Changing Scenario of Regional Anaesthesia Practice in Northeast India

Abstract

The North-East (NE) region of India comprises of eight states- Arunachal Pradesh, Assam, Manipur, Meghalaya, Mizoram, Nagaland, Sikkim and Tripura. (Fig 1) The anesthesia services in remote areas of this region are greatly restricted due to inadequate qualified manpower and infrastructure, as very few postgraduate and DNB (Diplomate National Board) seats are available each year across 4 out of 8 states through the NEET PG Test. (Fig 2a & 2b) Regional Anesthesia (RA) has several benefits in certain patients over general anesthesia. It not only allows for better post-operative pain management and a comfortable post-operative patient, but also allows for safer surgeries in patients with comorbidities that carry potentially life-threatening risks with general anesthesia, especially in a resource limited areas. The practice of RA took a backseat in the recent past due to lack of proper training in RA and the absence of a structured curriculum during PG training. However, during the last decade, we have witnessed a paradigm shift in RA and PNB (Peripheral nerve block) anesthesia with continued support from Academy of Regional Anaesthesia (AORA) & Indian Society of Anesthesiologists (ISA). For better understanding of the changing scenario of regional anesthesia practice in this region over years, we may divide the timeline into two phases, late 20th century and the 21st century.