The Cardiothoracic anesthesiology curriculum provides residents with a continuum of education and experience in the subspecialty of cardiothoracic anesthesia. Residents are exposed to a variety of cardiothoracic surgical patients, including those requiring conventional coronary bypass grafts, valve replacements, and implantation of automatic defibrillators. "Off-pump" coronary bypass grafting is routinely performed in selected patients.
Residents also do vascular and thoracic cases during this rotation. They are trained to become consultants in preoperative evaluation, formulation and implementation of anesthetic management and postoperative care of cardiac patients. Residents are instructed in physiology, anesthetic agents and monitoring devices that are common to cardiovascular anesthesia. A fellowship in cardiac anesthesia is also available.
The pediatric division of the department of anesthesiology is in the adjacent Cincinnati Children's Hospital Medical Center, a 291-bed acute and chronic care institution where 25,000+ anesthetic procedures are performed each year. Anesthesia is administered for operative and diagnostic procedures on patients from the premature age group through adolescence.
Every surgery specialty is represented, performing procedures that often require expertise in anesthetic techniques for premature infants with respiratory distress syndrome, pediatric patients with congenital anomalies, solid organ transplantation, specialized orthopedic surgery and cardiovascular surgery. The center has intensive care units for premature newborn infants and for older children. An ACGME accredited pediatric anesthesia fellowship is also offered.
The division of obstetrical anesthesia provides maternal analgesia and anesthesia for 2,500 deliveries a year and for an additional 700 surgical procedures. Approximately 40 percent of these patients have maternal and/or fetal high risk complications.
Although the major emphasis is on regional anesthesia (approximately 85 percent of all deliveries are performed under epidural or spinal analgesia or anesthesia), indications for other blocks and general anesthetic techniques are taught including ultrasound guided TAP blocks and epidural ultrasounds.
University of Cincinnati Medical Center is a regional referral center for all types of neurosurgical procedures, especially for neurovascular disease. Residents rotate on the neuroanesthesia service for one month during the CA-1 year and one month in the CA-2 year.
During this rotation, the resident gains experience with commonly employed neuroanesthetic techniques and expand his/her knowledge base in neuroanatomy and neurophysiology. A fellowship in neuroanesthesia is also available.
Regional Anesthesia/Pain Control Center
Considerable emphasis is placed on regional anesthesia and residents are taught special nerve blocks. This subspecialty training is part of the CA-1, CA-2, and CA-3 years. CA-3 experience in the department's free-standing interventional pain center is available. ACGME accredited fellowship in pain medicine is also available.
The Pain Control Center is a multidisciplinary service. The staff includes fully trained sub-specialists in pain management, as well as specialists from the Departments of Neurology, Otolaryngology/Maxillofacial Surgery, Psychology, and Physical Medicine and Rehabilitation. Other personnel include nurse practitioners, physical therapists and a clinical psychologist.
Procedures performed include spinal, epidural, central and peripheral nerve blocks, including neurolytic techniques. Special modalities utilized consist of transcutaneous electrical nerve stimulator therapy, psychological testing, biofeedback and acupuncture.
On the University of Cincinnati Medical Center based Acute Pain Control Service, in addition to nerve blocks, the use of regional opioids and epidural electrode placement are taught. This inpatient program allows residents an opportunity to learn the total management of the pain patient. An ACGME accredited fellowship in regional anesthesia and acute pain is also available.
Surgical Intensive Care Unit – Critical Care
Over the residency, residents receive three months training in the Surgical Intensive Care Unit. They have the opportunity to learn invasive monitoring techniques and, with staff supervision and direction, to recommend treatment of critically ill surgical patients. This unit is supervised on a collaborative basis by critical care anesthesiologists and trauma surgeons. ACGME accredited fellowship in critical care medicine are available.
The department has an active research program that emphasizes both the basic science and the clinical aspects of the neurotransmission of pain. Clinical research is also ongoing on techniques for airway management. Trainees are encouraged to take part in these projects and participate according to their interest. A specialized rotation in anesthesia research is available in the CA-3 year.