcranial Doppler, intracranial pressure monitoring, Depth of anaesthesia monitoring BIS/Entropy/Patient State Index (Masimo) techniques, NIRS, Pupillometry, and Cardiac output monitoring.

They also get an opportunity to train in EEG and other neurophysiology monitoring such as SSEP/MEP/BAER monitoring. The trainees have exposure to anaesthesia for stereotactic procedures, MRI, interventional and other neuroradiologic procedures. They are also trained in anaesthesia for emergency neurosurgery and neuro trauma. There is ample opportunity for research and trainees are encouraged to present scientific work in national conferences and publish their work in peer-reviewed journals.