Anaesthesiology

The Department of Anesthesiology is a hub and an important supporting platform for the safe and efficient operation of the hospital, and it occupies a pivotal position in the hospital’s overall development. It has a number of leading anesthesia and monitoring technologies in China, including visualization technology, difficult-airway management tools, hemodynamic monitoring, and brain-function monitoring. It provides safe and efficient support for the smooth performance of anesthesia for all kinds of operations in every clinical department, as well as invasive procedures and examinations. As a second-level discipline and a first-level clinical department, it has physician and nursing units.

Against the background of the hospital’s rapid development, the overall strength of clinical anesthesia and perioperative management has improved rapidly, and its influence at home and abroad has continued to grow. In recent years, the department has strengthened international exchange and cooperation by going out and inviting experts in; it has repeatedly given presentations at international academic conferences and hosted international academic exchange activities. In particular, advances in discipline development, clinical anesthesia and the anesthesia information system, the operation of a multifunctional anesthesia recovery room, establishment of an anesthesia-safety management system under an efficient operating model, and implementation of anesthesia quality control have further raised the level and efficiency of clinical anesthesia, while building extensive experience in rescuing and managing difficult and critically ill patients during the perioperative period. The operating model and efficiency of the Department of Anesthesiology have won high praise from colleagues in China and abroad and recognition from the competent government authorities.

In 2012, the Department of Anesthesiology was selected for the National Key Clinical Specialty Construction Project and established the development of a high-quality anesthesiology discipline at a world-class university-affiliated hospital as its strategic goal. In accordance with the project’s overall objectives and scale, it made the perioperative safety system and its optimization the core work of discipline development. Six subprojects have vigorously advanced systematic discipline development and personnel training: optimization of peri-anesthetic management for critically ill, emergency and severely ill patients and older patients; rational perioperative use of blood; standardized postoperative analgesia; chronic pain treatment; and optimization of the perioperative anesthesia-management information system.

In 1987, the Department of Anesthesiology formally became a clinical second-level discipline. Li Zhao was its first director; Jiang Jianyu served as director in 1989; Zhang Liping served from 2003 to 2009; and Guo Xiangyang has served as director since 2009. The department gradually established and improved a series of systems, including resident-physician training and study, the chief-resident system, preoperative handovers for clinical cases, discussions of critical, difficult and fatal cases, routine departmental work, and rescue and treatment of critically ill patients. It subsequently further standardized the training of resident and attending physicians and improved systems for morning handovers and literature reports, clinical case discussions, general departmental study, and the opening reports and discussions of research projects. These measures promoted the quality of clinical anesthesia, enriched professional knowledge, and improved research and teaching.

With the development of the anesthesiology discipline, anesthesia methods and monitoring techniques have continued to advance, and the volume and quality of clinical anesthesia have gradually improved. At present, all residents with more than 3 years in the department can skillfully perform deep-venous and arterial puncture catheterization and direct arterial monitoring. Physicians at attending level and above can independently manage anesthesia for operations in every specialty, including open-heart surgery and organ transplantation, and also conduct in-depth research into anesthesia management for particular specialties. In recent years, the department has applied numerous innovative signature technologies in major and critical operations, including visualization technology; comprehensive perioperative management of the difficult airway; 3D-printed airways; perioperative stroke prevention and control; transesophageal echocardiography; transcranial Doppler; regional cerebral oxygen saturation; bedside thromboelastography; and floating-catheter monitoring. It has conducted research on blood conservation in massive obstetric hemorrhage, expanded the uses of perioperative autologous blood transfusion, and provided evidence-based medical evidence; and developed an early-recovery system for older surgical patients (Enhanced recovery after surgery, ERAS). These efforts have optimized the perioperative safety-management system and greatly enhanced the platform’s service capacity. Using anesthesia quality control and tracing the causes of complications and adverse events (Anesthesia-event root cause analysis) as levers, the department makes full use of the multifunctional anesthesia recovery room and centers discipline development closely on its core work: optimizing the perioperative anesthesia safety and quality-management system.

Teaching and personnel training are among the important tasks of a clinical department in a teaching hospital. Despite severe understaffing, the Department of Anesthesiology has successfully completed the undergraduate teaching and internship assignments set by the university, as well as the training of master’s and doctoral students; many teachers have also received university-level and hospital-level outstanding-teacher titles. It has achieved considerable results in training personnel for primary medical institutions. It has successively held systematic anesthesia courses for the Xishuangbanna and Simao areas of Yunnan and for the suburban Beijing counties and districts of Yanqing, Shunyi and Changping, and most participants now serve as leaders or key staff in their respective positions. Over 50 years, it has trained several hundred visiting physicians, many of whom have become the backbone of anesthesiology in their hospitals. Since the 1990s, it has also done extensive work in educating and training residents and graduate students. At present, 36 of all the department’s physicians hold medical doctoral degrees and 37 hold medical master’s degrees. There are 2 doctoral supervisors and 3 master’s supervisors. The department has trained 32 doctoral students and 31 master’s students.

The Department of Anesthesiology focuses its scientific research on clinical research. In the 1960s, it observed the causes and treatment of headache after spinal anesthesia and studied, through animal experiments and observation, the toxicity of procaine–tetracaine mixtures and the optimal ratio of their concentrations, formulating Peking University Third Hospital’s own epidural No. I, No. II and No. III solutions. From the 1980s onward, it observed and summarized the site of action of epidural anesthesia; the effect of local-anesthetic pH on anesthesia; anesthesia management for major coronary-artery bypass surgery; the use of high-dose fentanyl for anesthesia in critically ill patients undergoing noncardiac surgery; and the pharmacology and clinical applications of new drugs such as alfentanil, ondansetron and propofol. After a master’s degree program was established in the early 1990s, it began admitting graduate students and conducting more in-depth research, including clinical and experimental studies of acute isovolemic hemodilution; experimental studies of myocardial protection and its mechanisms; combined use of propofol and ketamine; and the effects of general anesthesia combined with epidural block on cellular immune function.

Over the past decade, the department has consistently adhered to a translational-medicine research policy based on evidence-based medicine (evidence-based) and guided by mechanism research (mechanism-guided). It holds that the purpose of scientific research is to solve clinical problems and improve patients’ prognosis and outcomes, while cultivating anesthesiologists’ critical spirit and enterprising scientific attitude. It uses projects to drive discipline development and promotes the sound development of research through engineering-management methods. Following internationally accepted approaches, it established subspecialty groups, kept pace with developments in the discipline, and built a dynamic, efficient and more open innovation-driven system, achieving clear results. It has cumulatively obtained 14 National Natural Science Foundation projects, participated in 1 major chronic-disease research program of the Ministry of Science and Technology, and received 7 provincial- or ministerial-level projects and multiple hospital-level grants. The department has now formed stable research directions including anesthesia and brain function; airway management (ultrasound airway, 3D-printed airway and airway management); perioperative protection of vital organs; anesthesia and tumors; anesthetic pharmacology; and perioperative management, prognosis and outcomes. Over the past decade, it has published a cumulative total of 368 academic papers indexed by SCI and core journals, published 7 professional books, and applied for 41 scientific and technological patents, of which 9 have been granted.

Under the leadership of the Party branch, the Department of Anesthesiology emphasizes the exemplary vanguard role of Party members, actively carries out departmental cultural development, and strengthens team cohesion. The anesthesiology trade union has created and organized a rich variety of cultural activities, represented by the department’s wind orchestra. These activities have fostered a positive departmental atmosphere and united and inspired all medical staff to advance courageously and uphold dedication to their profession. In November 2016, the Department of Anesthesiology was awarded the honorific title Peking University Model Workers’ Small Home.

In the context of the new era, the Party branch and trade union of the Department of Anesthesiology uphold the idea that medical science popularization is a new form of doctor–patient communication. They actively organize and participate in diverse public-science activities, including the glaucoma band widely reported by multiple media outlets, patient meet-and-greets, science-popularization competitions, bringing science popularization to schools, establishing a science-popularization public account, and publishing science-popularization articles. Through these different forms of activity, they vigorously disseminate knowledge related to anesthesiology and promote a cultural philosophy that respects life.

The Department of Anesthesiology keeps in mind its sacred duty of lifting the rainbow of life for love. Through development of a talent echelon, it strives to practice the management concepts of standardization, normalization, specialization, refinement and informatization. It has now formed a high-quality, professional anesthesiology team that emphasizes management and has distinctive features. In quality service, scientific management, harmonious development and other areas, it has received the hospital’s recognition and praise and has repeatedly won honors including the Hospital Medical Excellence Award, Outstanding Management Team Award, Teaching Team Award, Outstanding Management Project Award, and Advanced Collective for Quality Service Award.

Anesthesiology has been an independent second-level discipline for only 30 years. We believe that, through the continuing efforts of all department staff and the care and support of hospital leaders and sister departments, it will continue to improve its rules and regulations and raise the level of clinical anesthesia, better meet the needs of clinical care, teaching and research, and enable the Department of Anesthesiology of Peking University Third Hospital to enter the ranks of the advanced departments of Peking University Third Hospital and of the national anesthesiology community.

The Department of Anesthesiology is a hub and an important supporting platform for the safe and efficient operation of the hospital, and it occupies a pivotal position in the hospital’s overall development. It has a number of leading anesthesia and monitoring technologies in China, including visualization technology, difficult-airway management tools, hemodynamic monitoring, and brain-function monitoring. It provides safe and efficient support for the smooth performance of anesthesia for all kinds of operations in every clinical department, as well as invasive procedures and examinations. As a second-level discipline and a first-level clinical department, it has physician and nursing units.

Against the background of the hospital’s rapid development, the overall strength of clinical anesthesia and perioperative management has improved rapidly, and its influence at home and abroad has continued to grow. In recent years, the department has strengthened international exchange and cooperation by going out and inviting experts in; it has repeatedly given presentations at international academic conferences and hosted international academic exchange activities. In particular, advances in discipline development, clinical anesthesia and the anesthesia information system, the operation of a multifunctional anesthesia recovery room, establishment of an anesthesia-safety management system under an efficient operating model, and implementation of anesthesia quality control have further raised the level and efficiency of clinical anesthesia, while building extensive experience in rescuing and managing difficult and critically ill patients during the perioperative period. The operating model and efficiency of the Department of Anesthesiology have won high praise from colleagues in China and abroad and recognition from the competent government authorities.

In 2012, the Department of Anesthesiology was selected for the National Key Clinical Specialty Construction Project and established the development of a high-quality anesthesiology discipline at a world-class university-affiliated hospital as its strategic goal. In accordance with the project’s overall objectives and scale, it made the perioperative safety system and its optimization the core work of discipline development. Six subprojects have vigorously advanced systematic discipline development and personnel training: optimization of peri-anesthetic management for critically ill, emergency and severely ill patients and older patients; rational perioperative use of blood; standardized postoperative analgesia; chronic pain treatment; and optimization of the perioperative anesthesia-management information system.

In 1987, the Department of Anesthesiology formally became a clinical second-level discipline. Li Zhao was its first director; Jiang Jianyu served as director in 1989; Zhang Liping served from 2003 to 2009; and Guo Xiangyang has served as director since 2009. The department gradually established and improved a series of systems, including resident-physician training and study, the chief-resident system, preoperative handovers for clinical cases, discussions of critical, difficult and fatal cases, routine departmental work, and rescue and treatment of critically ill patients. It subsequently further standardized the training of resident and attending physicians and improved systems for morning handovers and literature reports, clinical case discussions, general departmental study, and the opening reports and discussions of research projects. These measures promoted the quality of clinical anesthesia, enriched professional knowledge, and improved research and teaching.

With the development of the anesthesiology discipline, anesthesia methods and monitoring techniques have continued to advance, and the volume and quality of clinical anesthesia have gradually improved. At present, all residents with more than 3 years in the department can skillfully perform deep-venous and arterial puncture catheterization and direct arterial monitoring. Physicians at attending level and above can independently manage anesthesia for operations in every specialty, including open-heart surgery and organ transplantation, and also conduct in-depth research into anesthesia management for particular specialties. In recent years, the department has applied numerous innovative signature technologies in major and critical operations, including visualization technology; comprehensive perioperative management of the difficult airway; 3D-printed airways; perioperative stroke prevention and control; transesophageal echocardiography; transcranial Doppler; regional cerebral oxygen saturation; bedside thromboelastography; and floating-catheter monitoring. It has conducted research on blood conservation in massive obstetric hemorrhage, expanded the uses of perioperative autologous blood transfusion, and provided evidence-based medical evidence; and developed an early-recovery system for older surgical patients (Enhanced recovery after surgery, ERAS). These efforts have optimized the perioperative safety-management system and greatly enhanced the platform’s service capacity. Using anesthesia quality control and tracing the causes of complications and adverse events (Anesthesia-event root cause analysis) as levers, the department makes full use of the multifunctional anesthesia recovery room and centers discipline development closely on its core work: optimizing the perioperative anesthesia safety and quality-management system.

Teaching and personnel training are among the important tasks of a clinical department in a teaching hospital. Despite severe understaffing, the Department of Anesthesiology has successfully completed the undergraduate teaching and internship assignments set by the university, as well as the training of master’s and doctoral students; many teachers have also received university-level and hospital-level outstanding-teacher titles. It has achieved considerable results in training personnel for primary medical institutions. It has successively held systematic anesthesia courses for the Xishuangbanna and Simao areas of Yunnan and for the suburban Beijing counties and districts of Yanqing, Shunyi and Changping, and most participants now serve as leaders or key staff in their respective positions. Over 50 years, it has trained several hundred visiting physicians, many of whom have become the backbone of anesthesiology in their hospitals. Since the 1990s, it has also done extensive work in educating and training residents and graduate students. At present, 36 of all the department’s physicians hold medical doctoral degrees and 37 hold medical master’s degrees. There are 2 doctoral supervisors and 3 master’s supervisors. The department has trained 32 doctoral students and 31 master’s students.

The Department of Anesthesiology focuses its scientific research on clinical research. In the 1960s, it observed the causes and treatment of headache after spinal anesthesia and studied, through animal experiments and observation, the toxicity of procaine–tetracaine mixtures and the optimal ratio of their concentrations, formulating Peking University Third Hospital’s own epidural No. I, No. II and No. III solutions. From the 1980s onward, it observed and summarized the site of action of epidural anesthesia; the effect of local-anesthetic pH on anesthesia; anesthesia management for major coronary-artery bypass surgery; the use of high-dose fentanyl for anesthesia in critically ill patients undergoing noncardiac surgery; and the pharmacology and clinical applications of new drugs such as alfentanil, ondansetron and propofol. After a master’s degree program was established in the early 1990s, it began admitting graduate students and conducting more in-depth research, including clinical and experimental studies of acute isovolemic hemodilution; experimental studies of myocardial protection and its mechanisms; combined use of propofol and ketamine; and the effects of general anesthesia combined with epidural block on cellular immune function.

Over the past decade, the department has consistently adhered to a translational-medicine research policy based on evidence-based medicine (evidence-based) and guided by mechanism research (mechanism-guided). It holds that the purpose of scientific research is to solve clinical problems and improve patients’ prognosis and outcomes, while cultivating anesthesiologists’ critical spirit and enterprising scientific attitude. It uses projects to drive discipline development and promotes the sound development of research through engineering-management methods. Following internationally accepted approaches, it established subspecialty groups, kept pace with developments in the discipline, and built a dynamic, efficient and more open innovation-driven system, achieving clear results. It has cumulatively obtained 14 National Natural Science Foundation projects, participated in 1 major chronic-disease research program of the Ministry of Science and Technology, and received 7 provincial- or ministerial-level projects and multiple hospital-level grants. The department has now formed stable research directions including anesthesia and brain function; airway management (ultrasound airway, 3D-printed airway and airway management); perioperative protection of vital organs; anesthesia and tumors; anesthetic pharmacology; and perioperative management, prognosis and outcomes. Over the past decade, it has published a cumulative total of 368 academic papers indexed by SCI and core journals, published 7 professional books, and applied for 41 scientific and technological patents, of which 9 have been granted.

Under the leadership of the Party branch, the Department of Anesthesiology emphasizes the exemplary vanguard role of Party members, actively carries out departmental cultural development, and strengthens team cohesion. The anesthesiology trade union has created and organized a rich variety of cultural activities, represented by the department’s wind orchestra. These activities have fostered a positive departmental atmosphere and united and inspired all medical staff to advance courageously and uphold dedication to their profession. In November 2016, the Department of Anesthesiology was awarded the honorific title Peking University Model Workers’ Small Home.

In the context of the new era, the Party branch and trade union of the Department of Anesthesiology uphold the idea that medical science popularization is a new form of doctor–patient communication. They actively organize and participate in diverse public-science activities, including the glaucoma band widely reported by multiple media outlets, patient meet-and-greets, science-popularization competitions, bringing science popularization to schools, establishing a science-popularization public account, and publishing science-popularization articles. Through these different forms of activity, they vigorously disseminate knowledge related to anesthesiology and promote a cultural philosophy that respects life.

The Department of Anesthesiology keeps in mind its sacred duty of lifting the rainbow of life for love. Through development of a talent echelon, it strives to practice the management concepts of standardization, normalization, specialization, refinement and informatization. It has now formed a high-quality, professional anesthesiology team that emphasizes management and has distinctive features. In quality service, scientific management, harmonious development and other areas, it has received the hospital’s recognition and praise and has repeatedly won honors including the Hospital Medical Excellence Award, Outstanding Management Team Award, Teaching Team Award, Outstanding Management Project Award, and Advanced Collective for Quality Service Award.

Anesthesiology has been an independent second-level discipline for only 30 years. We believe that, through the continuing efforts of all department staff and the care and support of hospital leaders and sister departments, it will continue to improve its rules and regulations and raise the level of clinical anesthesia, better meet the needs of clinical care, teaching and research, and enable the Department of Anesthesiology of Peking University Third Hospital to enter the ranks of the advanced departments of Peking University Third Hospital and of the national anesthesiology community.