Departments

Mission

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To safely anesthetize all surgical and interventional procedures, assessment of preoperatively patient’s condition, and optimizing post-operative care for surgical patients.

Vision

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To establish a referral center for renal and hepatic transplantation surgeries.

Research Fields

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1. Pharmacodynamics and pharmacokinetics of different anaesthetic drugs and adjuvants.
2.  Comparative studies regarding different airway devices to secure airway during surgery with the least possible hazards andcomplications.
3.  Fluid Optimisation through comparing different intravenous fluids (crystalloids and colloids) as regard to goal directed therapy during major surgeries
4.  Conducting experimental studies on new anaesthetic drugs/techniques, this is done in cooperation with the Department of Surgery during experimental surgery.
5.  Evaluation of different recent monitoring devices and studying their efficacy and safety especially on critically hepatic and renal patients.
6.  Establishing protocols for post-operative enteral and parenteral nutrition for ICU patients according to patients’ specific needs and medical condition

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Structure

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1.  Well-equipped operative suite including two operating theatres with two advanced touch screen monitors including the capability of gas analyzer monitoring, cables for a pulse, ECG, pulse oximetry, end-tidal CO2, bispectral index, and temperature monitoring.
2.  Trans-oesophageal Doppler apparatus for cardiac output monitoring.
3.  Picco and Masimo apparatuses for goal-directed fluid therapy in major surgery.
4.  Fiber-optic intubating devicefor difficult intubation management.
5.  Thromboelastometry for coagulation monitoring and blood coagulation factors replacements during transplant and major bloody surgeries.
6.  Ultrasound apparatus for sonar guided nerve block and vascular access.
7.  Warming devices including Bair Hager mattress, water mattresses and rapid warming infusion pumps for keeping body temperature and warming patients during major,lengthy and bloody surgeries
8.  Fluid infusion warming apparatus.
9.  Target control infusion pumps for total intravenous anesthesia
10.  Updated anesthesia machines with vaporizers for various inhalational anesthetics (desflurane – sevoflurane – isoflurane ) to cope with all different patients’ requirements
11.  Post-anesthesia care unit (PACU) for patients’ recovery and adequate monitoringtill their transfer to the surgical ward.
12.  Well-equipped three surgical ICU beds with advanced monitors, infusion pumps, ventilators and crash trolley with DC shock apparatus with option of isolation of patients in specific isolation room.
13.  Ongoing development of three operating theatres with central pipe system, central condition, recent advanced monitors and anesthesia machines.

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1.  Well-equipped operative suite including five operating theatres with five advanced touch screen monitors including the capability of gas analyzer monitoring, cables for a pulse, ECG, pulse oximetry, end-tidal CO2, bispectral index, and temperature monitoring.
2.  Trans-oesophageal Doppler apparatus for cardiac output monitoring.
3.  Picco and Masimo apparatuses for goal-directed fluid therapy in major surgery.
4.  Fiber-optic intubating device for difficult intubation management.
5.  Thromboelastometry for coagulation monitoring and blood coagulation factors replacements during transplant and major bloody surgeries.
6.  Ultrasound apparatus for sonar guided nerve block and vascular access.
7.  Warming devices including Bair Hugger mattress, water mattresses and rapid warming infusion pumps for keeping body temperature and warming patients during major,lengthy and bloody surgeries
8.  Fluid infusion warming apparatus.
9.  Target control infusion pumps for total intravenous anesthesia
10.  Updated anesthesia machines with vaporizers for various inhalational anesthetics (sevoflurane – isoflurane ) to cope with all different patients’ requirements
11.  Post-anesthesia care unit (PACU) for patients’ recovery and adequate monitoringtill their transfer to the surgical ward.
12.  Well-equipped three surgical ICU beds with advanced monitors, infusion pumps, ventilators and crash trolley with DC shock apparatus with option of isolation of patients in specific isolation room.

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Techniques

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1. Thrompoelastometry (Rotem) for coagulation monitoring and blood coagulation factors replacements during liver transplantation and major bloody surgeries.
2.  Ultra sound guided nerve block and vascular access.
3.  Difficult intubation management using fibre-optic intubating device.
4.  Bispectral index for monitoring the depth of anaesthesia
5.  Goal directed fluid therapy, guided by Picco, Trans-oesophageal Doppler,Masimoor ICON.
6.  Cardiac output monitoringduring intra- and post-operative procedures using trans-oesophageal Doppler,Masimoor ICON.

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1.  Thrompoelastometry (Rotem) for coagulation monitoring and blood coagulation factors replacements during liver transplantation and major bloody surgeries.
2.  Ultra sound guided nerve block and vascular access.
3.  Difficult intubation management using fiber-optic intubating device.
4.  Bispectral index for monitoring the depth of anaesthesia
5.  Goal directed fluid therapy, guided by Picco, Trans-oesophageal Doppler,Masimo or ICON.
6.  Cardiac output monitoringduring intra- and post-operative procedures using trans-oesophageal Doppler,Masimo or ICON.

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Services

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Services offered by the department are conducted to all patients especially those with chronic hepatic and renal diseases undergoing either surgical or endoscopic interventions for either diagnostic or therapeutic purposes.

· Preoperative assessment

The anesthesia clinic offers preoperative assessment and evaluation of medical problems, optimization of the patient’s general condition for a safe surgical intervention and minimum hospital stays.

· Intra-operative management

The offered services include:

1.  Modern anesthetic techniques and anesthetic agents (inhalational [e.g. VIMA], intravenous or continuous intravenous infusion [e.g. TIVA], including muscle relaxants and narcotics.
2.  Recent drugs and techniques used in peripheral nerve blockade, central nerve blockade, acupuncture anesthesia, and analgesia in special surgical techniques.
3.  Adjusting anesthesia for liver resection and liver transplant.
4.  Adjusting Anaesthesia for laparoscopic surgery either urological or general surgery.
5.  Use of recent anaesthetic drugs and monitoring to control the depth of anesthesia to improve patients’ outcomes.
6.  Intraoperative fluid optimization in major abdominal surgery using advanced monitoring (Trans-esophageal Doppler, Masimo, and Picco).
7.  Remote location anesthesia including

• • •  Gastrointestinal endoscopy (ERCP- upper and colonoscopy)
    •  Interventional radiology techniques

· Postoperative management

The offered services include:

1.  Well-equipped postoperative care unit (PACU) for receiving the patients after surgery, optimizing their general condition, allowing full recovery and safe transfer.
2.  Studying different analgesic drugs and adjuvants (dexamethasone, gabtine, etc…) to improve patients, outcomes and decrease postoperative analgesic requirements.
3.  Studying different agents that could minimize postoperative complications (e.g., nausea and vomiting, etc…).
4.  Studying different narcotics with different doses to reach optimum and safe recovery with minimal side effects.
5.  Studying various extradural drug combinations (local anesthetics, narcotics, adjuvants) for postoperative pain relief after major surgeries.
6.  The department also cooperates with other institute departments on either human or animal studies to evaluate different anesthetic agents/ techniques as well as their effects on different body organs and systems.

Training

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a. Cannulation workshop including the theoretical overview and practical training on various cannulation techniques (arterial, central venous, and venous).

b. Airway management/intubation workshop including the theoretical overview and practical training courses on managing airway problems and various endotracheal intubation techniques as follows:

• •  Recent intubating devices (e.g.; air-track).
  •  Supraglottic devices (e.g.; I-gel and various types of laryngeal mask airway).
  •  Fiber-optic intubating device.

c. c. Neuro-axial block workshop including the theoretical overview and practical training on epidural analgesia (thoracic, lumbar, and caudal), spinal analgesia, continued spinal analgesia, and combined spinal epidural analgesia.

d. Ultra-sound workshop on vascular access, nerve block, and epidural localization.

e. Recent Monitoring Devices workshop including Trans-esophageal Doppler (TED) and Picco for cardiac output monitoring; Bispectral index (BIS) for depth of anesthesia monitoring and control; Masimo for fluid replacement therapy and Thrompoelastometry (Rotem) for coagulation monitoring and management.

f. Workshop for clinical nutrition

Achievements

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1.  Cooperation with famous hospitals in Germany for training of the anaesthesia staff members on hepatic and renal transplant anaesthesia and post-operative ICU.
2.  Performing renal transplant operations and multiple hepatic resection surgeries.
3.  Establishing a system for pre-operative liver transplants from living donors as well as establishing a surgical ICU dealing with critically post- operative transplant patients
4.  Establishing pain clinic as well as clinical nutrition unit.
5.  Utilizing high technology equipment including fiber-optic endoscopy for endotracheal intubation,Transoseophaeal Doppler-Masimo andPicco for goal-directed fluid therapy,Bispectral index monitoring depth of anaesthesia under different aesthetic agents and ultra-sound apparatus for nerve block and vascular cannulation.
6.  Four innovative prototypes including:

• • Diaphragm-Controlled Tracheobronchial Tube (DC-TBT) for one lung anaesthesia. Patency was issued by the Egyptian Patent Office, Academy of Scientific Research and Technology (ASRT), Arab Republic of Egypt on 15/4/2008.Patent number: 24054;PI:Prof.HossamEl-Din HelmyEl-Sebae
  •  A device for epidural identification and catheterization using continuous hydrostatic pressure. Patency was submitted to the Egyptian Patent Office, ASRT on 2009 and is still pending. Patent number: 871;Investigators:Hossam El-Din Helmy and Prof. Yasser Samhan
  • Anaesthesia device using distilled water injector to get rid of carbon dioxide physically. Patency was submitted to the Egyptian Patent Office, ASRT on 2011 and is still pending. Patent Number: 1028;Investigators:Prof. Hossam El-Din Helmy and Prof. Mohamed Zeidan
  • Multi-Directional Intubating Laryngeal Mask Airway. Patency was issued by the Egyptian Patent Office, ASRT on 2013. Patent number: 1277;Investigators:Prof. Hossam El-Din Helmy and Prof. Mohamed Zeidan

Medical services

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Publications

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• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
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Projects

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• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,
• Lorem Ipsum is simply dummy text of the printing and typesetting industry. Lorem Ipsum has been the industry's standard dummy text ever since the 1500s,