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Strategic Plan - AnaesthesiaMissionThe Department endeavours to be at the forefront of knowledge, best practice and maintain an active research programme to complement this. BackgroundAnaesthesia is primarily a service speciality linked to the practice of surgery that provides unique opportunities for the daily practice, demonstration and teaching of applied physiology and pharmacology, and information processing as well as technical procedures. The Department of Anaesthesia is a small department with a role in undergraduate and postgraduate teaching complemented by research. ResearchPart of the research has been on anaesthetic monitoring particularly with the predictive use of computer modeling. A computer programme has been developed to model anaesthetic uptake and distribution. Collaborating with an Australian team, the pharmacokinetics of sevoflurane uptake into the brain has been modelled, and the relationship between calculated effect-site sevoflurane levels and awakening from anaesthesia has been studied. The safe delivery of Anaesthesia has been looked at in patients with mitochondrial myopathies and prolonged QT syndromes. Needs of the Anaesthetic medical workforce in New Zealand (trainees and clinical directors) are surveyed to predict future workforce needs. Novel methods of perioperative pain relief have been developed particularly in the paediatric population with the intranasal route and the use of analgesic drops. The predictors and risk factors in the development of persistent acute postoperative pain have been studied. The psychosocial adjustment and physical health of children living with mothers with chronic pain has been explored. The role of parenting as a mediator has been probed. Our PhD student is looking at the comparison of usual surgical advice versus a non-aggravating six-month gym-based exercise rehabilitation program post-lumbar discectomy with three years of accumulated data thus far. In 2006, members of the Department had seven publications in peer-reviewed journals. TeachingThe Department is committed to ensure that medical students possess knowledge and skills in anaesthesia and pain medicine relevant to the health care system in which they will work. Medical students come to us during the 5th year and trainee intern year. The 5th year stay is designed to introduce them to anaesthesia and to get them to working alongside anaesthetists in theatre. In the trainee intern year they are exposed to the preadmission clinic, the acute and chronic pain services, and to in-theatre teaching. In addition they are given problem based learning cases, and are taught airway management, adult and paediatric cardiopulmonary resuscitation, and participate in clinical scenarios. They undertake a formal written examination, arrhythmia recognition programme, and skills testing. If successful they are awarded a level 7 certificate from the New Zealand Resuscitation Council. At the end of their run, they undergo a formal viva assessment. In addition, the Department is active in assisting anaesthetic registrars who are preparing for the FANZCA examinations. FutureWith the gradual but far-reaching changes in the new medical student undergraduate curriculum, and the establishment of vertical integration of physiology and pharmacology across the later clinical years, there is an urgent need to re-establish a Senior Lecturer post. With the future establishment of Pain Medicine as a separate Speciality in New Zealand, the Department will need to expand its teaching programme in this area as well. With respect to research, the Department needs to procure space for the establishment of a dedicated anaesthetic laboratory and exploit the enormous potential for multinational contract research in Anaesthesia and to attract grant funding. There is a necessity to expand the number of PhD and Master’s students that we supervise, and continue to foster collaborative partnerships with other Universities in New Zealand.
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