INTERNATIONAL NEUROANESTHESIA NEWS
25th Anniversary Meeting of the Finnish Neuroanesthesia Society
Riikka Takala, MD, PhD
Ari Katila, MD
Department of Anaesthesiology, Intensive Care, Emergency Care and Pain Medicine
Turku University Hospital
Turku, Finland
The Finnish Neuroanesthesia Society was founded in 1994 after a persistent initiative from the late Dr. Seija Kolehmainen. Unfortunately, she never saw how the Society has grown. Seven practicing neuroanesthesiologists were founders of the small society, together with an equal number of enthusiastic supporters outside neuroanesthesia.
At the beginning of 21st century, the Finnish Medical Association established various official subspecialities and neuroanesthesia was one of them. These seven members automatically received this subspeciality. Since then, a formal two-year training program in neuroanesthesia was established. Today, the training program is university-based; in Finland, there are five universities with medical faculties. This program is similar in each university and ends with a national written examination. Currently, there are 25 anesthesiologists who possess the subspeciality degree in neuroanesthesiology and there are eleven in training.
The Society has an annual afternoon meeting in May, usually conducted in Helsinki. However, there has been a tradition to hold the meeting every 5th year in Turku and these meetings last one and a half days. This year we celebrated our 25th Anniversary on May 24-25, 2019. The meeting was organised by Dr. Ari Katila and Dr. Riikka Takala. The author (RT) has been a member since 2003 and, over the years, the number of members attending our meetings has increased. Currently, there are 71 members, of which some 20 or more are active participants. This year our meeting attracted 32 participants.
The meeting was opened by the grand honorary lady of our Society, Dr. Tarja Randell (Associate Professor, Helsinki). She showed pictures from past decades on how hypothermia was induced in the 50’s in Töölö hospital (Helsinki) and how neuroanesthesia developed during those days. As she is about to be superannuated from services in the next few months, she was awarded with a brooch called “neural connections”, designed and made by society memberm Dr. Vesa Kontinen. Subsequently, all the members decided that the Society will make similar pins for its active members to embrace the sense of unity.
Figure 1: Dr. Tarja Randell and hypothermia in the 50’s in Töölö hospital and “Neural connections” brooch.
The first session of the day concentrated on future aspects. Neurosurgeon Dr. Juri Kivelev (Turku) spoke about the future in the operating theatres. He discussed the possibilities of 3-D bioprinting and tissue engineering in vascular surgery and in nerve regeneration. He also demonstrated how minimally invasive surgery has spread in spine surgery by showing videos of laparoscopic thoracic discectomy. Neurosurgeon, Dr. Rahul Raj (Helsinki), spoke about the use of artificial intelligence (AI) in neurocritical care. Helsinki University Hospital and their neurosurgeons have been in a leading position in Finland to develop AI. The audience was shown the unpublished data regarding how AI could be useful in neurocritical care in the prognostication of TBI. Neuroradiologist Dr. Hirvonen (Turku) also dealt with AI in his lecture. AI is already used in neuroradiology and its role is inevitably increasing.
Dr. Teemu Luostarinen (Helsinki) told the audience about his experience with adenosine in aneurysm surgery. He has done research on adenosine during aneurysm clipping. With the help of video clips, he demonstrated how the sinus arrest develops after adenosine and how the communication between anesthesiologist and neurosurgeon is vital when administering adenosine during the operation. Dr. Riikka Takala (Turku), attempted to cover the pathophysiology of DCI in SAH and current treatment modalities in a 30-minute talk. Clinical neurophysiologist, Dr. Santeri Aura (Turku), covered how EEG and somatosensory-evoked potentials could be used in prognostication. This year, one of our guest speakers was Prof. Eirik Søfteland from Bergen, Norway, who delivered a comprehensive lecture on cerebral vasculature physiology and vasoactive agents in neuroanesthesia. Despite the exhaustive research findings, no clear recommendations could be made, and more studies were suggested; especially how the vasoactive agents affect cerebral microcirculation in normal and pathological conditions. The other guest speaker, also from Norway, was Dr. Christina Drewes (Trondheim), who gave a nice talk on her thesis topic with the title “Outcome Assessment in Brain Tumor Surgery - Should We Ask the Patients?” It became clear that patient report outcomes of language, cognitive and motor deficits at 30 days are worse than hospital records at discharge. After glioma operation, independent risk factors for negative quality of life development are high grade histopathology, subtotal tumor resection and ASA class >3 (Odds ratio 3). The last speaker of the day was a patient and colleague who shared an emotional and thought-provoking experience about their subarachnoid hemorrhage with three weeks neurocritical care and rehabilitation.
As Finnish neuroanesthesiologists are known for their love of good food and wine, it was self-evident that the first day ended with a four-course dinner.
Figure 2: Dinner in E.Ekblom, Neuvola
Although the dinner ended past midnight, all attendants participated in the Saturday morning session. Neurologist, Dr. Pauli Yli-Kotila (Turku), reviewed current treatment modalities in acute ischemic stroke and the new time windows for endovascular treatment. PhD candidate, Minna Kallioinen (Turku), gave a thorough lecture on dexmedetomidine (which is actually developed in Turku, Finland) and its current role in neuroanesthesiology. She also showed some yet unpublished data about her dexmedetomidine study on subarachnoid hemorrhage patients. PhD candidate, Matias Rantanen (Turku), enlightened us with information on opioid-free anesthesia. Neurologist, Dr. Jori Ruuskanen (Turku), finished the meeting by speaking about new anti-epileptic drugs, such as perampanel and brivaracetam, and various interactions of antiepileptic drugs.
Finally, this short report functions also as an invitation for our 30th Anniversary Meeting in Turku in 2024.
