|Contact phone numbers|
|Chief Officer||Stavroula Lakoumenta||210 94 93 312|
|Deputy Chief Officers:||Christina Antzaka||210 94 93 000|
|Division Heads:||Theophili Kousi
|Attending doctors Α΄:||Apostolos Thanopoulos||“|
The Anesthesiology Division consists of experienced doctors specialized in Cardiac anesthesiology and is equipped with modern anesthesia apparatus and high quality vital signs monitors and specialized support devices of the vital functions. The Anesthesiology Division carries out the following work:
It applies preoperative assessment, determines the risk of the scheduled surgery, and prepares the patients, in order to ensure the best possible outcome of the surgery and reduce the possibility of complications in high risk patients.
- It ensures adequate depth of anesthesia and analgesia, monitor and support of the vital functions of adult patients and children
- It provides General Anesthesia or Controlled Sedation for the percutaneous aortic valve implantation and also, in high-risk patients who undergo diagnostic or therapeutic interventions in the catheterization laboratory.
- It provides Anesthesia in pediatric patients undergoing cardiac surgery and invasive and therapeutic interventions in the catheterization laboratory.
- It offers postoperative post-anesthetic care and management of acute postoperative pain and painful syndromes.
- It participates in the Team that responds to an emergency call and performs Cardiopulmonary Resuscitation for the treatment of hospital-acquired Cardiac Arrest.
Every patient who is scheduled for a heart surgery meets for the first time the anesthesiologist at the Anesthesiology Clinic, several days before his/her admission to the hospital. In the Anesthesiology Clinic, the patient’s general state of health is assessed (record, physical examination, paramedical examinations). The condition of the respiratory and renal function are assessed, the severity of coexisting diseases is evaluated and if it is necessary additional laboratory tests are requested or the medication is modified, in order to prepare better the patient for anesthesia and surgery. The preparation is essential in order for the patient to be taken to the operating room in the best possible health and to achieve the best possible result.
The anesthesiologist evaluates the cardiac record and the diagnostic results, because they must be taken into account for the planning of anesthesia.
In the Anesthesiology Clinic, the patient has the opportunity to ask questions if there are issues for which more explanations are needed. It is natural to feel fear, because the surgery is a new and unknown experience, as well as, anxiety, because during anesthesia he/she has no control over his/her functions. Providing all the information about the role of the anesthesiologist who not only provides the anesthesia, but is also, responsible for monitoring the vital functions and does what is required for their restoration establishes a climate of confidence and trust.
Anesthetic Preparation of the Patient before surgery
When the patient is admitted to OCSC for cardiac or cardiac surgery under General Anesthesia or Controlled Sedation, he/she is re-evaluated by the anesthesiologist who informs him/her about the type of anesthesia that will be provided. In children, recent respiratory infection is a reason to delay a surgery. The anesthesiologist monitors the latest laboratory findings and prescribes medication and premedication to be given just before surgery.
The purposes of anesthesia are:
- Securing and maintaining vital functions of the organism
- The discharge of the patient from the pain and stress of surgery
- Ensuring appropriate conditions in order for the surgery to be performed.
The administration of general anesthesia is characterized by three main phases:
- Introduction to anesthesia
- the Management of anesthesia throughout the surgery, and
- Awakening from anesthesia
For each phase of anesthesia a variety of medications and anesthesia techniques are used. During anesthesia, the anesthesiologist is always next to the patient. With special equipment he/she monitors constantly the status of the patient’s functions (cardiac function, respiratory function, renal function, etc.) and provides drugs that suppress the stress of surgery and also, the appropriate intravenous fluids, blood and blood derivatives.
The success of a cardiac surgery is based on the continuing excellent communication and consultation between the anesthesiologist, the cardiac surgeon and the operator of extracorporeal circulation as well as the collaboration with the nurses and the operating room staff.
At the end of the surgery the patient is taken to the Intensive Care Unit with continuing repression and wakes up when it is safe according to the type of surgery and the specific circumstances of each case.
The interest, care and responsibility of the anesthesiologist for the patient continues during the post-operative period, with the post-operative visits to the ICU and the treatment rooms.
Perioperative management of Bleeding from the Anesthesiologist
The contribution of the Anesthesiologist in the treatment of perioperative bleeding begins with the preoperative evaluation of the high risk patients for significant bleeding, it continues with the application of protocols and procedures to reduce blood loss, blood transfusions and derivatives, and is completed with the intraoperative monitoring of coagulation and hemostasis mechanism in collaboration with the Hematology Laboratory and the implementation of targeted interventions.
Intraoperative transesophageal echocardiography by the Anesthesiologist
The Intraoperative Echocardiography is a part of the usual monitoring for the cardiac surgeries and in fact, many of them are performed safely, only when there is the possibility of applying Echocardiography.
With the Intraoperative Echocardiography the structures and function of the heart throughout the surgery are examined and the preoperative diagnosis is confirmed, new findings are highlighted, the treatment throughout the surgery is accurately directed, and the surgical result at the end of surgery is examined ensuring in this way the best possible outcome for the patients.
In the OCSC Anesthetic Division all the anesthesiologists have experience in the implementation of intraoperative Echocardiography and many members of the Anesthesiology Division own a European Certification in Intraoperative Echocardiography and participate in promoting the education of Anesthesiologists in this new objective of specialty.
Postoperative pain management
The Anesthesiologist is the appropriate doctor to administer drugs that treat pain. He/She actively participates and helps in treating postoperative patients’ pain.
Anesthesia – Controlled Sedation for Children
The Pediatric Cardiac Anesthesiologists are skilled and experienced in the administration of general anesthesia or sedation in children, infants and neonates because these patients have specific features associated with the age, size, and type of congenital heart disease. Parents of young children are informed throughout the process such as the receipt of the child, the possibility to accompany the child, the type of anesthesia, the placement of intravascular catheters, the likelihood for transfusion, the suppression of pain, the transfer to the Intensive Care Unit, or stay in post-anesthetic care unit with any relevant detail.
Anesthesiology Transplant Management
It implements the pre anesthetic assessment of patients with heart failure who are in process of joining the list for transplantation to be evaluated by the Selection Committee. It provides perioperative anesthetic support to patients undergoing transplants and implantation of mechanical support cardiac function devices.
It performs also, the support of the organ donor at any hospital.
Training – Retraining in Cardiac Anesthesia
The cardiac anesthesiology is a specialization of anesthesiology and is usually obtained after the specialty of Anesthesiology.
The OCSC Anesthesiology Division educates junior anesthesiologists, who follow the program of theoretical courses and clinical activities of OCC, which are recorded in the trainee book (log-book).
The OCSC Anesthesiology Division also enables skilled anesthesiologists to be retrained in Cardiac Anesthesiology and Intraoperative Echocardiography with the Organization of Postgraduate Seminars as well as the clinical application of Intraoperative Echocardiography with the supervision of an experienced field executive.