Dr. Rudy Noppens, Program Director
Neurosurgery and Interventional Neuroradiology, encompassing all types of elective and emergency cases, are performed at two sites - University Hospital (adult) and Victoria Hospital (pediatric). There is a core group of anesthesiologists with neuroanesthesia fellowship training. The academic program, established under previous chair, Dr. Adrian Gelb, has national and international recognition.
The goal of the Neuroanesthesia program is to provide advanced training to those individuals (residents/fellows) who either plan to enter academic anesthesiology with an emphasis in neurosurgical anesthesia or those who wish to practice in a setting that has a large number of neurosurgical procedures. Trainees gain knowledge not just through case experience, but also through an organized teaching program. Our program is designed to gain expertise in the following areas: Clinical Care, Non-Anesthesia Experience, and Research/Academic Activities.
London Health Sciences Centre is a national referral centre for the management of patients with cerebral aneurysms and arteriovenous malformations. In recent years, it has been discovered that surgery for Intractable Epilepsy has valuable therapeutic potential and this has resulted in epilepsy surgery becoming one of the “fastest growth areas” in neurosurgery. Patients are done awake but sedated so that their speech and motor areas of the brain can be mapped prior to surgical excision.
Stereotactic Surgery is used for diagnostic biopsies, management of chronic pain and movement disorders, and the management of intractable epilepsy. Each of these requires different anesthetic approaches.
In addition to the above “special areas”, residents/fellows will be exposed to a wide variety of the more usual neurosurgical procedures, including endoscopic neurosurgery, craniotomies for tumors and hemifascial spasm, carotid endarterectomy, and spinal instrumentation.
Residents/Fellows will also have the opportunity to learn how to use Transcranial Doppler, Cerebral Oximetry, Evoked Potential and EEG monitoring during surgery.
Residents/Fellows will spend a brief period on the epilepsy service to have a better understanding of the total management of patients with epilepsy and to learn (much) more about the reading, use and potential of EEG monitoring.
As well, a similar brief period will be offered in the Neuroradiology Department to learn more about the indications and uses of diagnostic and interventional neuroradiology and to become much more facile with the interpretation of CT scans, MRI, etc.
The Department of Anesthesia and Perioperative Medicine offers a variety of research opportunities. It is our expectation that each fellow will complete at least one research project taking it from conception through to completion. In addition, each fellow is expected to write at least one review article/book chapter. Further participation in research and writing activities is always welcomed and encouraged.
Under supervision, fellows will also review manuscripts submitted to a variety of anesthesia journals, abstracts submitted to anesthesia scientific meetings, and grant applications. These activities together with the research activities outlined above will provide fellows with an excellent insider’s view of the entire research process.