St. Luke's-Roosevelt Department
of Anesthesia
Introduction
Research Activities
Fellowships
Residency Programs
INTRODUCTION
In 1992, St. Luke's-Roosevelt marked the beginning of a new era in
delivering health care with the realization of the first phase of
a half-billion dollar rebuilding program, including a 10-story facility
at St. Luke's Hospital and a 13-story building at Roosevelt Hospital.
As a result of the rebuilding program, one of the largest hospital
in the country has become one of the most modern. Highlights include
advanced diagnostic services easily accessible to surgical suites;
ambulatory sites adjacent to the operating suites; and new cardiac
care units with advanced telemetry monitoring systems.
The state-of-the-art Hospital Center greatly enhances the training
and education young physicians receive in preparing for the high technology
medical practice of the future.
We are strongly committed to resident education and believe that
we can offer first-class training in anesthesiology. To assure that
each resident receives a quality education, we limit the number to
9 per year. In our recruitment process, we look not only for individuals
with an excellent educational background, but also with well-developed
social skills. In a small program, team spirit and getting along with
one's peers are essential. At St. Luke's-Roosevelt, the working environment
is second to none.
The Department of Anesthesiology is in charge of the surgical intensive
care unit and manages the only obstetric critical care unit in New
York City. In addition, we have acquired state-of-the art anesthesia
and monitoring equipment. Every operating room is outfitted with eight-channel
color monitors for hemodynamic monitoring, mass spectometry for gas
analysis, and a computer for automated anesthesia record-keeping.
Each cardiac operating room has a dedicated echoscanner for transesophageal
echocardiography, which is part of routine monitoring in cardiac surgery.
The labor and delivery suites, where full automation is also the rule,
are among the most modern in the country. When our residents graduate,
they have extensive experience with the most up-to-date technology
presently available in anesthesiogy.
In addition to St. Luke's-Roosevelt's superb technological environment,
we believe that the Department of Anesthesiology's greatest asset
is its faculty. Subspecialty training and a strong commitment to the
Department's educational and research mission is mandatory for a faculty
appointment at the Hospital Center. Our attending anesthesiologists
are dedicated teachers who are also compassionate and sensitive to
the patient's needs.
Daniel M. Thys, MD
Director, Anesthesiology
St. Luke's-Roosevelt Hospital Center
Professor, Department of Anesthesiology
Columbia University College of Physicians and Surgeons
RESEARCH ACTIVITIES
Institutional Research Activities
Recognizing that patient care and teaching are best accomplished in
an environment which encourages scholarly activities, St. Luke's-Roosevelt
Hospital Center has a long-standing tradition of research excellence
both through its Institute for Health Sciences and in its role as
a teaching hospital affiliated with Columbia University College of
Physicians and Surgeons. The Hospital Center's nationally and internationally
renowned clinicians and research scientists have made and continue
to make important contributions to the understanding of basic disease
processes, to developing new therapeutic approaches, and to evaluating
the efficacy of treatments.
At Roosevelt Hospital, a large research facility is located in the
Antenucci Medical Research Building. At St. Luke's Hospital there
is an animal care facility with fully appointed operating rooms. The
most recent addition to the Hospital Center's research endeavors is
the Center for Research in Clinical Nutrition located at St. Luke's
Hospital. The Center, which is a collaborative effort of St. Luke's-Roosevelt,
Columbia University, and Brookhaven National Laboratory, is leading
the way in National Institutes of Health-funded studies of nutrition,
body composition, and metabolism using highly sophisticated new instruments.
Departmental Research Activities
An extensive computerized data base within the Department of Anesthesiology
facilitates clinical research endeavors. The administration of an
anesthetic consists of a major but short-lived intervention in the
homeostatic milieu of patients. The Department affords abundant and
important opportunities to study the effects of these interventions.
Clinical
Regional Anesthesia
Basic research
1.Determinations of plasma levels of local anesthetics by HPLC method
2. Mechanisms of peripheral neuronal blockade; simulation on animal
model
3. Electro-physiologic variations, mechanisms and novel methods of
nerve stimulation
Clinical research
1. Application of peripheral nerve blocks in ambulatory anesthesia
practice for lower extremity surgery
2. New approaches to sciatic nerve blockade
3. Effects of neuraxial anesthesia on cardiac performance
Clinical Pharmacology
Members of the faculty have documented expertise in the performance
of pharmacologic studies in the areas of ambulatory, obstetric, and
cardiac anesthesia. Drugs that have been studied include new anesthetic
agents, muscle relaxants, inotropes, and anti-emetic.
Pain
The pain division is particularly active in clinical research. Efforts
have focused on the study of new vehicles for drug administration
(such as iontopheresis) and new methods for pain relief (cryotherapy).
Basic Sciences
The Department of Anesthesiology has made a major commitment to the
development of basic research by its faculty. Substantial material
resources and personnel have been allocated to the task. The primary
goal of the Department's basic science research is to establish a
direct link between the laboratory and the clinical environment.
Imaging Technology
The Department is active in developing new procedures and education
in imaging technology. A well-equipped laboratory provides investigators
with the latest invideo editing and digital image storage techniques.
In addition, there are opportunities to interact with the engineering
and computer science departments of Columbia University.
Cardiac Electrophysiology and Pharmacology
In cooperation with the Department of Pharmacology of the Columbia
University of College and Physicians and Surgeons, the effects of
new anti-arrhythmic agents are being studied in a chronic infarct
model. This research is funded by the Foundation for Anesthesia Education
and Research.
Neuro Physiology and Pharmacology
The effects of cerebral ischemia on the metabolic activity of the
brain are being studied using novel microcirculation techniques. The
cerebro-protective effects of various agents are currently under investigation.
Research Facilities
Automated Record Keeping
St. Luke's-Roosevelt Hospital Center is one of the first medical centers
in the world to be equipped with a fully integrated Compurecord Anesthesia
Information Management System. This system automatically samples all
the relevant physiologic and anesthetic parameters during surgery
and stores this information for record-keeping purposes. The system
provides the anesthesiologist with a printed record at the end of
the procedure. It also facilitates the Department's quality assurance
efforts, the daily assignment of residents for optimal educational
benefit and automates patient billing activities.
Anesthesia Local Area Network (ALAN)
ALAN is extremely useful for administrative and educational activities.
Thirty computer terminals, which members of the Department can use
to access personal computer files, are distributed throughout departmental
locations. The system is supplied with word processing, spreadsheet,
compact disk server, medical graphics, statistics, professional slide
making and data base programs. The department network is linked to
the hospital wide network providing e-mail throughout the institution
and also allows full internet access.
A Word From Our Statistician:
The research projects in our department are challenging and diverse
-- quality improvement through intraoperative monitoring, the use
of peripheral nerve blocks in short and long saphenous vein stripping,
the use of acupressure as an antiemetic in parturients receiving spinal
anesthesia, a comparison of laryngoscope blades, the effects of temperature
and drugs on the elaboration of neurotoxic amino acids and catecholamines,
to name just a few. My role as research associate is to assist in
the design and analysis of these studies. Whenever these committed
physician lament that the statistical aspect of their science escapes
them, I'm reminded of Twain - "Figures often beguile me, particularly
when I have the arranging of them myself; in which case the remark
attributed to Disraeli would often apply with justice and force: 'There
are three kinds of lies: lied, damned lies, and statistics.' "
[Neider, C., ed. The autobiography of Mark Twain. Harper & Row,
1959]
My job is to alleviate this perception. Quite often I find myself
merely soothing the perplexed and suspicious. For the really tough
questions I run to my biostatistician friends at Columbia and Berkeley.
-- Max Kuroda
FELLOWSHIPS
RESIDENCY PROGRAMS
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