The objective of the neuroanesthesia rotation is to provide the resident with a thorough understanding of the neurophysiology and pathophysiology of the brain. A knowledge of the fundamental principles of neuroanesthesia will allow residents to integrate new technology and drugs into the management plans for these patients.
Neuroanesthesia is a subspecialty which treats critically ill patients and requires special skills and dedication. For example, neurosurgical patients have vascular disease which affects all of the vascular beds, including the cardiac circulation. While the neurosurgical service repairs the brain, the neuroanesthesiologist also needs to address a diseased heart – and sometimes the treatment for the heart contradicts the therapy for the brain. We need to constantly develop a balanced anesthesia technique that will honor all of the body systems.
Since University of Illinois at Chicago is a leading neurosurgical center in the United States, we treat some of the sickest patients with the most serious brain pathologies. The acuity of some of these patients frequently requires changes in the operating room schedule. Because of this unpredictability, our residents learn to become adaptable and flexible. One has to be constantly ready to “change course” at a moment’s notice, whether it be due to an intraoperative catastrophic event or due to a change in the OR schedule. At first this is difficult, because change and disruption of plans is disconcerting. But over time, our residents gain confidence, knowing that they have the knowledge and skills to quickly adapt to rapid changes.
This subspecialty rotation is extremely important because it fosters creative thinking, organization, and adaptability. It provides anesthesia residents with a knowledge data base and a set of skills that are essential for safe anesthesia management for many patients during their professional career, whether it be academic or private practice.
The time commitment for this rotation can and may be extensive, but the enjoyment of “knowing the brain” is a cerebral and exciting event. It is staffed by several former Teacher of the Year Award winners, and is consistently one of the highest rated rotations by our residents.
NUTS and BOLTS of Neuroanesthesia
The neuroanesthesia team (all of the attending neuroanesthesia team members are fellowship trained):
Verna L. Baughman, MD
Ben Changyaleket, MD
Guy Edelman, MD
Edina Kim, MD
Chanannait Paisansathan, MD
Steven Roth, MD
Peggy Wheeler, MD
Sabine Kreilinger, MD
Lisa Adiutori, DO
We cover a wide range of cases including craniotomy for aneurysm clipping and tumor resection, spine cases, peripheral nerve/muscle biopsies, anesthesia for interventional acute/chronic pain procedures, and deep brain stimulators for Parkinson’s disease. Invasive monitoring (arterial line, CVP) is needed for the larger cases. Some cases require special anesthesia techniques for neurophysiologic monitoring.
The neuroanesthesia service covers all major neurovascular, sitting procedures, and pediatric cases (< 2 years old) 7 days/week. All other cases are covered by the regular OR call team during nights and weekends.
Neuroanesthesia Conference meets every Thursday from 6:30 – 7:00am.
Week 1: General neuroanesthesia concepts
Week 2: Journal Club
Week 3: Resident PowerPoint presentations
Week 4: Test (both oral and written examinations)
Residents are provided with the Neuroanesthesia Goals and Objectives at the start of the rotation. Each neuroanesthesia resident will be evaluated by the attendings and the fellow following each rotation. Evaluation is based on the six ACGME competencies. Residents will be given a list of “talking topics” to stimulate discussion with the attendings and fellow during the day. Residents will also be evaluated on their procedure skills, and they are required to keep an accurate log of all neurosurgical cases using the Case Log program. Residents will be asked to evaluate their neuroanesthesia education at the end of each rotation. These evaluations will be anonymous – summarized by the office staff and returned to the Division on a semiannual basis.