+973 17 253447

+973 17 234194

+973 17 248118

+973 17 248110

or

+973 17 248121

+973 17 248145

AMH Directions

For appointments Ext. 351

Services

AMH has two full time anesthesiologists.

Each of them has wide experience in the anesthetic management of complex surgical operations. Their responsibilities include a pain management service and resuscitation of cardiac and respiratory emergencies: Epidural analgesia is provided for pain relief during labor.

Equipment

The operating rooms of AMH are equipped with modern Drager Cato and Ohmeda Excel anesthesia workstations which have a number of built in safety features which follows all safety standards set by the American society of Anesthesiologists.

Pre Anesthetic clinics

All patients scheduled for elective surgery go through a pre-anesthetic checkup by one of the anesthesiologists. This assessment helps in the careful planning of the anesthetic procedure. Patients can use this opportunity to clear their doubts about anesthesia and could voice their preference of techniques used.

Anesthetic Techniques

Anesthetic Techniques

Depending on the nature of the surgical operation and the patient's physical condition, the choice is made from a variety of available anesthetic techniques.

These include balanced general anesthetic techniques with controlled ventilation, total intravenous anesthesia using target controlled ventilation, total intravenous anesthesia using target controlled infusions, and a number of regional anesthetic techniques. Multi modal analgesia is often used to make the postoperative period as pain free as possible.

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EPIDURAL PAIN RELIEF IN LABOR

Although childbirth is a natural process, most women experience pain. If women know what is happening during labor, know what to expect, and are supported by caring family, friends, and health care professionals, this pain is lessened. Breathing exercises and relaxation techniques often help. However, some women need medical help to control the pain.

Pain can be lessened by injection of morphine or pethidine. These medications will allow for relaxation, especially between painful contractions. Because these medications can make the baby sleepy when he or she is born, they are not recommended if the baby will be born sson. Epidural analgesia is the most effective method of providing pain relief in labor. An anesthetist inserts a small plastic tube into the mother's back, and a mixture of local anesthetic drugs and a powerful painkiller is injected. By using a pump, a slow continual stream of these medications runs into the mother's back and gives pain relief.

While the plastic tube is being inserted, you have to be on your side and arch your back towards the anesthetist. It is very important that you should not hold your back stiff and should not make any sudden movements.
The medicines that are injected act on the nerves just outside the membranes covering the spinal cord. It is probably reasonable to assume that at the basis of every woman's consideration of epidural analgesia are two questions:

1. How is it likely to benefit me?
2. What risks does it present for my child and myself?

An anesthetist for every woman in labor who requests epidural analgesia performs a 'risk-benefit analysis' of this kind. There are few procedures in medicine, which do not have a large list of potential problems associated with them. Likewise, Epidural analgesia also carries potential for many complications. Some of these are relatively common but not serious. Others are extremely rare and serious. Permanent paralysis, cardiac arrest and death are very rare but serious complications. These occur in arrange between 1/20,000 to 1/1,000,000 in patients in labor. Epidural Analgesia has been performed over a period of four decades. In hospitals with large obstetric units it is common for 50% of the women to receive epidural analgesia for labor analgesia for labor analgesia and 90% for cesarean section. It has a very good safety record. This is due to the very high standard of training of anesthetists who perform them. Anesthetists are specialist doctors.

As a result of this, it is reasonable for a laboring woman. Who is otherwise healthy, to consider pain relief for severe pain as the benefit of epidurals outweigh the risks. If pain can be adequately managed using simpler techniques, then the benefit associated with epidural analgesia may not outweigh the risks. Developing a birth plan in which these issues have been considered, but which is flexible, is a good approach to pain relief in labor. Many women employ a 'wait and see' approach and it works well.

While this is generally very safe, and has been used all over the world for many years without serious problems, you should also know about possible risks and complications.

1. Common side effects:

Your leg will feel heavy and you may have difficulty moving or passing urine. If necessary we will help you move and put a small tube (catheter) into your bladder to empty it.
Tour blood pressure may drop. This will be checked and treated with intravenous (IV) fluids and medication if necessary.

When local anesthetics are used by themselves, shivering occurs commonly following an epidural. Most of the patients are not concerned about this. Strangely enough those who shiver do not usually feel cold. The cause for such shivering is obscure. The incidence of shivering is much less when other painkillers are mixed with local anesthetics.

2. Possible problems:
Some studies have suggested that epidurals in early labor may increase the risk of forceps delivery or caesarian section. Other studies have not confirmed this.

Many women suffer backache during pregnancy and after labor. Current research suggests that this is not worsened by epidurals. Some women have an area of numbness, which lasts for several days.

3. Serious problems:

These are rare-
The epidural catheter can be put in the wrong place.

A) About 5% of the time it goes into a blood vessel in the back, and has to be pulled back or reinserted. Very rarely a dose of local anesthetic is injected into the blood vessel and the patient notices a metallic taste in her mouth, becomes dizzy, and may go on to have a convulsion or even a heart attack. With prompt treatment, complete recovery from this complication is possible

B) About 1-2% of epidurals enter the fluid, which surrounds the spinal cord.
This frequently causes a severe headache, which may need further treatment. This may be in the form of a repeat epidural and injection of a small amount of blood to seal the leak of the fluid. This can be treated with analgesics, IV fluids and lying flat in bed until the headache disappears. Very rarely a large dose of logical anesthetic is injected, causing serious complications.

C) Other complications include the introduction of infection into the area around the spinal cord.

Exceedingly rarely, epidural analgesia can cause death or permanent paralysis. Anesthetics are specially trained to know these risks, and avoid or treat complications.

Effect on baby:
Epidural analgesia has little or no effect on the newborn.

Effectiveness:
Epidural analgesia works well, providing about 9 women out of 10 with complete or nearly complete pain relief. Sometimes it is necessary to add more medication, adjust the tubing, or even reinsert the epidural in order to achieve good pain relief. Epidural analgesia often avoids the need for general anesthetic, which is more risky than epidural analgesia.

AVAILABILITY:
If you wish to make use of this service, we strongly recommend that you meet one of the anesthetist at AMH during antenatal visits to discuss about epidural analgesia.

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Dr. PAUL L. ARMERDING

Title:
Chief Executive Officer (CEO) & General Surgeon

Qualification:
Rutgers College, New Brunswick, New Jersey: BS - 1969
Albany Medical College, Albany, New York: MD - 1973

Diplomate, American Board of Surgery: (re certified 1993)
Fellow of the American College of Surgeons

Dr. Paul Ludwig Armerding is the American General Surgeon. He has been our CEO from 1988 till date and has overseen the transition of AMH from its original status as a ministry of the Reformed Church in America to becoming a registered Bahrain society. He has been involved with trauma surgery, as well as all forms of General surgery including laproscopic techniques.

In his role as CEO and surgeon he is able to oversee the quality of medical treatment in the hospital while through his administrative capacity is able to extend this to the community-at -large. His missionary zeal and vision has been a driving force in the remarkable improvement seen in the hospital since 1988 and the American Mission Hospital has tripled in size to become the largest private medical provider in Bahrain.

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Dr. SANJAY GUPTA

Title:
Assistant Chief of Medical Staff

Specialty:
General Surgery

Training/Schooling:
Government Medical College, Jabalpur - M.B.B.S. - 1985
Government Medical College, Jabalpur - MS General Surgery - 1989

Certificates/Qualifications:
Ethicon Institute, Bombay, Laproscopic Surgery -1996
Member Of Association Of Surgeons Of India, MP Chapter.
Working on Advanced Laproscopic Surgery, PD Hinduja Hospital & Research Center, Bombay – 1996.

Workshop on Laproscopic hernia repair IAGES Delhi - 2006
Member Of Indian Association Of Gastrointestinal Endo-Surgeons (IAGES)
Member Of Society Of Endoscopic & Laproscopic Surgeons of Asia (ELSA)

He has a consistently busy practice and he has dedicated a considerable time in the challenging and constantly evolving world of surgery. He is particularly interested in the advances of Laproscopic Surgery. He developed the breast clinic and started the endoscopic unit in AMH with gastroscopy and colonoscopy.

He is a second-generation AMH doctor. His father, Dr Chandra Gupta, was with AMH for fifteen years and Dr Sanjay has been with AMH for eleven years, so between the both of them they have a quarter of a century of providing medical care for the community of Bahrain.

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  Nanik A. Sakhrani, M.D.

Specialty:  General, Cancer and Laparoscopic Surgery

Training/Schooling:

Doctor of Medicine – FEU-NRMF College of Medicine, Philippines

Surgical Residency Training – FEU-NRMF Medical Center, Philippines

Trauma – Thoraco-Cardiovascular Surgery rotation – Philippine General Hospital

Basic/Advance Laparoscopic Surgery – Queen Mary Hosptial, Hong Kong

Certificates/Qualifications:

Philippine College of Surgeons

Philippine Society of General Surgeons

Philippine Society of Laparoscopic Surgery

Philippine Medical Association

Personal introduction:

I believe in the saying that:   “A GOOD Surgeon knows how to operate

                                            A BETTER Surgeon knows when to operate

                                            But the BEST Surgeon knows when NOT to operate!”

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Dr. Kanubhai Parmar

Specialty:
Anesthesiologist

Certificates/Qualifications:
 

Training/Schooling:

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Dr. HEMANGINI AL MOULA

Specialty:
Anesthesiologist

Qualifications:
MD.

Affiliations:
Member of Bahrain Medical Society
Member of Maharashtra Medical Council
Member of Anesthesiologists, India

She Joined AMH in July 1994 as a full time consultant Anesthesiologist. Before joining AMH she worked as the senior resident Anesthesiologist at the Salmaniya Hospital.

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OPERATION THEATER SUITE

The Operation Theater suite of AMH consists of three operating rooms, a well equipped recovery room (post Anesthesia care unit), a Day care unit (DCU) and a Central sterilization unit. Our operating rooms are equipped for a variety of major surgical procedures in general surgery, obstetrics & gynecology, orthopedics, ENT and plastic surgery.

Anesthesia

Highly qualified and experienced physicians run our anesthesia service. Meticulous care is taken so that standards prescribed by the American society of Anesthesiologists are always maintained. For more information on the Department of Anesthesia, Please click here.

Minimal Invasive Surgery-

A large number of diagnostic procedures, laproscopic surgery for diseases of the gallbladder and appendix, uterine and ovarian tumors as well as arthoscopic joint surgery are done regularly. For more details about these operations, please refer to the pages on general surgery, gynecology & orthopedics.

Outpatient surgery

The day care unit (DCU) helps patients to undergo operations with minimal hospital stay and reduced cost. The proximity to the operation theater ensures frequent observation by surgeons and anesthesiologists. Many operations that include laproscopic and arthroscopic procedures, which earlier required admission to the wards, are now done on an outpatient basis.

Surgery for children

About 30-35% of our patients in the operation theater are infants and children for surgeries like tonsillectomies, circumcisions, hernia repairs, appendectomies and dental treatment. Trained staff endeavor to provide a safe, pleasant and pain free hospital stay for all children and to avoid psychological trauma in the young patients.

Post Anesthesia care unit (Recovery Room)

Patients recovering from anesthesia are observed in the recovery room. One to one nursing is provided for each patient. The unit is well equipped to monitor each patient & every effort is made to ensure that patients are pain free before they are transferred to the ward or DCU.

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