St. Luke’s International Hospital

St. Luke’s International Hospital

Perioperative Center: Department of Anesthesia and Intensive Care Unit (ICU)

写真:部長

NAGASAKA Yasuko
Director

Greetings

We at the Department of Anesthesia, St. Luke’s International Hospital, are daily committed to assure patients’ safety and comfort during the perioperational period. Medical treatment Patients who will undergo elective surgery have a consultation with the Department of Anesthesia beforehand to explain the method of anesthesia to be used the drugs involved, and to select an individual anesthesia plan for each patient. The anesthesia team at this hospital consists of traditional anesthetists and operation room nurses, as well as nurses who have completed a master’s course in perianesthesia at St. Luke’s International University Graduate School, as well as pharmacists and engineers specialized in operating room equipment and techniques. We collaborate to assure the best possible medical service, not only for the duration of anesthesia in the operating room, but for the entire perioperational period from the preparatory stage before surgery through the postoperative course.

Research

We actively promote further education and training of our physicians and medical students, as well as overseas exchanges.
Apart from weekly conferences, we also hold regular grand rounds, which are attended by expert North American physicians, and many medical students have participated in the medical clerkship system (whereby clinical training rotation at our department is accredited by overseas medical schools). (Note 1)
Our devotion to medical education and training does not only cover Japanese medical care systems, but also leading edge medicine from overseas.

Training

One of the important pillars supporting medicine is research (clinical/basic). Anesthesia research teams include members from various other departments at St. Luke’s international Hospital and collaborate with advanced medical institutions in North America and Singapore to address yet unsolved medical problems and issues. Through the joint process of trying to find answers, new medicine is born. Any institutions that wish to join our clinical research, please contact us!

Note 1: Former medical clerkship participant’s report:
Alisa Yamasaki(Student, Harvard University Medical School)
− My elective at St. Luke’s International Hospital was an enriching opportunity to build on my clinical skills in the inpatient ward, outpatient clinic, and perioperative settings. During my four-week rotation, I was exposed to the nuanced differences in clinical management between Japan and the US in the context of the vastly different infrastructure, reimbursement mechanisms, medico-legal environment, and cultural differences between the two medical systems. The other medical students, residents, and attendings were all welcoming and created a supportive environment for learning and collaboration.

Overview

Anesthesiology

Many may consider the job of anesthesiologists to be only giving anesthesia to patients undergoing surgery. However, their job is much more complex. Their role extends beyond the operating room.

Before the operation, anesthesiologists see their patients for outpatient consultation to explain the anesthesia that will be used and to evaluate the patient’s physical condition.

On the day of the operation, they ask the patient if they slept well, are feeling anxious or if there are any changes in their physical condition before entering the operating room with them.

Once inside the operating room, they will apply the type of anesthesia most appropriate for the patient, including general, epidural, spinal, or other types of anesthesia. They act as the patient’s life support by sustaining blood pressure and heart rate during surgery, standing closer to the patient than the surgeons, and monitoring and reporting the patient’s condition to ensure that the operation runs smoothly. This detailed care can minimize stress by controlling pain and anxiety. Anesthesiologists are especially careful with regard to anxiety in children. Children from the age of one up until elementary school have the option of having a parent enter the operation room until the anesthesia kicks in (pediatric surgery, plastic & reconstructive surgery).

After surgery, anesthesiologists observe patients in the recovery room until they wake up, confirm if there is any pain and check their condition before returning them to their room.

The next day, a doctor from the Department of Anesthesia will visit the patient in their room asking about pain or other concerns, checking if the anesthesia and physical management was adequate during the operation.

It is the job of the Department of Anesthesia to comfort the patient and make sure the operation proceeds without any complications. The anesthesiologist’s job is total coordination of physical and emotional management, and pain control.

Intensive Care

When the overall condition of the patient becomes severe enough that detailed supervision and treatment is necessary, the patient will be admitted into the intensive care unit where doctors and nurses will manage the patient’s condition around the clock. An anesthesiologist will work together with doctors from other departments to provide the most effective treatment.

Perioperative Care

Operative care is not limited to the operation room but also includes the pre-operative and post-operative process. Doctors from various disciplines including anesthesiologists, surgical nurses, clinical engineers and pharmacists work together as a team.By sharing information with each section, we are able provide the best possible care to each patient throughout the operative cycle; pre-operative, operative and post-operative. This is what we call “perioperative care.” Our goal is to treat all our patients with this teamwork approach in order to provide optimal care.

Perianesthesia Nurses

Perianesthesia nurses are hospital-certified nurses who have graduated from the St. Luke’s College of Nursing Graduate School with education/training in the Nurse Anesthetist Master’s Course (2 years). They acquire the techniques necessary for administrative support of anesthesia, such as airway and cardiorespiratory management.

Working under the instruction and supervision of an anesthesiology specialist certified by the Japanese Society of Anesthesiologists, they help support anesthesiology operations both inside and outside of the operating room. This includes patient evaluation and explanation before and after anesthesia, whole-body management during anesthesia, post-operative pain control and sedative/pain-relief management. Our nurses help provide a safe and reliable anesthesia procedure that considers the patient’s feelings by understanding anesthesia, assisting the doctor as a nurse and providing support for the patient. Perianesthesia nurses only work under the direct supervision and instruction of anesthesia specialists in accordance with Japanese law.

Results

In 2014, we were in charge of anesthesia for over 6,000 patients. Doctors from the Department of Anesthesia conducted all general anesthesia cases. The procedures ranged from relatively small operations to major procedures such as thoracotomy, open-heart surgery, craniotomy and laparotomy. Epidural and spinal anesthesia, including epidurals for labor during childbirth, are also conducted by the Department of Anesthesia.

  Anesthesia Cases Total Number of Operations
FY 2008 4,813 7,460
FY 2009 4,936 7,335
FY 2010 4,897 7,532
FY 2011 4,701 8,257
FY 2012 5,487 8,281
FY 2013 5,667 8,734
FY 2014 6,061 9,153

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