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General Anesthesia Division

The Division of General Anesthesia encompasses not only general surgery, trauma surgery and surgical oncology but also oversees perioperative services and critical care. Stony Brook University Hospital serves as the only Level 1 Trauma center for the nearly 1.5 million people of Suffolk County. A 20 bed Surgical Intensive Care Unit which is run by both surgical and anesthesia faculty. Additional Critical Care takes place in our Coronary Care Unit, Medical Intensive Care, Pediatric Intensive Care and Neonatal Intensive Care Units.

Division Members


Daryn Moller, MD
Chief of General Anesthesia
           

Residency Training

The division of general anesthesiology provides a diverse, well rounded experience for both residents and attendings, from the most basic aspects of the practice of anesthesiology up to the most demanding and complex. Residents will gain significant experience in dealing with complex multi-trauma cases including closed head injury, intra-abdominal injury and major orthopedic injury simultaneously. Although uncommon in this geographic area, penetrating trauma is managed by our trauma services as well. Trauma/Critical Care experience is augmented by a four-week rotation in the 20 bed Surgical Intensive Care Unit which is run by both surgical and anesthesia faculty. Additional Critical Care experience can be done on an elective basis in our Coronary Care Unit, Medical Intensive Care, Pediatric Intensive Care and Neonatal Intensive Care Units.

  • CA-1: Four-week rotation with close faculty supervision immediately following the six-week introduction for new residents. Focus is on patient management and problem solving in the OR. The clinical experience is supplemented with medical simulation of routine cases and critical events. Dedicated PACU rotation. Advanced airway management.
  • CA-2: There is a focus on invasive monitoring and transesophogeal echocardiography for the diagnosis of ischemia and monitoring of volume status. Residents rotate through Vascular Anesthesia for four weeks with a focus on minimally invasive endovascular procedures. There is also some exposure to major vascular procedures and the physiologic changes associated with surgical procedures involving aortic cross clamping.
  • CA-3: This is an advanced clinical rotation for major general and radical oncologic procedures. The focus is on increasing complex patients with multiple co-morbid conditions. Senior residents are given increasing independence as they gain additional experience in the management of these patients.  They also rotate through “Airway II”, a two-week block focusing on management of the difficult airway.  Senior residents are given additional responsibilities as team leader on call and assist in the triage and management of patients involved in emergent surgical procedures.
  • ▶ A day in the life of a Resident on General Rotation ...
  • ▶ A day in the life of a Resident on Advanced Clinical Rotation ...
  • ▶ A day in the life of a Resident on Vascular Rotation ...
  • ▶ A day in the life of a Resident doing a Trauma case ...
  • ▶ A day in the life of a Resident on Pre-op Rotation ...
  • Critical Care Rotation
Recent Division Activity

Dr. Kiamanesh at the 2017 PGA Meeting

Dr. Richman presenting at Israeli Society of Anesthesiologists meeting 2017

Recent Publications
Resident authors denoted by bold type
  • Gupta R, Reinsel R. Career Development and Mentorship during Anesthesia Residency Training: An Internet Survey. J Educ Perioper Med. 2017; 19(2):E
  • Holubar SD, Hedrick T, Gupta R, Kellum J, Hamilton M, Gan TJ, Mythen MG, Shaw AD, Miller TE; Perioperative Quality Initiative (POQI) I Workgroup. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on prevention of postoperative infection within an enhanced recovery pathway for elective colorectal surgery. Perioper Med (Lond). 2017 Mar 3;6:4
  • Boublik J, Gupta R, Bhar S, Atchabahian A. Prilocaine spinal anesthesia for ambulatory surgery: A review of the available studies. Anaesth Crit Care Pain Med. 2016 Jun 21
  • McEvoy MD, Scott MJ, Gordon DB, Grant SA, Thacker JKM, Wu CL, Gan TJ, Mythen MG, Shaw AD, Miller TE, Thiele RH, Raghunathan K, Brudney CS, Lobo DN, Martin D, Senagore A, Holubar SD, Hedrick T, Kellum J, Gupta R, Hamilton M, Moonesinghe SR, Grocott MPW, Bennett-Guerrero E, Hopkins TJ, Bergamaschi R, McCluskey S, Gottumukkala V. American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on optimal analgesia within an enhanced recovery pathway for colorectal surgery: part 1-from the preoperative period to PACU. Perioper Med (Lond). 2017 Apr 13;6:8.
  • Martinelli SM, Chen F, DiLorenzo AN, Mayer DC, Fairbanks S, Moran K, Ku C, Mitchell JD, Bowe EA, Royal KD, Hendrickse A, VanDyke K, Trawicki MC, Rankin D, Guldan GJ, Hand W, Gallagher C, Jacob Z, Zvara DA, McEvoy MD, Schell RM. Results of a Flipped Classroom Teaching Approach in Anesthesiology Residents. J Grad Med Educ. 2017 Aug;9(4):485-490.
  • Benveniste H, Lee H, Ding F, Sun Q, Al Bizri E, Makaryus R, Probst S, Nedergaard M, Stein EA, Lu H. Anesthesia with Dexmedetomidine and Low-dose Isoflurane Increases Solute Transport via the Glymphatic Pathway in Rat Brain When Compared with High-dose Isoflurane. Anesthesiology. 2017 Dec;127(6):976-988.
  • Hedrick TL, McEvoy MD, Mythen MMG, Bergamaschi R, Gupta R, Holubar SD, Senagore AJ, Gan TJ, Shaw AD, Thacker JKM, Miller TE, Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, Thiele RH, Everett S, Grocott M, Abola RE, Bennett-Guerrero E, Kent ML, Feldman LS, Fiore JF Jr; Perioperative Quality Initiative (POQI) 2 Workgroup. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Gastrointestinal Dysfunction Within an Enhanced Recovery Pathway for Elective Colorectal Surgery. Anesth Analg. 2017 Dec 29.
  • Abola RE, Bennett-Guerrero E, Kent ML, Feldman LS, Fiore JF Jr, Shaw AD, Thacker JKM, Gan TJ, Miller TE, Hedrick TL, McEvoy MD, Mythen MMG, Bergamaschi R, Gupta R, Holubar SD, Senagore AJ, Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, Thiele RH, Everett S, Grocott M; Perioperative Quality Initiative (POQI) 2 Workgroup. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Patient-Reported Outcomes in an Enhanced Recovery Pathway. Anesth Analg. 2017 Dec 29.
  • Wischmeyer PE, Carli F, Evans DC, Guilbert S, Kozar R, Pryor A, Thiele RH, Everett S, Grocott M, Gan TJ, Shaw AD, Thacker JKM, Miller TE, Hedrick TL, McEvoy MD, Mythen G, Bergamaschi R, Gupta R, Holubar SD, Senagore AJ, Abola RE, Bennett-Guerrero E, Kent ML, Feldman LS, Fiore JF Jr; Perioperative Quality Initiative (POQI) 2 Workgroup. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Nutrition Screening and Therapy Within a Surgical Enhanced Recovery Pathway. Anesth Analg. 2018 Jan 23.
  • Makaryus R, Miller TE, Gan TJ. Current concepts of fluid management in enhanced recovery pathways. Br J Anaesth. 2018 Feb;120(2):376-383.
  • Gupta R, Pyati S. Controversies in office based anesthesia: obstructive sleep apnea considerations. Minerva Anestesiol. 2018 May 14.
  • Makaryus R, Lee H, Robinson J, Enikolopov G, Benveniste H.
    Noninvasive Tracking of Anesthesia Neurotoxicity in the Developing Rodent Brain.
    Anesthesiology. 2018 Apr 24.
  • Benveniste H, Dienel G, Jacob Z, Lee H, Makaryus R, Gjedde A, Hyder F, Rothman DL.
    Trajectories of Brain Lactate and Re-visited Oxygen-Glucose Index Calculations Do Not Support Elevated Non-oxidative Metabolism of Glucose Across Childhood.
    Front Neurosci. 2018 Sep 11.
  • Alvarez-Nebreda ML, Bentov N, Urman RD, Setia S, Huang JC, Pfeifer K, Bennett K, Ong TD, Richman D, Gollapudi D, Alec-Rooke G, Javedan H. Recommendations for Preoperative Management of Frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI). J Clin Anesth. 2018 Mar 15;47:33-42.
  • Richman DC and Pulley DD. Preoperative Assessment and Management. In: Musculoskeletal and AutoImmune. Sweitzer BJ (ed). Wolters Kluwer 2018
Recent Presentations
  • Gupta R. Airway Considerations in the Allgrove Patient. Perioperative Medicine Summit, Ft. Lauderdale, 2017
  • Richman D, Georges R. Pre-operative Considerations In A Patient With A Symptomatic Coronary Artery Fistula. Perioperative Medicine Summit, Ft. Lauderdale, 2017
  • Licata S, Richman D. Using the EMR – this is a bear, or perhaps a dragon? . Perioperative Medicine Summit, Ft. Lauderdale, 2017
  • Hua B, Richman D, Branigan M. My Laparoscopic Appendectomy patient has a LVAD, now what? Perioperative Medicine Summit, Ft. Lauderdale, 2017
  • Wetcher A, Bacon J, Azim S, Beg T. Pulmonary and Brain Fat Embolism Syndrome. PGA 2017
  • Bacon J, Kogan A, Richman D. When to Call Code H: Challenges to Managing Acute ST Depressions in the Intraoperative Setting. PGA 2017
  • Gupta R. Introduction of a Comprehensive Enhanced Recovery Program in Cardiovascular Surgery Resulted in Measurable Improvements. ASER 2018
  • Abola RE, Romeiser J, Rizwan S, Gupta R, Bennett-Guerrero E. Randomized Controlled Trial of Sugammadex versus Neostigmine for Reversal of Neuromuscular Blockade: Impact on Measures of Early Postoperative Strength. ASA 2018
  • Gupta R, Romeiser J, Denoya P, Setaro J, Page CR, Kitterle S, Gan TJ. Enhanced Recovery After Surgery Program Shortens Hospital Length of Stay and Reduced Opioid Consumption in Colorectal Surgical Patients. ASA 2018
  • Gupta R, Rizwan S, Romeiser J. Survey of ERAS Provider Practices Across North America and Europe. ASA 2018
  • Gupta R, Romeiser J, Gan TJ. Survey Related to the Fasting Experience Prior to and after Implementation of an Enhanced Recovery Pathway. ASA 2018
  • Rid S, Jacob Z, Makaryus R, Hyder F, Dienel G, Rothman DL, Benveniste HD. Trajectories of Brain Lactate Do Not Contribute to Aerobic Glycolysis across Childhood. IARS 2018
  • Makaryus R, Yu M, Chen K, Boyd M, Enikolopov G. Multiple neonatal anesthesia exposures suppress neuronal proliferation in the adult rodent hippocampus. Society for Neuroscience 2018
  • Escobar DP, Richman DC, Wang M. Airway Management of Lower Paratracheal Mass. ASA 2018
  • Fleischer L, Richman DC, Brown A. 23 And You: How Genetics Can Impact Your Anesthetic and Your Life. Perioperative Medicine Summit Fort Lauderdale FL Mar 2018