In conclution, I want to say that; We Anesthesiologists are diserve to work in pain clinic, because pain management is a part of our competence.

1. The Role of Anesthesiologist in
Pain Manajement
Husni Tanra
Department of
Anesthesiology, IC and Pain Management
Faculty of Medicine Hasanuddin University
Makassar

2. Before Eva was created from
Adam’s rib, he was put into sleep
Anesthesia was the first
applied science in the world
Prof. Hyodo
Japan

3. First Ether Anesthesia in 1846 at Massachusetts Hospital
William T, Morton (left) holding globe inhaler
John C Warren the Surgeon
Gilber Abbot the Patient

5. The feat earned Morton the
epitaph in Massachusetts
• The Inventor of anesthetic inhalation
• By whom pain in surgery was annulled
• Since whom science has control of PAIN
• Before whom, surgery as agony

6.  What is Anesthesiology?
Anesthesiology is the practice of
medicine dedicated to the pain relief
and total care of the surgical patient
before, during and after surgery.

7.  Who is Anesthesiologist?
Anesthesiologists is a physician who
focus on surgical patient and pain relief.
( perioperative pain management doctor)

8. The main role of Anesthesiologist
Two main role of anesthesiologists
are:
1. Life Saving
(we r master in CPR)
2. Alleviate suffering
(pain relief)

9. History of Pain Management
and Critical Care Medicine

10. Steven D. WALDMAN
 First Anesthesiologist who practice pain management in US.
 Founder the Society for Pain Practice Management (SPPM).
 One of the leader of Intervention Pain Management.

11. ANESTHESIOLOGIST  is a superman Doctor
IS NOT JUST IN THE OPERATING ROOM
• Operating room
hospital
surgicenter
• Labor & delivery suite
• Other procedural areas
• Intensive care unit (ICU)
• PACU
• Pain management
acute pain
chronic/ cancer pain
o Emergency Medicine
• “Code Blue” team
• Respiratory therapy
• Administration
operating room
hospital
medical school
• Education
health professionals
public
• Research
• Managers
Copyright © 2003 American Society of Anesthesiologists. All rights reserved

12. The Ideal
Anesthesiologist

13. Who is Anesthesiologist?
• Anesthesiologist Is a suprman phycisian, not
only in OR but also ........
• Anesthesiology, best job in America.
• Their salary of;
 Anesthesiologist earn $ 292.000/year
 Obgy doctor $ 222.000/year
 Psychiatrist $ 177.000/year
GREAT Z’S 2009

14. Why it has to be an
anesthesiologist in Pain Clinic?
• We are working with various analgesic drugs in our
daily basis;
1. Common analgesic (paracetamol)
2. Non-opioid analgesic (NSAIDs)
3. Opioid analgesic
4. Local anesthetic
5. We had been trained in regional blocks, cenrally or
peripherally. So we are mastering in pain pathway.

15. Why Anesthesiologist for PM?
• Our experiences in OT, made us to
get use in peripheral as well as
neuroaxial block
This is the Basic intervention
pain management

16. Peripheral Neural blockade

18. Neuraxial Blockade

22. Epidural Block
Multipurpose weapon for;
• Epidural Anesthesia
• Post operative pain
relief
• Treatment of chronic
pain (LBP, symphatic
pain, etc).
• Cancer pain, if oral
or iv is failed.

26. Acute pain (Management of post operative pain at APS):

27. Epidural for Postoperative
Pain management.

28. Caudal Block in Pediatric

29. Caudal Block in Pediatric
Before Caudal Block
After Caudal Block

30. Caudal Block in Adult

31. Epiduroscopy
( Minor Surgery)

32. Epiduroscopy
Minor Surgery

33. Epiduroscopy
(Minor Surgery)

34. Chronic pain in Pain clinic
STELLATE GANGLION BLOCK
at pain - clinic

35. Stellate Ganglion Block
Indication of SGB:
1. Reflex Symphatic
Dystrophy (RSD)
2. Phantom Limb Pain
3. Herpes Zooster
4. Raynaud’s Syndrome
5. Facial Palsy

36. Epidural steroid for radicular pain
At pain-clinic
Chronic Pain

37. Femoral Block for Post
Herpetic neuralgia
done in pain-clinic

38. Femoral Block for Post Herpetic neuralgia.
done in pain-clinic

39. Anesthesiology residents learn pain
management in Onomichi Hospital, Japan

50. Historyry of Intervention Pain
Management?
 Interventional pain management have been
developing new technique since 1960 by John Bonica.
 This tehnique was previously the role of
Anesthesiologists, but now is opened to many other
spesialists ( neurosurgeons, orthopaedics,
rehabilitation medicine, and so on).
 American Society of Interventional Pain Physicians
(ASIPP),
 Imaging techniques have become a part of this new
techniques.

52. KepMenkes 779/Menkes/Sk/VIII/2008 ttg
standar pelayanan anestesiologi dan
reanimasi di rumah sakit

53. Why it has to be an
anesthesiologist in Pain Clinic?
• We are working with various analgesic drugs in our
daily basis;
1. Has been trained at least 4 years in
2. using Analgesic Opioid, Non- opiod as well as Adjuvan
drugs, inlude Local anesthetics.
3. We had been trained in regional blocks, cenrally or
peripherally. So we are mastering in pain pathway.
4. We are mastering in CPR, cause this is our daily activity In
Operating teatre

54. In conclution, I want to say that;
We Anesthesiologists are diserve to
work in pain clinic, because pain
54
management is a part of our
competence.
Husni Tanra

55. 55
If we don’t want to do it,
somebody else will
Eddy Rahardjo

56. • Be a good Anesthesiologist
 Not only providing good and safe
anesthesia in OT, but also
Providing pain management
 jangan mau disebut sebagai
Dokter Bius (Bihos)

57. Thank you very much
For your attention
Memory picture with Prof. John Bonica in Seattle, US. January 1988

58. atas perhatian dan pengertiaannya.
Makassar 23 Oktober 2013.