4th Neuroanesthesia Symposium in Kuching, Malaysia

Vanitha Sivanaser, MBBS, MMed (Anesthesiology, UM)
Postdoctoral Fellowship (NeuroAnesthesia, Canada)
Consultant Neuro-Anesthesiologist, Department of Anesthesia and Intensive Care
General Hospital Kuala Lumpur, Kuala Lumpur, Malaysia

Neuroanaesthesia Symposium (NAS) is a biennial scientific meeting held in Malaysia. From its inception in 2010, NAS has gained momentum in academia along with regional participation of delegates. The tranquil town of Kuching which is the capital of Sarawak, Borneo Island in Malaysia played the perfect host for the 4th NAS from March 31 to April 2, 2017, at Riverside Majestic Hotel, Kuching, Sarawak. ‘Back to the Future: Advances in Neuroanesthesia was the theme of this symposium with the primary objective of emphasizing the recent advances in neuroanesthesia practice. The event was organized by the Department of Anesthesiology and Intensive Care, Sarawak General Hospital (SGH) in collaboration with the Neuroanesthesia Special Interest Group, College of Anaesthesiologists, and Academy of Medicine Malaysia.

Looking back at the NAS 2017, it is difficult to enumerate the rich exchange of academic interest shared over three days; however, some of the key outputs are presented here. The symposium brought together an impressive attendance of 250 participants from Malaysia and other regional neighboring countries. Delegates from Indonesia and India formed a notable number of the foreign delegates who attended NAS. The participation of esteemed foreign speakers from the Asian Society of Neuroanesthesia and Critical Care (ASNACC) included Professor Mathew Chan Tak Vai from The Chinese University of Hong Kong (CUHK), Hong Kong; Professor Girija Prasad Rath from All India Institute of Medical Sciences (AIIMS), New Delhi, India; and Professor Thomas Lew Wing Kit from Tan Tock Seng Hospital (TTSH), Singapore (Figure). The local faculty speakers included neuroanesthesiologists who are responsible for many advances in neuroanesthesia practice in Malaysia.

4th Neuroanaesthesia Symposium

Figure: Organizers of 4th Neuroanaesthesia Symposium (NAS 2017) along with Invited International Speakers.

Pre-Congress Workshops
A day before the symposium, two workshops focused on an array of stimulating neuromonitoring modalities featuring their advanced uses in Malaysia. There was a half-day workshop on Bispectral Index (BIS) Titration Simulator/Target Control Infusion (TCI) which allowed the participants to navigate the BIS titration simulator. The afternoon progressed with a Neuromonitoring Workshop (TCD, NIRS, ICP monitoring, SSEP, MEP, and EMG). This half-day workshop included a series of lectures and hands on participation with the various intraoperative monitoring modalities available.

The Anesthetic Crisis Simulation was a full-day workshop held at Sarawak General Hospital. This workshop was conducted by the stimulation special interest group, College of Anesthesiologists, Malaysia. The attendees were exposed to a variety of neuroanesthesia crisis situations. By all measures, it was a sensational success with the participants.

Neuroanaesthesia Symposium (NAS)
The first day of the symposium started off with a packed auditorium of participants. Sarawak General Hospital’s chief anesthesiologist Dr. Hasmizy Bin Muhammad’s insightful welcome speech touched on neuroanesthesia activities at Sarawak General during the past decade. This was followed by the opening speech by the NAS organizing chairperson, Dr. Teo Shu Ching.

The symposium commenced with an impressive plenary lecture by Professor Thomas Lew Wing Kit from TTSH, Singapore on the ‘Application of Improvement Science in Neuroanesthesia and Neurocritical care’.This was followed by mini-symposiums; the presentations were tailored to cover a wide array of clinical based topics targeting the common issues. ‘Cerebral Autoregulation and Anaesthesia - An Update’ was discussed by Dr. Lim Wee Leong (Sungai Buloh Hospital). ‘Current Perspectives on Neurotoxicity of General Anesthesia’ by Professor Thomas Lew (Singapore), ‘Anesthesia for Complex Spinal Surgery’ by Dr. Vanitha Sivanaser (General Hospital, Kuala Lumpur), and ‘Pain Management After Major Spinal Surgery - Current Evidence’ by Dr. Athena Tang Mee Yee (Faculty of Medicine and Health Sciences, University Malaysia Sarawak).

The morning symposium concluded with a wonderful lunch during which Dr. Loh Pui San from the faculty of anesthesiology, University Malaya presented on ‘Fine Tuning Neuromuscular Block in Neuroanesthesia’. The afternoon progressed with an equal array of absorbing presentations. Dr. Teo Shu Ching (SGH, Kuching) spoke on ‘Pediatric Neuroanesthesia for Occasional Neuroanesthetists’ which was followed by a talk on ‘Anesthetic Concerns for Specific Pediatric Neurosurgical Procedures’ by Professor Girija Prasad Rath (AIIMS, New Delhi). Dr. Hari Krishnan S.K. Puvaneswaran (Ramsay Sime Darby Ara Damansara) shared his experience from a private hospital on epilepsy surgery which was followed by another lecture by Professor Girija Prasad Rath on ‘Awake Craniotomy - The Current and Future Challenges.’ The enthusiasm of the participants was infectious, and suffice to say, the day ended on a high note.

The morning session on the second day began with a plenary lecture by Professor Matthew Chan. His command on ‘Research in Neuroanesthesia: What Have We Learned So Far?’ was impressively insightful and comprehensive. Mini-symposium lectures followed after that: Dr. Wan Mohd Nazaruddin Wan Hassan (School of Medical Sciences, University Sains Malaysia) discussed ‘Scalp Block - How Useful Is It?’, Dr. Vanitha Sivanaser elaborated on ‘Complications During Neurosurgery’, and Professor Matthew Chan spoke on the ‘Need For Specialized Training in Neuroanesthesia.’ This was followed by a lunch symposium where Dr. Lim Wee Leong delivered a lecture on ‘Anesthesia Choice and Cancer.’ After lunch, there were a series of mini-symposium lectures. Dr. Tang Ing Ping (Faculty of Medicine and Health Sciences, University Malaysia Sarawak) delivered a lecture on ‘Present and Future of Endoscopic Skull Base Surgery.’ It was followed by ‘Cervical Immobilization During Airway Management: Comparison of Different Techniques’ by Dr. Mohd Fahmi Lukman (National Defense University of Malaysia) and ‘Highlights on 2016 Guidelines for the Management of Adult Traumatic Brain Injury’ by Dr. Hui Mun Tsong (Tropicana Medical Centre). The objectives of this symposium were appropriately delivered and the target audience was pleased with the success of the meeting. A sense of accomplishment and fulfillment described the atmosphere at the completion of the 4th NAS, Au Revoir, Sekian Terima Kasih! We look forward in seeing you at the 5th NAS 2019!

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