Anesthesiology Pain and Intensive Care Division

In early 2024, Tel Aviv Sourasky Medical Center inaugurated the new underground Kissufim Surgical Complex, featuring 10 state-of-the-art operating rooms. This expansion has made the Medical Center's surgical facilities the largest in Israel and is expected to help reduce surgical waiting times nationwide.

The new operating rooms are equipped with advanced medical technologies, modern infrastructure, and innovative digital systems designed to enhance patient care and support surgical teams.

The Anesthesiology Division and operating rooms function 24 hours a day, 365 days a year, providing anesthesia services for scheduled, urgent, and emergency procedures. The surgical facilities are also prepared to respond to mass-casualty incidents.

Operating room services are delivered by multidisciplinary teams of anesthesiologists, nurses, support staff, and administrative personnel, assisted by engineers and biomedical technicians responsible for maintaining and operating complex medical equipment.

Postoperative recovery is a critical stage of surgical care. Following surgery, patients are transferred to the Post-Anesthesia Care Unit (PACU) for monitoring, recovery from anesthesia, and initial pain management. Depending on their condition, patients may receive respiratory support, medications, and other necessary treatments.

The duration of recovery depends on the type of surgery, the patient's medical condition, and any underlying illnesses. Once stable, patients are transferred to the appropriate inpatient department.

The PACU is staffed by physicians and nurses trained in intensive care and equipped with advanced monitoring and treatment systems. Patients requiring more complex care may remain under observation until their condition stabilizes or be transferred to an intensive care unit.

The General Intensive Care Unit provides advanced treatment for critically ill patients with complex medical conditions. Patients are admitted from the Emergency Department, inpatient departments, operating rooms, and other hospitals.

Conditions requiring intensive care include:

• Severe respiratory failure requiring advanced ventilation, invasive monitoring, or extracorporeal membrane oxygenation (ECMO).

• Severe traumatic injuries, including road accidents and conflict-related injuries.

• Recovery following major or complex surgical procedures.

• Severe infections, including sepsis and multiple organ dysfunction.

• Poisoning and other life-threatening medical emergencies.

• Critical obstetric conditions, including preeclampsia and childbirth-related complications.

• Care following liver transplantation.

• Severe liver failure requiring Molecular Adsorbent Recirculating System (MARS) therapy.

The Unit's medical team is also responsible for emergency resuscitation throughout the hospital.

Care is provided by a multidisciplinary team of intensive care specialists, nurses, physiotherapists, social workers, and medical consultants. Senior physicians are trained in intensive care medicine and additional specialties, including anesthesiology, internal medicine, thoracic surgery, pulmonology, and nephrology.

Patients receive continuous monitoring and advanced organ support using invasive monitoring systems, mechanical ventilators, dialysis equipment, enteral and parenteral nutrition, ECMO, and artificial liver support systems.

The Obstetric Anesthesia Unit at Lis Maternity and Women's Hospital is part of the Medical Center's Anesthesiology Division.

The Unit is staffed by anesthesiologists specializing in obstetric anesthesia and pain management, with expertise in the medical conditions and unique needs of pregnant women.

The team provides labor pain relief, including epidural anesthesia, as well as anesthesia for planned and emergency cesarean deliveries.

The Pediatric Anesthesia Unit at Dana-Dwek Children's Hospital is dedicated to ensuring a safe, comfortable, and reassuring experience for children and their families before, during, and after surgery.

The Unit places particular emphasis on reducing anxiety, pain, and the emotional stress associated with surgical procedures.

Pediatric operating rooms are designed to provide a child-friendly environment and are equipped with modern medical technologies. Advanced anesthetic medications and techniques, together with the expertise of the pediatric anesthesia team, help ensure safe and effective care tailored to each child's needs.

The Pre-Anesthesia Clinic plays an essential role in preparing patients for surgery and minimizing potential complications during and after anesthesia.

During the consultation, anesthesiologists review the patient's medical history, evaluate existing medical conditions, and determine whether additional tests or treatment adjustments are needed before surgery.

Appointments generally take place several days to several weeks before the scheduled procedure, depending on its urgency and availability.

The visit includes an assessment by an anesthesiologist and a consultation with a nurse. Patients receive information about anesthesia, the surgical process, postoperative recovery, and pain management, and have an opportunity to discuss any concerns.

The Pain Management Institute provides comprehensive, multidisciplinary assessment, treatment, and rehabilitation for patients experiencing acute, chronic, and cancer-related pain.

The team includes physicians specializing in pain medicine from various disciplines, including anesthesiology, emergency medicine, neurology, orthopedics, and rehabilitation medicine, alongside nurses, psychologists, and complementary medicine practitioners.

The Institute provides daily consultations for hospitalized patients, Emergency Department patients, and community referrals, with particular expertise in complex and persistent pain conditions.

Conditions Treated

• Acute herpes zoster (shingles) and postherpetic neuralgia.

• Diabetic neuropathy.

• Headache disorders.

• Peripheral nerve injuries, including complex regional pain syndrome (CRPS).

• Myofascial pain syndromes.

• Postoperative pain syndromes.

• Non-rheumatologic joint pain.

• Herniated discs.

• Spinal stenosis.

• Lower back pain.

• Work-related injuries.

Treatment Methods

The Institute offers advanced pain management techniques, including image-guided injections using fluoroscopy or ultrasound, spinal cord and peripheral nerve stimulation, radiofrequency treatments, spinal drug pump management, transcranial magnetic stimulation, and pharmacological therapies.

Treatment plans are individualized and may involve collaboration with specialists from other medical disciplines.

The Day Surgery Unit provides surgical procedures that allow patients to undergo surgery, recover, and return home on the same day, without requiring overnight hospitalization.

Day surgery is increasingly available to a broad range of patients, including children, older adults, and individuals with underlying medical conditions. Procedures are performed across various surgical specialties.

This approach reduces unnecessary hospitalization and exposure to hospital-acquired infections while allowing patients to recover in familiar surroundings. It is particularly beneficial for children, older adults, and patients who may find changes in their environment challenging.

Some patients may require postoperative hospitalization, depending on the type of procedure, their medical condition, available family support, and home environment. The Unit also provides surgical care for patients already hospitalized in other departments.

Sedation is a medically induced state between full wakefulness and general anesthesia, intended to reduce anxiety, discomfort, and pain during diagnostic or therapeutic procedures.

Sedative medications may be administered orally, intravenously, or by inhalation, according to the anesthesiologist's assessment. Throughout the procedure, patients are monitored for blood pressure, heart rate, and oxygen saturation and receive supplemental oxygen as needed.

Patients generally regain consciousness shortly after sedation is discontinued. Possible side effects include nausea, vomiting, and drowsiness.

Sedation services are provided by experienced anesthesiologists trained in administering anesthesia and sedation outside the operating room.

Adult Sedation and Anesthesia

Sedation is provided for diagnostic and therapeutic procedures, particularly for patients experiencing anxiety or difficulty cooperating with treatment.

Services include sedation for imaging examinations, endoscopy, bronchoscopy, transesophageal echocardiography, and electroconvulsive therapy (ECT).

Sedation is also available in inpatient departments for painful procedures, such as dressing changes for patients with burns.

Pediatric Sedation – The Dream Service

The Dream Service provides sedation and anesthesia for children undergoing diagnostic examinations and medical procedures, helping reduce anxiety, discomfort, and the need to remain still for extended periods.

Dental Procedures Under Sedation or General Anesthesia

Sedation and general anesthesia are available for dental procedures involving children, adults, and patients with special needs.

These services are particularly beneficial for patients experiencing significant dental anxiety or undergoing lengthy or extensive dental treatments.

Emergency and Resuscitation Services

Anesthesiologists also play a central role in the hospital's emergency response and resuscitation teams.

They assist in managing patients with severe traumatic injuries, multiple organ dysfunction, and serious infections in the Emergency Department.

They are also called upon to stabilize critically ill patients whose condition deteriorates during hospitalization and to participate in emergency resuscitation throughout the Medical Center.