About the Department of Anesthesiology
The Department of Anesthesiology at Upstate Medical University, Syracuse, New York, was established in 1960 previously having been a Division of the Department of Surgery under the direction of Dr. E. Joseph Delmonico.
The first Chairman of the department was Dr. Allen B. Dobkin who initiated the policy of all-physician anesthesia and a strong commitment to research which has persisted to this day. During his chairmanship, 1960-1973, much research was done on the pharmacology and biochemistry of new anesthetic agents including enflurane and the first 200 human administrations of isoflurane, as well as extensive investigations of the metabolic and neuroendocrine effects of general anesthesia and their interactions with hypoxia, hypercarbia and blood loss. In 1965 University Hospital moved into its current building and the number of faculty as well as residents, increased. Dr. Edward T. Thomas was Chairman from 1973-1976 followed by Dr. Howard Zauder, 1977-1988, during whose tenure the department continued to strengthen its teaching program and began an ongoing interest in interactive computer teaching. Other areas of special interest included the use of blood and blood products and the use of fiber-optic endoscopy, as well as the development and rapid expansion of the Pain Treatment Service.
From 1989-2005 Dr. Enrico M. Camporesi assumed the Chairmanship of the department and with the addition of faculty reinvigorated the research program with special interest in human physiology, hyperbaric medicine and the pharmacology of spinal narcotics.
In 2006, Dr. Nancy A. Nussmeier was appointed the Chair of the Department. Dr. Nussmeier had previously served as the Director of Cardiovascular Anesthesia Research at the Texas Heart Institute in Houston, TX. Her current mission is to enhance the Department's academic productivity, with interdisciplinary clinical and labatory research activity and enhanced opportunities for faculty and resident scholarship. Furthermore, her vision is that the Department of Anesthesiology will become a prominent resource for education and teaching on the Upstate campus.
The Pain Treatment Center at SUNY Upstate is one of the largest and most established services of its type in the upstate area. Led by Dr. P. Sebastian Thomas, the chronic pain division and pain management fellowship was established in 1981. Our Chronic Pain Mangement Clinic sees 6,000 patients per year along with the offering of a very specialized chronic pain services such as neuron ablative procedures, dorsal column stimulator insertions, and morphine pump insertions. The fellowship offers 4 ACGME approved positions a year. It is one of the most competitive programs in the Northeast. For more information on the Pain Mangement Fellowship visit our Pain Treatment Center.
In 1995, Cardiac Anesthesia services were also instituted. Presently, three full-time faculty and three part-time faculty rotate through this section of the department with integrated echocardiography services provided.
Since 1997, Pediatric services have been expanded to include five full-time faculty with sub-specialization in pediatric anesthesia. A full range of anesthesia services (including acute post-operative pain service) is offered with an emphasis on both safety and comfort for young patients undergoing surgery and other procedures. Opening in 2009, The Golisano Children's Hospital will be the signature piece of the East Wing vertical expansion at University Hospital. Housed on the top of the expansion, the new children's center will provide over 87,000 square feet devoted to patient and family friendly amenities.
Additional Procedural Changes:
Pretesting of patients for preparedness for anesthesia has evolved to comprise the Preadmission Clinic, staffed daily by an anesthesiology resident, a physician assistant, several nurses and clerical staff under the direction of an anesthesiology attending.
In answer to increasing patient volumes and the quest for improved efficiency, we have implemented the concept of an Anesthesia OR Officer of the Day to provide continuity of effort in coordinating the efficient management of the main operating rooms and the pediatric operating rooms. The trend we have observed is towards more complex patients who arrive with reduced preparation opportunities and a need for discharge to high-intensity care units.
Another important addition in the past few years has been an active and well-organized Acute Pain Service. This is comprised of a team including a pain fellow and an anesthesia resident under the direction of Dr. Donna-Ann Thomas who completed her residency and pain fellowship training at SUNY Upstate. The service comprises an active post-operative PCA epidural, regional blocks and catheter and intrathecal service as well as treatment of patients with chronic pain and acute or chronic pain issues. The service is also an interventional pain service with several different types of blocks being placed. It also provides epidural blood patches for patients with post dural puncture headaches.
Furthermore, the Medical Director of Perioperative Services is our Vice Chair, Dr. Colleen O'Leary. Her duties include assuring the perioperative area's compliance with accrediting and regulatory agencies, providing oversight of Perioperative quality initiatives, orientation of new medical staff, and oversight of professional practice issues.
In February of 2005, Dr. Carlos J. Lopez III was named the new Residency Program Director. Under Dr.'s Lopez and Nussmeier's direction, the residency education program has experienced a new and innovative learning environment that fosters clinical and didactic teaching.
A Difficult Airway Mangement Hands-On Training with mannequin and intubation workshops under the direction of Dr. Wendy Howard. This also includes a one-month airway rotation for all senior residents. This rotation allows the resident to spend a month focused on airway management and gain skills through repetition.
The department has recently expanded the regional anesthesia service with the addition of sub-speciality trained anesthesiologists including an experienced Director of Regional Anesthesia, Dr. Sheldon A. Isaacson. A one-month intensive regional resident rotation has been developed that assigns the regional resident to cases appropriate for application of regional block techniques on a daily basis. This allows a continuum of clinical exposure that allows the resident to perfect his peripheral regional anesthetic techniques using ultrasound and nerve stimulation modalities.
Every year, the residents participate in a cadaver dissection course. The brachial plexus is dissected in a cadaver, as well as crucial anatomy of central line insertion in the neck, airway anatomy with special laryngeal mask adaption, and the lumbar plexus. Additional areas of key interest to anesthesiologists such as common regional anesthesia procedures and blocks are performed.
Board Review Course
Every spring, senior residents are sent to one of the top board review courses in the country. All expenses for this course are paid for by the department.
All CA-2 residents are sent to the Brigham & Women's Hospital in Boston, MA. This one-month rotation gives residents experience in obstetric anesthesia. The department owns an apartment close to the hospital and covers all expenses for the month. Senior residents who would like to do an outside rotation are given the opportunity to do so. The rotation has to be pre-approved by the GME office and the department. Residents also rotate to local hospitals including the VA Hospital, Crouse Hospital, and St. Joseph's Hospital for additional OB, vascular and additional general anesthesia training.
Increased Research Opportunities
The Department is experiencing a revitalization of its research efforts, both in the laboratory and in the clinical arena. Faculty members are involved in ongoing basic research projects that include hyperbaric oxygen treatment of traumatic brain injury, prevention of neurologic injury after cardiopulmonary bypass with second-generation perflurocarbon, and new methods to prolong allograft survival after organ transplantation.
Clinical research projects include investigation of novel drugs to minimize blood loss during and after cardiac surgery. Other clinical studies involve administration of dexmedetomidine to prevent postoperative delirium, administration of peripheral opiate antagonists to prevent postoperative ileus, and clinical validation of new devices that measure blood pressure or cardiac output. The residents and medical students at Upstate Medical University have opportunities to participate in clinical research. We are proud of the fact that some currently smaller-scale clinical research projects were initiated by these trainees.