Neuroanaesthesia and Neurocritical Care

The full range of complex neurosurgery takes place at QMC including awake craniotomy, functional, paediatric, skull base, and vascular neurosurgery. There is also a significant provision of interventional neuroradiology at QMC. A variety of techniques are used including volatiles and TIVA and the use of pEEG. The intraoperative MRI facility has been running for a year. An ERAS program for microdiscectomy has recently started. As a Regional Trauma Unit and the Neurosurgical Centre for the East Midlands there is a high elective and emergency (neuro trauma) workload. There will also be opportunities to collaborate in the development of the neurosimulation course.

Experience in Neuro Critical Care is available depending on personalised requirement. We have > 400 neuro ICU patients admitted each year. Neuro Critical Care is part of a general ICU, with Dr T De Beer the link for the fellow.

The stroke unit has recently moved to the QMC campus and an increasing number of mechanical thrombectomies are becoming part of the workload.

Spinal Surgery

Queen’s Medical Centre is a national and international referral centre for complex spinal pathology of all aetiologies. There are around 1000 surgical cases per year. Specialist anaesthesia is provided for surgery for major spinal deformity, both adult and paediatric, neuromuscular deformity, spinal oncology, degenerative conditions of the spine and emergency and trauma patients. Monitoring of spinal neurophysiology during deformity work is routine, requiring the anaesthetist to be skilled at providing total intravenous anaesthesia. Management of the difficult airway, provision of one-lung ventilation for intra-thoracic surgery and management of significant intra-operative blood loss along with blood conservation techniques are key skills which will be developed during the fellowship.

Both paediatric and adult anaesthetic pre-assessment clinics are offered at QMC. This provides opportunities for the fellow to take part in patient selection and optimisation and to become an integral part of the multidisciplinary team. There is potential to develop patient pathways and ERAS programmes.

More about the Centre for Spinal Studies and Surgery at QMC can be found at http://www.nottinghamspine.co.uk/

DUTIES OF THE POST

1. Clinical

Up to 4 sessions per week accompanied clinical work with core consultants with complex neurosurgical and spinal surgery practice. List allocation on a weekly basis decided cooperatively by trainee and supervisors.

2. Professional Development

The same study leave allowance will be given to the fellow as to other anaesthetic trainees in Nottingham.

3. Supervision

Posts will be supervised by Dr S Wake (Spinal Surgery) and Dr TBC (Neurosurgery). Arrangements will include development of timetables and learning plans with tailored learning outcomes and specific objectives. Assessment will be conducted in form of CBD and reflective practice portfolios