Message from the President
Dr. Durga Prasada Rao Posani
President, ISA, AP State
Dear Members,
It is a matter of great satisfaction and pride to revive the quarterly Newsletter of the Indian Society of Anaesthesiologists, Andhra Pradesh State Chapter.
The rapid advances in the field of Anaesthesiology and the ever-changing spectrum of clinical practice throw up new challenges, making it imperative for us to remain connected and share our expertise and experiences.
This Newsletter will be an ideal platform for all of us to share not only clinical knowledge but also the activities of the ISA at all levels, particularly those of the City branches.
It will also feature articles and guidance aimed at helping young Anaesthesiologists blossom into successful practitioners. I request all members, senior and junior alike, to contribute actively towards achieving this objective.
I commend the editorial team, headed by Dr. Nori Venugopal, for taking up this challenging yet noble task.
I also express my gratitude to the past National Presidents from our State — Dr. Tagore KRN, Dr. Chakra Rao SSC, Dr. Kameswara Rao AS, Dr. Kuchela Babu V and Dr. Bhimeswar MV — and to the past and present office bearers of ISA AP State and ISA National for their support and encouragement.
I sincerely wish this endeavour great success.
Long Live ISA
Dr. Durga Prasada Rao Posani
President, ISA, AP State
ISA AP Executives
President
Dr. Durga Prasada Rao P
Hon. Secretary
Dr. Madan Mohan
Vice-President
Dr. Malleswara Rao
Treasurer
Dr. Srinivas Yadav
President-Elect
Dr. Atchyutha Ramaiah
Immediate Past President
Dr. S. Srinivasa Rao
Past ISA National Presidents – AP
Dr. K. L. N. Tagore
Dr. SSC Chakra Rao
Dr. A. S. Kameswara Rao
Dr. M. V. Bhimeswar Rao
Dr. Kuchela Babu
Past ISA AP Executives
Dr. Rana Pratap Simha
Dr. N. Sreenivas
Dr. Nagaraj
Dr. R. S. Naik
Dr. Rao Srikanth
Dr. V. Sreedevi
Dr. Vineela Nath
Dr. KSGC Kumar
Dr. Y. V. Rao
Dr. Mahesh Kumar
Dr. Allu Padmaja
Dr. Rajsekhar
Dr. Aparanjii K
Dr. Rajesh Ch.
Dr. Anil Kumar P
Dr. Uday Sankar K.
Editorial Board Members
Brig. TVSP Murthy
Dr. Bala Venkata Subramanyan
Dr. Mahesh Babu
Dr. Murali Thando Bave
Dr. Binil Mathews
Dr. Paliwal
Dr. Alok Samant Ray
Dr. Madan Mohan
Message from the Editor
Dr. Nori Venkata Venu Gopal
Editor
Past President ISA, Andhra Pradesh
Dear Colleagues,
It is my pleasure to present this edition of the Anaesthesia Andhra Pradesh Newsletter.
Our specialty continues to evolve rapidly, driven by innovation, research, and an unwavering commitment to patient safety. This newsletter reflects the dedication, knowledge, and achievements of our members across the state.
In this issue, you will find updates on academic activities, clinical advancements, conference highlights, society initiatives, and inspiring contributions from colleagues.
We hope these articles encourage learning, stimulate discussion, and strengthen professional collaboration.
As anaesthesiologists, we play a pivotal role in perioperative care, critical care, pain management, and emergency medicine.
Let us continue to uphold the highest standards of clinical excellence, ethical practice, and compassionate patient care while embracing lifelong learning.
I extend my sincere gratitude to all authors, reviewers, contributors, and the editorial team whose efforts have made this publication possible.
I also encourage every member to actively participate by sharing original articles, clinical experiences, innovations, and achievements in future editions.
Together, let us continue to advance the science and art of anaesthesiology while fostering a vibrant and supportive professional community across Andhra Pradesh.
Wishing you enjoyable reading and continued success in your professional journey.
With warm regards,
Dr. Nori Venkata Venu Gopal
Editor
Past President ISA, Andhra Pradesh
ISA National Executives
President
Dr. Naveen Malhotra
Secretary
Dr. Rajiv Gupta
Vice-President
Dr. C. Radha Kishen Rao
Treasurer
Dr. Sunil Kumar Sethi
President-Elect
Dr. Al Meenakshi Sundaram
Academic Chair
Dr. Bala Venkat Subramanian
GC Members
Dr. Rama Krishna Reddy M
Dr. Indrani Hemant Kumar
Dr. Rasesh Diwan
Dr. Ravindra Kumar Bhasker
Dr. Langoklapakam Chaoba Singh
Dr. Srinivasalu D
Dr. Chandrasekharan K Cham
Dr. Heena Sunil Chanwal
Dr. Sujata Ghosh
Dr. Tanveer Singh
Dr. Parul Jindal
Dr. Manjusha Shah
Dr. Kiran Kumar Gear
Editorial Board Members
Brig. TVSP Murthy
Dr. Bala Venkata Subramanyan
Dr. Mahesh Babu
Dr. Rakesh Garg
Dr. Murali Thando Bave
Dr. Binil Mathews
Dr. Paliwal
Dr. Alok Samant Ray
Dr. Madan Mohan
Dr. Prasada Rao
Best Wishes from ISA AP Leadership
Dr. Madan Mohan Reddy
Hon. Secretary, ISA AP
My best wishes on inauguration of ISA AP E-Newsletter.
Dr. Malleswara Rao
Vice-President, ISA AP
My best wishes on inauguration of ISA AP E-Newsletter.
Dr. Srinivas Yadav
Treasurer, ISA AP
Hearty congratulations and best wishes on the occasion of ISA AP E-Newsletter.
Dr. Surisetti Srinivas
Past President, ISA AP
Happy to see our ISA AP E-Newsletter again. Congratulations to the Editorial Board.
Dr. Atchutramayya
President-Elect, ISA AP
My best wishes.
Dr. Taraka Prasad
Past President, ISA AP
My best wishes.
Dr. Prashanti Alla
Past President, ISA AP
Hearty congratulations to the Editorial Board.
Dr. Reddy Prasad
Past President, ISA AP
Hearty congratulations to the Editorial Board.
Wishes from Past ISA National Presidents
Dr. M. V. Bheemeshwar
Past President, ISA National
My best wishes to the Editorial Board for restarting the ISA AP E-Newsletter after a gap of two years. My greetings and wish you all success.
Dr. Kuchela Babu
Past President, ISA National
Board Member, WFSA
Happy to hear that ISA AP is starting the E-Newsletter. Congratulations and my best wishes.
Dr. SSC Chakra Rao
Chairman, IRCF
Past President, ISA National
Best wishes to the Editorial Board for coming up with the ISA AP E-Newsletter.
Dr. A. S. Kameswara Rao
Past President, ISA
Congratulations to ISA AP for restarting the E-Newsletter.
Message from ISA National President
Dr. Naveen Malhotra
President, ISA National
Dear esteemed members of ISA AP,
Greetings from ISA National Headquarters!
It is with great pride and enthusiasm that I extend my heartfelt greetings on the launch of the ISA Andhra Pradesh publication.
It gives me immense pleasure to extend my warmest wishes to the editorial team on the publication.
In the rapidly evolving field of anesthesiology, perioperative care, and pain management, staying updated with the latest clinical evidence and practices is vital.
This newsletter serves as a commendable initiative to bridge knowledge, share clinical insights, and promote excellence in patient safety.
I congratulate the Editorial Board, contributors, and the entire department for their dedication and hard work in bringing this edition to fruition.
Wishing the newsletter great success in all its future editions!
Warm regards,
Dr. Naveen Malhotra
President, ISA National
Message from ISA National Honorary Secretary
Dr. Rajiv Gupta
Honorary Secretary, ISA National
Dear esteemed members of ISA AP,
Greetings from ISA National Headquarters!
It is with great pride and enthusiasm that I extend my heartfelt greetings on the launch of the ISA Andhra Pradesh E-Newsletter.
This landmark initiative represents a powerful step forward in advancing academic exchange, strengthening professional communication, and fostering deeper collaboration among members of the Indian Society of Anaesthesiologists.
I am confident that this E-Newsletter will emerge as a vibrant and influential platform—showcasing knowledge, celebrating achievements, highlighting innovations, and keeping our community connected and inspired across the state.
I extend my sincere congratulations to the entire ISA Andhra Pradesh team, especially the Editorial Board, whose vision, dedication, and tireless efforts have brought this commendable initiative to life.
I wish the ISA Andhra Pradesh E-Newsletter resounding success and a lasting legacy of meaningful contribution to our fraternity.
May it continue to grow into a dynamic and impactful forum that drives excellence, nurtures innovation, and strengthens the bonds within our professional community for years to come.
Long Live ISA, Long Live ISA AP
With warm regards and best wishes,
Dr. Rajiv Gupta
Honorary Secretary
ISA National
Felicitation Message
Dr. Al Meenakshi Sundaram
President-Elect, ISA National
It gives me immense pleasure to learn that the Indian Society of Anaesthesiologists, Andhra Pradesh State Branch is restarting its official newsletter.
I extend my heartfelt congratulations to the State President, Secretary, Editor, Editorial Board and all the members who have taken the initiative to revive this important academic platform.
A newsletter is much more than a compilation of events. It serves as a vibrant medium for sharing scientific knowledge, highlighting innovations in anaesthesiology, showcasing research, documenting state branch activities, and fostering meaningful academic interaction among members.
It also provides an excellent opportunity for young anaesthesiologists to contribute their ideas, experiences and scholarly work.
I am confident that this newsletter will become a valuable source of scientific updates, thought-provoking articles, clinical insights, and professional news, thereby strengthening the academic culture of our society and promoting continuous learning.
As President-Elect, ISA National, I convey my best wishes to the editorial team for the successful publication of the newsletter.
May this initiative grow from strength to strength and inspire excellence in academics, research, education, and patient care.
With my sincere compliments and best wishes for a successful and enduring journey.
Dr. Al Meenakshi Sundaram
President-Elect, ISA National
Message from the Vice-President, ISA National
Dr. C. Radha Kishan Rao
Vice-President, ISA National, Hyderabad
I am happy to send my best wishes to the Editor of the newsletter of ISA Andhra Pradesh State Branch.
It unfolds another scientific program. It will help all Anaesthesiologists of Andhra Pradesh State Branch.
I congratulate Prof. Dr. N. Venugopal, Editor of the Anaesthesiology newsletter, for taking up this initiative.
Congratulations on the ISA AP E-Newsletter
Dr. Manjusha Shah
Governing Council Member
Indian Society of Anaesthesiologists (ISA) National
Dear Colleagues,
I extend my heartfelt congratulations on the launch of the inaugural issue of the ISA AP E-Newsletter. Congratulations to the entire ISA AP team on this wonderful initiative.
This newsletter marks the beginning of a valuable platform for sharing knowledge, achievements, academic updates, innovations, and the remarkable activities of our society.
Effective communication is the cornerstone of a vibrant professional organization, and this initiative will undoubtedly strengthen the bond among members while promoting learning and collaboration.
I commend the editorial team and all those who have worked diligently to bring this vision to fruition.
May this newsletter continue to inspire, inform, and connect anesthesiologists across the state, reflecting the excellence and spirit of ISA AP.
Wishing the E-Newsletter great success and a bright future.
With warm regards and best wishes,
Dr. Manjusha Shah
Governing Council Member
Indian Society of Anaesthesiologists (ISA) National
Message from Dr. M. Rama Krishna Reddy
Dr. M. Rama Krishna Reddy
GC Member, ISA National
Dean, College of ISA
Program Head, ISA National Quiz
Medical Superintendent & Professor
PMRIMS, Hyderabad
I am very much privileged to write this message for ISA AP E-Newsletter.
I am sure this E-Newsletter will be informative. It has academic updates, ISA events in AP and non-academic contents like art and literary.
ISA is growing fast, now reaching total membership nearly 52,000.
State chapters are doing excellent job and contributing in all aspects.
My best wishes to ISA AP State.
Longlive ISA.
Best Wishes from ISA National
Dr. Srinivas
G C Member
ISA National
Bellary
Best Wishes ISAAP Executive & Editorial Board ISSAP E-News Letter.
Dr. Srinivas
G C Member
ISA National
Bellary
Congratulations on the Anesthesia Newsletter
Bala Venkata Subrahmanian J.
Academic Chair
ISA National
Congratulations on the Anesthesia Newsletter!
Sending my best wishes to the entire editorial team and contributors on the release.
Thank you for creating a wonderful platform to share clinical knowledge, patient safety insights, and recent advances in anesthesiology.
Wishing you continuous success and smooth publishing for all upcoming editions!
With regards,
Bala Venkata Subrahmanian J.
Academic Chair
ISA National
Article 1
Central Neuraxial Anaesthesia
The newsletter next moves from leadership messages to its first academic article on Central Neuraxial Anaesthesia, covering clinical considerations in neuraxial anaesthesia and the management of high spinal anaesthesia.
The article discusses the importance of continuous observation of the patient during regional anaesthesia, particularly in obstetric patients undergoing LSCS.
Careful monitoring of the patient’s haemodynamic and respiratory status is essential. Communication with the patient should be maintained throughout the procedure, as changes in the patient’s ability to speak or voice quality may provide an early indication of an excessively high block.
Oxygen supplementation and respiratory support should be provided whenever necessary.
The anaesthesiologist should remain prepared to manage cardiovascular changes associated with a high neuraxial block and maintain adequate haemodynamic stability.
After achieving the required level of anaesthesia, appropriate positioning and table tilt should be considered according to the patient’s clinical condition.
Different central neuraxial techniques are available for LSCS, particularly in high-risk patients, allowing the anaesthesiologist to individualize the regional anaesthesia technique according to the patient’s requirements.
Dr. Naresh Paliwal, MD
Article 2
Anaesthesia for Interventional Pulmonology: Principles and Contemporary Practice
Dr Gautam Reddy MD, FAORA
Associate Consultant, Department of Anaesthesiology, Apollo Hospitals, Bangalore
Dr Murali Thondebhavi MD, FRCA, FFPMRCA, CCT, MBA
Senior Consultant, Department of Anaesthesiology and Pain Medicine, Apollo Hospitals, Bangalore
Abstract
Interventional pulmonology has evolved into a rapidly expanding subspecialty encompassing a wide spectrum of diagnostic and therapeutic procedures involving the tracheobronchial tree and pleural cavity.
Increasing procedural complexity has transformed the role of the anaesthesiologist from that of a provider of procedural sedation to an integral member of a multidisciplinary team responsible for airway management, ventilation, haemodynamic stability and crisis management.
The defining feature of these procedures is the “shared airway”, where simultaneous access by the anaesthesiologist and bronchoscopist demands meticulous planning and seamless communication.
Anaesthetic management must be individualised according to the planned intervention, patient comorbidities and anticipated airway challenges.
Contemporary practice has also witnessed the emergence of robotic bronchoscopy, advanced navigational techniques, bronchoscopic lung volume reduction and increasingly sophisticated therapeutic interventions, all of which require refined anaesthetic strategies.
This review discusses the principles of pre-procedural assessment, airway management, sedation, ventilation techniques and procedure-specific considerations in interventional pulmonology while highlighting recent advances and current evidence that influence modern anaesthetic practice.
Keywords: Interventional pulmonology, bronchoscopy, rigid bronchoscopy, anaesthesia, jet ventilation, airway management, EBUS.
Introduction
Interventional pulmonology has undergone remarkable evolution over the past two decades.
Procedures that were once confined to diagnostic bronchoscopy have expanded to include advanced imaging, tumour debulking, airway stenting, bronchoscopic lung volume reduction, cryobiopsy, bronchial thermoplasty and minimally invasive pleural interventions.
These procedures are increasingly performed outside the conventional operating theatre in dedicated interventional pulmonary suites equipped with fluoroscopy, endobronchial ultrasound (EBUS) and navigation systems.
From an anaesthetic perspective, interventional pulmonology represents perhaps the quintessential example of a shared airway.
The airway simultaneously serves as the patient’s lifeline, the surgical field and the route for ventilation.
Consequently, successful outcomes depend not only on technical expertise but also on effective communication and close coordination between the bronchoscopist and anaesthesiologist.
The objectives of anaesthesia extend beyond patient comfort. They include maintenance of oxygenation and ventilation despite an open airway, provision of optimal procedural conditions, suppression of airway reflexes, rapid recovery and preparedness for potentially catastrophic complications such as airway obstruction, massive haemorrhage and cardiovascular collapse.
Scope of Interventional Pulmonology
Bronchoscopic procedures may broadly be categorised into diagnostic and therapeutic interventions.
Diagnostic procedures include flexible bronchoscopy, bronchoalveolar lavage, endobronchial biopsy, transbronchial biopsy, EBUS-guided transbronchial needle aspiration, radial EBUS, electromagnetic and robotic navigational bronchoscopy, and transbronchial cryobiopsy.
Therapeutic procedures encompass rigid bronchoscopy, management of central airway obstruction, airway stenting, tumour debulking, laser therapy, argon plasma coagulation, electrocautery, cryotherapy, foreign body removal, bronchial thermoplasty and endobronchial valve placement.
Thoracoscopic procedures, both diagnostic and therapeutic, further expand the spectrum of interventional pulmonology by facilitating pleural biopsy, talc pleurodesis, management of recurrent pleural effusions and treatment of empyema.
Figure 1: Interventional Pulmonology Suite
[Insert the Interventional Pulmonology Suite image from the newsletter here]
The increasing complexity and duration of these procedures have shifted contemporary practice towards deep sedation or general anaesthesia, particularly for advanced interventions.
Pre-Procedural Assessment
Thorough preoperative evaluation is essential because many patients present with advanced pulmonary disease, malignancy or significant cardiopulmonary comorbidities.
Evaluation should include:
- Detailed history with emphasis on respiratory symptoms, exercise tolerance and previous airway interventions.
- Review of computed tomography to understand airway anatomy, degree of obstruction and relationship of lesions to major vessels.
- Pulmonary function tests whenever feasible.
- Baseline oxygenation and arterial blood gas analysis in selected patients.
- Echocardiography in suspected pulmonary hypertension or cardiac disease.
- Assessment of coagulation profile before biopsy procedures.
Equally important is discussion with the bronchoscopist regarding procedural objectives, anticipated duration, expected bleeding risk, requirement for fluoroscopy or laser therapy, and the preferred ventilation strategy.
Airway Management
Airway management in interventional pulmonology must be planned according to the nature and complexity of the procedure.
Different airway devices and techniques may be required depending on whether the procedure involves flexible bronchoscopy, rigid bronchoscopy, navigational procedures, thoracoscopy or other advanced interventions.
Double-lumen tubes are primarily reserved for thoracoscopic procedures requiring one-lung ventilation or whole lung lavage.
Bronchial blockers are used regularly for thoracoscopic procedures.
The contemporary trend, particularly in robotic and navigational bronchoscopy, favours larger endotracheal tubes under general anaesthesia to facilitate stable ventilation and improve procedural precision.
Sedation and Anaesthetic Techniques
The depth of anaesthesia should match procedural complexity.
Awake bronchoscopy is now relatively uncommon and is largely confined to dynamic airway assessment or evaluation of vocal cord function.
Nevertheless, generous topical airway anaesthesia remains fundamental regardless of the anaesthetic technique employed.
Moderate sedation using combinations of midazolam, fentanyl and carefully titrated propofol continues to be appropriate for short diagnostic procedures.
Deep sedation is increasingly preferred for advanced flexible bronchoscopy because it improves procedural conditions and minimises coughing.
General anaesthesia has become the standard of care for rigid bronchoscopy, airway interventions, cryobiopsy, navigational bronchoscopy and thoracoscopy.
Total intravenous anaesthesia (TIVA) with propofol, combined with a short-acting opioid such as remifentanil or fentanyl, remains the preferred technique.
Unlike inhalational anaesthesia, TIVA is unaffected by interruptions in ventilation and minimises contamination of the bronchoscopy suite.
Neuromuscular blockade improves procedural precision and suppresses coughing during complex interventions.
Emerging Sedation Options
Recent literature has highlighted growing interest in dexmedetomidine and remimazolam for selected bronchoscopic procedures.
Dexmedetomidine provides cooperative sedation with minimal respiratory depression, while remimazolam offers rapid onset and recovery with haemodynamic stability.
Their precise role in advanced interventional pulmonology continues to evolve.
Ventilation Strategies
Ventilation during interventional pulmonology procedures requires careful planning because the airway is shared between the anaesthesiologist and the proceduralist.
The choice of ventilation technique depends on the nature of the intervention, airway anatomy, duration of the procedure and the equipment being used.
Techniques may include conventional positive-pressure ventilation, spontaneous ventilation and jet ventilation. The anaesthetic team must continuously anticipate interruption of ventilation and maintain close communication with the bronchoscopist.
Rigid Bronchoscopy
Rigid bronchoscopy remains an important therapeutic platform for the management of central airway obstruction, foreign-body removal, tumour debulking and airway stenting.
General anaesthesia is usually required, with careful attention to airway control, oxygenation, ventilation and haemodynamic stability.
The rigid bronchoscope itself functions as both the procedural instrument and the airway conduit. This creates specific challenges for the anaesthesiologist and requires close coordination with the bronchoscopist.
EBUS and Advanced Diagnostic Bronchoscopy
Endobronchial ultrasound-guided procedures have become an important component of contemporary interventional pulmonology.
Anaesthetic requirements depend on procedural complexity and duration. Patient immobility, suppression of coughing and maintenance of adequate oxygenation are important for successful completion of these procedures.
General anaesthesia or deep sedation may be selected depending on patient characteristics, institutional practice and procedural requirements.
Navigational and Robotic Bronchoscopy
The introduction of electromagnetic navigation and robotic bronchoscopy has expanded access to peripheral pulmonary lesions.
These procedures demand stable operating conditions and precise airway management. General anaesthesia with controlled ventilation is increasingly preferred.
Larger endotracheal tubes may facilitate bronchoscope passage and help maintain procedural stability.
Airway Stenting and Tumour Debulking
Patients requiring airway stenting or tumour debulking may already have significant airway compromise.
Pre-procedural imaging should therefore be carefully reviewed to identify the site and severity of obstruction and its relationship to surrounding structures.
The anaesthetic team should be prepared for sudden deterioration in airway patency, bleeding, hypoxaemia or haemodynamic instability.
Rigid bronchoscopy may provide an important means of securing the airway while simultaneously permitting therapeutic intervention.
Cryotherapy and Cryobiopsy
Cryotherapy has become an increasingly important bronchoscopic technique.
Transbronchial cryobiopsy can obtain larger tissue specimens than conventional forceps biopsy but may also be associated with clinically significant bleeding and pneumothorax.
Anaesthetic planning should therefore include strategies for airway control and rapid management of complications.
Bronchial Thermoplasty
Bronchial thermoplasty is performed in selected patients with severe asthma.
Anaesthetic considerations include the patient’s underlying airway hyper-reactivity, potential bronchospasm and the need to provide adequate procedural conditions while maintaining oxygenation and ventilation.
Endobronchial Valve Placement
Endobronchial valves may be used as part of bronchoscopic lung-volume-reduction strategies.
These patients often have advanced underlying pulmonary disease and limited respiratory reserve.
Pre-procedural assessment and careful anaesthetic planning are therefore particularly important.
Complications and Crisis Management
Interventional pulmonology can be associated with potentially serious complications.
These may include:
- Hypoxaemia
- Hypercapnia
- Airway obstruction
- Bronchospasm
- Haemorrhage
- Pneumothorax
- Haemodynamic instability
- Cardiovascular collapse
The anaesthesiologist must remain prepared for rapid airway intervention and resuscitation throughout the procedure.
Effective communication between the anaesthetic and interventional pulmonology teams is essential, particularly during unexpected airway or cardiovascular emergencies.
Conclusion
Interventional pulmonology represents one of the most challenging areas of contemporary airway anaesthesia.
The increasing sophistication of diagnostic and therapeutic bronchoscopic procedures requires anaesthesiologists to understand the procedure, anticipate airway and ventilation challenges, and work closely with the bronchoscopist.
Individualised anaesthetic planning, meticulous preparation, effective communication and readiness to manage complications remain fundamental to safe practice.
The continued development of robotic bronchoscopy, navigational technologies and advanced therapeutic procedures will further expand the role of the anaesthesiologist within the multidisciplinary interventional pulmonology team.
Article 3
MENTORING ANESTHESIOLOGISTS
Introduction
The medical profession is an amalgam of science and art. Excellence in the profession cannot be achieved with just knowledge. Multiple nuances and skills can only be acquired through good guidance and handholding.
Mentoring plays a crucial role in the development and success of healthcare professionals. Mentorship is essential for training and career advancement in academic medicine today.
There is a significant variation in the prevalence of mentorship in the medical field, and it has been reported to vary from 19 to 93%, depending on the medical discipline.
The General Medical Council of the United Kingdom recommends regular mentoring of doctors, particularly during changes in their career roles.
The Standing Committee on Postgraduate Medical and Dental Education of the United Kingdom recommended mentoring as part of the residents’ “stress support system.”
However, a survey in the United Kingdom found that only 20% of anesthesia trainees knew who their mentor was; of them, only 38% had met with their mentor.
Anesthesiology is a specialized field that requires a high level of skill, knowledge, and expertise.
Mentoring junior doctors is vital for transitioning from medical school to clinical practice. Mentoring young anesthesiologists is essential for their professional growth and development.
Effective mentoring can help them navigate the complexities of the specialty, develop clinical competencies, and excel in their careers.
Mentorship benefits include better education, better pay, faster climbing the ladder, and more career satisfaction.
What is Mentorship?
The Oxford Dictionary defines a mentor as “an experienced person who advises and helps somebody with less experience over time” and a mentee as “a person who is advised, trained, or counseled by a mentor.”
The concept of mentorship has been practiced through the ages, and we find its mention in ancient literature worldwide.
Ancient Indian literature used the term “guru-shishya”, while Western literature referred to it as “chaperoning,” “fostering,” and “godfathering.”
Distance Mentoring
Distance mentoring has expanded and opened new avenues for learning and collaboration in healthcare settings.
Distance mentoring sessions can be facilitated with telemedicine and virtual communication tools such as video conferencing and messaging applications.
Regular communication can be established by scheduling virtual meetings to maintain communication and provide ongoing support and guidance.
Active participation and engagement are needed to maximize the benefits of distance mentoring.
Remote mentoring helps share educational resources, best practices and teaching tools to support professional development.
Mentees can engage in virtual workshops and online learning activities to gain expert knowledge and expertise from pioneers and established practitioners.
However, a survey found that almost 80% of mentees undertaking long-distance mentoring felt it was less effective than onsite mentoring.
Speed Mentoring
In some cultures, speed dating has been successful in traditional matchmaking. The same method has also been tried to facilitate matching mentors and mentees.
A mentee spends about 10 minutes talking with each rotation mentor during speed mentoring.
In a study, mentees felt that the event helped them expand their network and identify needed resources. Both mentees and mentors thought that this short interaction benefited them.
Speed mentoring ensures that the expertise of a mentor benefits multiple mentees, and if the mentees need further help, they can interact again.
Speed mentoring is a low-resource intervention requiring minimal time commitment for mentees and mentors.
It has been successfully used to mentor women anesthesiology trainees.
Reverse Mentorship
The current generation is very comfortable with information technology and is skilled at managing the hospital’s electronic medical records.
This enables cross-generational mentorship to introduce the concept of “reverse mentorship.”
Reverse mentorship may also help overcome gender-specific and ethnic barriers.
Female physicians-in-training could mentor their faculty members in modern challenges specific to females.
Reverse Mentorship
The current generation is very comfortable with information technology and is skilled at managing the hospital’s electronic medical records. This enables cross-generational mentorship to introduce the concept of “reverse mentorship.”
Reverse mentorship may also help overcome gender-specific and ethnic barriers. Female physicians-in-training could mentor their faculty members in modern challenges specific to females.
Reverse mentorship was particularly relevant to postgraduate medical education during the coronavirus disease 2019 (COVID-19) pandemic.
Junior anesthesiologists can also provide new perspectives on clinician management. They can help change the workplace culture and promote learning.
Phases of a Mentoring Program
Matching Phase
Potential mentees search for experienced, successful people they perceive as good role models.
The program’s proposed volunteer mentors and mentees are initially matched. Based on common goals/objectives, specialty interests, career goals, and personality compatibility, mentors are paired with mentees.
Initiation Phase
An introductory meeting is conducted to understand and establish goals, expectations, and communication preferences.
Cultivation Phase
This is the primary stage of learning and development.
Periodic meetings between mentors and mentees are scheduled to discuss progress, challenges, and growth opportunities.
The mentor shares lessons from the mentor’s experience and expertise, new technologies, new methodologies, and emerging issues in the field with the mentee.
Psychosocial mentoring begins after the mentor and mentee have established an interpersonal bond.
Feedback Phase
A feedback mechanism for mentors and mentees is established to provide input on the effectiveness of the mentoring relationship.
Separation Phase
The mentoring relationship may continue unless something is left to learn, or the mentee wants to establish an independent identity.
It generally describes the end of a mentoring relationship.
Redefinition Stage
After the mentoring relationship is completed, both mentor and mentee recognize that their relationship can continue as a collegial or social friendship, no longer focusing on the mentee’s career development.
Suggested Schedule for Mentoring in a 20-Week Anesthesia Program
Week 1–2: Orientation
- Introduce mentees to the program.
- Discuss expectations, goals, and objectives.
- Preinduction assessment to identify areas for development.
Week 3–6: Clinical Preceptorship
- Pair mentees with mentors for hands-on clinical experience.
- Rotate through different subspecialties to gain diverse clinical exposure.
- Debrief after clinical sessions to discuss cases, challenges, and learning points.
Week 7–10: Case-Based Learning
- Facilitate case-based discussions on complex anesthesia scenarios.
- Analyze case studies to enhance clinical reasoning and decision-making skills.
- Encourage mentees to present cases and participate in group discussions.
Week 11–14: Simulation Training
- Organize simulation sessions to practice anesthesia techniques and crisis management.
- Conduct debriefing sessions to review performance, provide feedback, and identify areas for improvement.
- Emphasize teamwork, communication skills, and leadership in simulated sessions.
Week 15–18: Research and Scholarly Activities
- Support mentees in identifying research projects or quality improvement initiatives.
- Provide guidance on literature review, study design, data analysis, and manuscript preparation.
- Encourage mentees to present their work at conferences or publish in peer-reviewed journals.
Week 19–20: Reflection and Goal Setting
- Reflect on the mentoring experience and discuss achievements, challenges, and lessons learned.
- Set goals for future professional development and career advancement.
- Evaluate the effectiveness of the mentoring program and provide feedback for improvement.
Monitoring of the Program
The mentorship program must be monitored to ensure that its objectives are achieved.
Communication with all participants must be constantly maintained, and feedback must be solicited on its efficacy.
A written summary of the mentorship experience from all participants must be taken.
Group meetings or socials must be regularly conducted to evaluate the program and to suggest ways to improve it.
All participants must complete a program evaluation form at the end of the program.
The proceedings of these meetings and the participants’ feedback will help suggest ways of improving the mentor program for future mentors and mentees.
The standard parameters to evaluate mentees attending the mentoring program are discussed in Box 1, and the parameters for assessing mentors are discussed in Box 2.
Mentorship Malpractice
Mentorship malpractice can be active or passive.
Some examples of active mentorship malpractice are the mentor hijacking a mentee’s idea, project, or grant for self-gain, the mentor acting like an exploiter who destroys a mentee’s success by burdening them with low-yield activities, and the mentor dominating the mentee across various areas of collaboration.
Some examples of passive mentorship malpractice are:
The mentor is preoccupied with his priorities and does not have the time or the desire to attend to mentees.
The mentor evades conflict and avoids difficult but necessary conversations.
The mentor spends little time or effort on mentoring and instead exploits the mentee for self-promotion.
The mentor discourages mentees from seeking other mentors as it stokes the mentor’s ego.
Conclusion
Mentorship is the partnership between a mentor, who acts as a guide, and a mentee, who acts as a learner.
It works beyond the curriculum content and conveys nonclinical aspects of training such as professionalism, networking, values, clinical judgment, and other soft skills that need to be taught in a structured curriculum format.
Mentoring is essential for personal and professional trainee growth.
Mentoring enhances individual practice, well-being, and professional development of mentees and mentors and benefits patients’ care.
It is precious during change and when taking on new roles, such as for newly appointed consultants.
It enhances job satisfaction, well-being, working relationships with patients and colleagues, confidence, problem-solving abilities, collegiality, organizational commitment, and job performance.
References
- Flexman AM, Gelb AW. Mentorship in anesthesia. Curr Opin Anaesthesiol. 2011;24(6):676-81.
- Sambunjak D, Straus SE, Marusic A. Mentoring in academic medicine: a systematic review. JAMA. 2006;296(9):1103-15.
- McCrossan R, Swan L, Redfern N. Mentoring for doctors in the UK: what it can do for you, your colleagues, and your patients. BJA Educ. 2020;20(12):404-10.
- Gould G. Mentor system for anaesthesia trainees. Anaesthesia. 2004;59(4):411.
- Roch GR. Much ado about mentors. Harv Bus Rev. 1979;57(1):14-20.
- Tobin MJ. Mentoring: seven roles and some specifics. Am J Respir Crit Care Med. 2004;170(2):114-7.
- Straus SE, Chatur F, Taylor M. Issues in the mentor-mentee relationship in academic medicine: a qualitative study. Acad Med. 2009;84(1):135-9.
- Maguire A. (2020). 7 Qualities That Make a Good Mentor (and How to Find Someone Who Has Them All).
- Choi AMK, Moon JE, Steinecke A, Prescott JE. Developing a Culture of Mentorship to Strengthen Academic Medical Centers. Acad Med. 2019;94(5):630-3.
- Bin Ghali KN, Al Subaie AT, Nawab AA. Mentorship in anesthesia: a perspective survey among anesthesia residents in Riyadh, Saudi Arabia. Saudi J Anaesth. 2021;15(2):144-8.
Article 4
Beyond Intubation: Perioperative Airway and Extubation Challenges in a Child Undergoing Syngnathia Release Surgery
Dr. S. Geetha – Additional Professor
Dr. Noorain – Senior Resident
Prof. Padmaja Durga
Nizam’s Institute of Medical Sciences, Hyderabad
Background
Syngnathia is a rare congenital craniofacial anomaly characterized by fusion of the maxilla and mandible, resulting in significant airway management challenges.
In paediatric patients, not only intubation, but extubation also can be particularly challenging because of restricted mouth opening, limited airway access, and rapid oxygen desaturation.
While airway management strategies for securing the airway and intubation have been described, studies on postoperative airway care and safe extubation remain underreported.
We present the perioperative anaesthetic management of a child with syngnathia undergoing osteotomy and release, highlighting the challenges encountered beyond intubation.
Case Presentation
A 5-year-old girl weighing 12 kg with recurrent left-sided syngnathia was scheduled for osteotomy and release under general anaesthesia.
Anticipating a difficult airway, an uncuffed endotracheal tube was inserted through one nostril and used as a nasopharyngeal airway to facilitate oxygenation and delivery of sevoflurane while maintaining spontaneous ventilation.
Flexible fibreoptic bronchoscope-guided nasal intubation was then successfully performed through the opposite nostril.
The surgery proceeded uneventfully.
Given the anticipated postoperative airway oedema following extensive surgical manipulation, the patient was electively shifted on mechanical ventilator support to the intensive care unit.
Careful postoperative monitoring, airway assessment, and a planned extubation strategy enabled successful extubation on the following day without respiratory compromise.
Case Report
A 5-year-old female child weighing 12 kg presented with complaints of restricted mouth opening since childhood.
She was born by caesarean section with trismus and had no associated congenital anomalies or comorbidities. Developmental milestones were normal except for delayed speech.
Due to severe restriction of mouth opening, she was fed through a nasogastric tube until 9 months of age.
She underwent her first syngnathia release at 9 months with blind nasal intubation, followed by a second maxillomandibular fusion release at 2 years of age, after which oral liquid feeding was initiated.
She subsequently developed recurrence of jaw fusion and was scheduled for a third surgery involving osteotomy and release to improve mouth opening, facilitate oral feeding, and support adequate growth and development.
Airway Examination
Airway examination revealed restricted mouth opening of one finger breadth, precluding Mallampati assessment, along with retrognathia, a thyromental distance of two finger breadths, disordered dentition, and absent temporomandibular joint movement.
Computed tomography confirmed left-sided maxillomandibular syngnathia.
Figure 1: CT image demonstrating maxillomandibular syngnathia.
[Insert Figure 1 from the newsletter here]
Other systemic examinations and investigations were unremarkable.
After obtaining high-risk consent, standard ASA monitoring and difficult airway preparations, including emergency surgical airway equipment, were instituted.
Fibreoptic-guided nasal intubation under spontaneous ventilation was planned.
Anaesthetic Management
Following inhalational induction with sevoflurane and intravenous access, xylometazoline nasal drops and 2% lignocaine jelly were applied to the nostril.
An uncuffed 4.0-mm endotracheal tube was inserted through one nostril as a nasopharyngeal airway for oxygenation and anaesthetic delivery.
Sedation was supplemented with glycopyrrolate, fentanyl, and propofol.
Fibreoptic-guided nasal intubation was successfully performed through the other nostril using a 5.0-mm cuffed flexometallic endotracheal tube.
Figure 2: Fibreoptic-guided nasal intubation.
[Insert Figure 2 from the newsletter here]
Anaesthesia was maintained with oxygen–air, isoflurane, atracurium, and fentanyl.
Surgical release of the syngnathia restored adequate mouth opening.
Figure 3: Mouth opening following surgical release of syngnathia.
[Insert Figure 3 from the newsletter here]
In anticipation of postoperative airway oedema, the child was electively ventilated overnight and successfully extubated the following day.
Discussion
Literature review demonstrates a greater proclivity of syngnathia recurrence in congenital jaw bony fusion cases.
The child also came for repeat syngnathia release surgery despite two previous surgeries. This may be related to the underlying pathology and difficulty in maintaining postoperative oral exercises.
Anaesthesia for these repeat surgeries is challenging, and airway management is the primary concern.
Awake intubation with spontaneous ventilation is recommended, but is not feasible in an uncooperative child who demands sedation supplementation.
However, sedation may lead to upper airway obstruction and difficulty with mask ventilation, increasing the risk of a cannot intubate–cannot ventilate (CICV) situation, which may lead to bradycardia and arrest.
Rescue devices such as supraglottic airways, regularly employed in CICV, have no role in an airway with inadequate mouth opening, while emergency cricothyrotomy and tracheostomy are technically challenging in children.
In our patient, previous surgeries were performed using blind nasal intubation because of the unavailability of a suitably sized fibreoptic bronchoscope, resulting in significant airway trauma and prolonged postoperative ventilation.
For the current procedure, a flexible fibreoptic bronchoscope (Ambu® Scope) was selected because it allowed easy railroading of a 5.0-mm endotracheal tube over the 3.5-mm scope and provided improved manoeuvrability through tip flexion and rotational control.
To maintain oxygenation and spontaneous ventilation during intubation, an uncuffed endotracheal tube was inserted through one nostril and used as a nasopharyngeal airway for delivery of oxygen and sevoflurane anaesthesia due to lower nasal bleed, laryngospasm, and better ventilation.
While successful intubation is often the focus of airway management in syngnathia, postoperative airway care and extubation are equally important.
Surgical release may result in airway oedema, bleeding, and soft-tissue swelling, increasing the risk of postoperative airway compromise and extubation failure.
Reintubation in such patients can be extremely difficult because of distorted anatomy and restricted access to the airway.
Anticipating these challenges, we elected to continue postoperative mechanical ventilation in the intensive care unit.
Careful monitoring and delayed extubation after resolution of airway oedema resulted in a favourable outcome.
This case highlights that airway management in syngnathia extends beyond successful intubation.
A planned, stepwise approach incorporating maintenance of spontaneous ventilation, fibreoptic-guided nasal intubation, preparedness for emergency airway rescue, and vigilant postoperative airway management is essential to minimize perioperative morbidity and ensure safe extubation.
Conclusion
Airway management in paediatric syngnathia extends beyond successful intubation and requires meticulous perioperative planning.
The use of a nasopharyngeal endotracheal tube for oxygenation and inhalational anaesthesia, combined with fibreoptic-guided nasal intubation under spontaneous ventilation, provided safe airway control in this child.
Anticipation of postoperative airway oedema, elective mechanical ventilation, and a planned extubation strategy were crucial for a favourable outcome.
This case highlights the importance of a stepwise approach to both intubation and extubation in children with syngnathia undergoing surgical release.
References
- Altuwairgi O, Aljabab A, Makrami A, et al. Congenital maxillomandibular fusion: Case series and review of the literature congenital syngnathia treatment approach. Advances in Oral and Maxillofacial Surgery. 2022;6.
- Gurakan SGHATSUB. Congenital gum synechiae as an isolated anomaly: a case report. The Journal of Clinical Pediatric Dentistry. 2003;28:81–83.
- Eduardo Alfredo Duro, SMB, Albano del Cristo Barreto, Paternina. Early treatment of congenital syngnathia. A case report. Journal of Pediatric and Neonatal Individualized Medicine. 2018;7.
- Fiadjoe JE, Nishisaki A, Jagannathan N, et al. Airway management complications in children with difficult tracheal intubation from the Pediatric Difficult Intubation (PeDI) registry: a prospective cohort analysis. The Lancet Respiratory Medicine. 2016;4:37–48.
- Holm-Knudsen R, Eriksen K, Rasmussen LS. Using a nasopharyngeal airway during fiberoptic intubation in small children with a difficult airway. Paediatric Anaesthesia. 2005;15:839–845.
- Kumar V, Rattan V, Rai S. Congenital Maxillomandibular Syngnathia: Review of Literature and Proposed New Classification System. J Maxillofac Oral Surg. 2021;20:19–36.
- Heninger J, Phillips M, Huang A, Jagannathan N. Management of the Difficult Pediatric Airway. Current Anesthesiology Reports. 2020:361–369.
- Cook TM, Woodall N, Frerk C, Fourth National Audit P. Major complications of airway management in the UK: results of the Fourth National Audit Project of the Royal College of Anaesthetists and the Difficult Airway Society. Part 1: anaesthesia. British Journal of Anaesthesia. 2011;106:617–631.
- Lonnée H, Rashad A, Rahimi GR, Labat F. Airway Management of an Infant Presenting with Syngnathia for Surgical Correction. Open Journal of Anesthesiology. 2013;03:35–37.
- Bolton P. Emergency jet ventilation in children. Pediatric Anesthesia. 2009;19:425–427.
Article 5
Research Waste in Anaesthesiology: Are We Generating Evidence or Publications?
Introduction
The advancement of anaesthesiology has always been closely linked to scientific inquiry. From the introduction of pulse oximetry and capnography to the evolution of regional anaesthesia, perioperative medicine, and critical care, research has played a pivotal role in improving patient outcomes.
In today’s academic environment, however, an important question deserves reflection: Are we generating evidence that advances patient care, or are we merely generating publications?
The pressure to publish has become a defining feature of modern academic medicine. Publications influence promotions, academic recognition, institutional rankings, grant opportunities, and career progression.
While this emphasis has undoubtedly increased research output, it has also raised concerns regarding the quality, relevance, and impact of scientific investigations.
The challenge facing contemporary anaesthesiology is not a lack of research activity, but ensuring that research meaningfully contributes to patient care and scientific progress.
The Concept of Research Waste
Research waste refers to the avoidable loss of scientific value at any stage of the research process—from conception of a research question to dissemination and implementation of findings.
A landmark analysis by researchers suggested that a substantial proportion of biomedical research may ultimately contribute little to patient care because studies are poorly designed, inadequately reported, unnecessarily duplicated, or never translated into practice.
Where Does Research Waste Occur?
Research waste can occur at multiple stages of the scientific process.
1. Asking the Wrong Research Question
A study may be methodologically sound but still have limited value if the research question has little clinical relevance.
Research should ideally address genuine gaps in knowledge and questions that matter to patients, clinicians, and healthcare systems.
When studies are conducted primarily because they are easy to complete, suitable for publication, or required for academic progression, their ability to influence clinical practice may be limited.
2. Poor Study Design
Inadequate methodology can significantly reduce the scientific value of research.
Small sample sizes, inappropriate study designs, inadequate randomization, weak control groups, improper statistical methods, and poorly defined outcomes may prevent reliable conclusions.
Even considerable effort and resources cannot compensate for fundamental methodological weaknesses.
3. Duplication of Research
Replication is an essential component of science when it is purposeful.
However, unnecessary duplication of already answered research questions without a clear scientific rationale contributes to research waste.
Researchers should therefore undertake an appropriate literature review before beginning a new project and identify whether the proposed study genuinely adds new knowledge.
4. Failure to Publish Research
Research that remains unpublished cannot contribute effectively to the scientific community.
Non-publication may occur because studies have negative or statistically non-significant results, investigators lose interest, or manuscripts are never completed.
Failure to disseminate results creates an incomplete scientific record and may lead other investigators to repeat similar studies unnecessarily.
5. Incomplete or Selective Reporting
Selective reporting of favourable outcomes can distort the available evidence.
Research should transparently report the methodology, predefined outcomes, limitations, and relevant results so that readers can accurately interpret the findings.
6. Failure to Translate Evidence into Practice
The final objective of clinical research is not simply publication.
Scientific findings achieve their greatest value when reliable evidence is incorporated into clinical practice and ultimately improves patient care.
A well-conducted study that is published but never communicated, implemented, or incorporated into clinical decision-making may have limited practical impact.
The Publish-or-Perish Culture
Academic medicine increasingly places importance on publication metrics.
Publications may influence faculty promotions, institutional assessments, postgraduate requirements, research grants, and professional recognition.
This academic environment has undoubtedly encouraged clinicians to participate in research.
However, when publication itself becomes the primary objective, researchers may begin to prioritize quantity over quality.
This creates the risk of producing multiple small studies with limited clinical relevance instead of fewer, well-designed investigations capable of answering important questions.
The pressure to publish may also encourage fragmentation of research findings into multiple publications, repetitive studies, and selection of projects based primarily on their likelihood of being published.
Quantity Versus Quality
The number of publications produced by an individual or institution does not necessarily reflect the quality or clinical significance of the research.
A single well-designed multicentre study capable of changing clinical practice may have considerably greater scientific value than numerous small studies that add little new information.
Research productivity should therefore be evaluated not merely by counting publications, but by examining the relevance of the research question, methodological quality, transparency, reproducibility, and potential impact on patient outcomes.
Research Relevant to Anaesthesiology
Anaesthesiology provides numerous opportunities for meaningful clinical research.
Important research areas include:
- Patient safety
- Airway management
- Perioperative medicine
- Regional anaesthesia
- Acute and chronic pain management
- Critical care
- Haemodynamic monitoring
- Perioperative outcomes
- Enhanced recovery
- Quality improvement
- Patient-centred outcomes
Research priorities should ideally emerge from important unanswered clinical questions rather than purely academic requirements.
Role of Collaboration
Collaborative research can help overcome several limitations associated with small single-centre studies.
Multicentre studies allow recruitment of larger and more diverse patient populations and may improve the generalizability of findings.
Collaboration also enables researchers to share expertise in study design, statistics, methodology, clinical practice, and scientific writing.
Rather than multiple institutions independently conducting similar underpowered studies, collaborative research networks can potentially answer clinically important questions more effectively.
Importance of Research Methodology
Improving the quality of anaesthesia research requires stronger training in research methodology.
Researchers should understand:
- Formulation of clinically relevant research questions
- Appropriate study design
- Sample-size calculation
- Randomization and blinding
- Selection of meaningful outcomes
- Statistical analysis
- Research ethics
- Scientific writing
- Critical appraisal of literature
Research methodology training should form an important component of postgraduate and faculty development.
Patient-Centred Research
The ultimate beneficiary of clinical research should be the patient.
Traditionally, many studies focus on surrogate outcomes or physiological measurements because they are easier to measure.
While these outcomes may be scientifically useful, future research should increasingly examine outcomes that are meaningful to patients.
These can include postoperative recovery, pain, functional status, complications, quality of life, duration of hospitalization, long-term outcomes, and patient satisfaction.
Improving the Value of Research
Reducing research waste requires a shift in academic culture.
Researchers, institutions, journals, professional societies, and funding bodies all have a role to play.
Future research should emphasize:
Relevance – Ask questions that address genuine gaps in knowledge and important clinical problems.
Rigour – Use appropriate study designs and robust methodology.
Transparency – Register studies when appropriate and report results completely.
Collaboration – Encourage multicentre and multidisciplinary research.
Patient-Centred Outcomes – Measure outcomes that matter to patients and clinical practice.
Dissemination – Ensure research findings are communicated effectively.
Implementation – Translate reliable evidence into clinical practice whenever appropriate.
From Publication to Evidence
The purpose of scientific research is not simply to create another article.
A publication should represent one step in a larger process of evidence generation.
A clinically important question should lead to a well-designed study.
The study should produce reliable data.
The results should be transparently reported and critically evaluated.
When evidence is sufficiently strong, it should influence clinical guidelines, education, and everyday practice.
Only then does research achieve its fullest potential.
Conclusion
The success of academic anaesthesiology cannot be measured solely by the number of publications produced each year. Scientific progress depends on generating evidence that addresses important clinical questions, improves patient outcomes, and advances the specialty.
As researchers, educators, and clinicians, we must continually ask whether our efforts are contributing to knowledge or merely adding to literature.
The future of anaesthesia research lies not in publishing more, but in publishing better. By prioritizing relevance, rigor, transparency, and collaboration, we can move from a culture of publication accumulation to one of genuine evidence generation.
The true measure of research is not how often it is published, but how effectively it changes practice and improves patient care.
It is important to acknowledge that every research study represents a significant investment of time, effort, resources, and commitment. Behind every publication are investigators striving to answer questions, improve practice, and contribute to scientific knowledge.
The purpose of this discussion is not to diminish the value of existing research, but rather to encourage reflection on how future research can generate even greater impact.
As a specialty, anaesthesiology has made remarkable academic progress. The challenge before us is not whether we are publishing enough, but whether we are maximizing the value of what we publish.
By focusing on clinically relevant questions, robust methodology, collaborative research, and meaningful patient-centred outcomes, we can ensure that every study contributes more effectively to the advancement of science and the improvement of patient care.
In Memory of Prof. Phannendra Nath Thota
Prof. Phannendra Nath Thota
Born: 11th November 1951
Died: 29th November 2004
MBBS – JIPMER, Puducherry
MD, Anesthesiology – PGIMS, Chandigarh
SCTIMST – Tiruvanthapuram
1979–2000 (21 years) – K.M.C., Manipal
2000–2004 – Andhra Pradesh
He laid the foundation stone for the well-known academic and teaching Department of Anesthesiology, KMC, Manipal.
He served as HOD, Department of Anesthesiology, KMC, Manipal from 1990–1995.
He was the 1st Controller of Examinations, MAHE, Manipal.
Remembered As
- Teacher par excellence
- Exemplary clinical Anesthesiologist
- Thorough professional
- Left his indelible mark for meticulous planning
- Popular speaker
[Place Prof. Phannendra Nath Thota’s photograph here]
ISA National Conference Details
ISACON National Conference 2026
Dates: November 26–28, 2026
Venue:
Hotel Uday Samundra Kovalam
Thiruvananthapuram, Kerala
ISACON National Conference 2026
Closing Message
“Your body and mind will work and find fullest expression only when you are joyful and peaceful….”
– Sadhguru
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