Welcome to Department of Anesthesiology at Taipei Veterans General Hospital!

    The Division of Anesthesiology first originated when Taipei Veterans General Hospital was constructed in 1959. It was a part of the Department of Surgery until 1989, when it became an independent department. Progress in anesthesiology over the years has expanded its scope to include clinical anesthesia, pain management, emergency medicine, intensive and critical care. The department has five subspecialties in clinical practice, namely general anesthesiology, neurosurgical anesthesiology, maternal and pediatric anesthesiology, cardiothoracic anesthesiology, and pain management. At present, there are 49 doctors, 128 nurse anesthetists, and 5 administrative staff in the department. The department's ongoing growth is under the leadership of Dr. Wen-Kuei Chang.

    As of now, there are anesthesia services for 52 operating rooms situated across the hospital. By 2023, this number is expected to increase to 69 rooms. Additionally, there are 40 general beds and 6 intensive care beds available in the PACU (post-anesthesia care unit). In the past few years, anesthesia services have extended beyond the vicinity of the operation rooms, involving MRI, angiography, procedures in cardiovascular Cath rooms, treatment in Cancer Therapy Center (CTC), and anesthetic services for the health screening program, including routine health check-up and sedated gastrointestinal endoscopy. Providing anesthesia service in various fields has helped to keep all the cooperated departments in Taipei Veterans General Hospital at the forefront and a well-known center. In addition, our department collaborates with others to provide anesthetic and pain care for a wide variety of international patients. Among them are a Tibetan rin-po-che who received a kidney transplant, a Vietnamese baby who underwent a liver transplant (Figure 1), and the Maori king of New Zealand who received both surgical and medical treatment.

Figure 1. The anesthesia and transplant teams collaborated to perform a pediatric liver transplant on a Vietnamese baby.

    Besides, our Vascular Center was established in 2007 and provided services for sono-guided placement of TDC (tunneled dialysis catheters), and successfully solved the difficult problem of dialysis catheter placement for high-risk patients. From 2011 and on, we have been actively conducting and realizing the concept of a “pain-free hospital”. Aside from improving the preexisting division of PCA (Patient controlled analgesia) management, the 24-hour uninterrupted PCA service is widely praised as well. Other aspects of clinical practice in pain management have also been elaborated to include pain consultations, pain clinics, and pediatric pain clinics (Figure 2).

Figure 2. Services for clinical pain management and training courses on pain procedures.

    The feature of anesthesia changes with the advent of new devices.  The 3D transesophageal echocardiography has been introduced in our department for cardiac surgeries since 2006 (Figure 3).  Recently, as surgical procedures are moving towards minimally invasive, painless service for invasive examinations, and enhanced recovery after surgery (ERAS) had been major trends, the demand for precise anesthesia is increasing. We inherit the glorious history of the past and lead the trend to maximize patient safety and comfort.  In recent years, we have introduced a large number of advanced instruments to monitor the depth of anesthesia such as BIS (Bispectral index), Entropy, SEF (spectral edge frequency), ANI (analgesia nociception index), Sedline, etc. At the same time, advanced TCI (Target-controlled infusion) pumps are also used to precisely titrate the dosage of various anesthetics based on individual needs, and cooperate with physicians and surgeons to complete many complex operations, such as awake craniotomy, TAVI, mitral clipping, organ transplantation (Figure 3) and non-intubation endoscopic thoracotomy (Figure 4) and so on. The precise anesthesia protects the safety of surgical patients in all aspects, improves medical quality, enhances recovery after surgery and improves prognosis. Our medical experience and achievements have also been widely recognized and won numerous awards.

Figure 3. Three-dimension transesophageal echocardiography (TEE) for cardiac anesthesia and surgery.

Figure 4. Anesthetic teams for non-intubation endoscopic thoracotomy and Video-Assisted Thoracic Surgery (VATS)

    Providing outstanding training and supporting staff members in their specialty researches is heavily valued (Figure 5).  Major contributions from our staffs include ultrasonography guided epidural catheter placement, publications about new advances and application of biostatics, the Health Matric APP on portable devices, liver transplantation researches, pain mechanism researches and others. There had been reached more than 20 ministry appointed teachers, along with other clinical teachers, we provide a cradle for nurturing a new generation of anesthesiologists and nurse anesthetists.

Figure 5. Simulation training and test courses for staff training.

    We not only respond to in-hospital emergency resuscitation codes, but also dedicate ourselves to critical care and emergency medicine after the 921 earthquake in 1999 and the Baxian dust explosion accident in 2015. Besides, we were devoted to the airway management and care of critically ill patients during the raging epidemic of SARS in 2003 and COVID-19 in 2020 (Figure 6). We have no staffs infected during advanced airway management for these patients. We also developed standard operating procedures for clinical tasks from the relevant experiences.  Our services reach beyond the scope of Taipei Veterans General Hospital into suburban areas such as Kinmen Hospital (Ministry of Health and Welfare), Taoyuan, Zhudong, Suao and Yuanshan Veterans Hospital,  and the affiliated hospital of National Yang Ming Chiao Tung University.  We hope to continually advance ourselves and become a role model in the field of anesthesia (Figure 7).

Figure 6. Well training staffs with full protect equipment for advance COVID-19 patient airway management.

Figure 7. Our record of awards.

Update by Shih-Pin Lin