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Improving Access to Ultrasound-Guided Anesthesia Practices in India

Amandeep Hospital in India

This is the second of an ongoing series of blog posts from the Global Health Initiative, an international educational program from the Department of Anesthesiology aimed at advancing the practice of regional anesthesiology abroad.

As you may recall, I shared my experience teaching regional anesthesia in Uganda as part of the Department of Anesthesiology’s Global Health Initiative. Following the trip to Uganda, Dr. Swetha Pakala and I journeyed on to Amritsar, India, a large city within the state of Punjab.

We spent the majority of our time between two hospitals within the city. While visiting Sri Guru Ram Das Institute of Medical Sciences and Research, an academic hospital, we conducted a workshop on ultrasound-guided regional anesthesia during a conference for anesthesiologists throughout India. We also visited a private hospital that performs mostly orthopedic and trauma-related cases. Both departments were interested in learning more about ultrasound-guided techniques.

The use of ultrasound in India is growing, but is limited by the availability of ultrasounds throughout the country. According the head of the Department of Anesthesiology at Sri Guru Ram Das, it is estimated that only 30% of hospitals have access to an ultrasound machine, which may be because ultrasound has been a controversial subject in India recently.

However, at both hospitals we visited, the department heads believe the benefit to be gained will be worth the risk. This is especially true for improving post-operative pain control, which is a challenge within Punjab where there are great barriers for hospitals to obtain pain control drugs due to a prevalence of narcotic addiction in the area.

The combination of the long-lasting analgesia gained with regional anesthesia and the cost effectiveness compared with general anesthesia is now pushing many anesthesiologists to opt for regional anesthesia whenever there is an option. In fact, many of the surgeons we met with also expressed a great interest in advocating for increased regional anesthesia for their patients.  They admit that regional anesthesia can greatly improve postoperative recovery of their patients and minimize the need for extra nursing and administration of pain medication.

Both institutions in India believe that the role of regional anesthesia — and especially the ability to teach these techniques — will be greatly augmented with the use of ultrasound. The anesthesiologists at both institutions were eager to have Dr. Pakala and I return and teach a core curriculum in regional anesthesia.  They are keen to learn and then disseminate the skills and knowledge to other anesthesiologists as well.

Education is the key to lasting, sustainable development.

Anesthesiologists from Hospital for Special Surgery visit Amandeep Hospital in Amristar, India to teach ultrasound-guided regional anesthesia techniques.
Anesthesiologists from Hospital for Special Surgery visit Amandeep Hospital in Amristar, India to teach ultrasound-guided regional anesthesia techniques.


Dr. Lee Rasamny is a 2015-2016 Regional Anesthesiology and Acute Pain Medicine fellow focusing on global outreach.

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