Foundation and Institutional Context
The Department of Anaesthesia, Analgesia and Intensive Care Medicine is one of the key clinical-academic units within the Faculty of Surgery at Bangladesh Medical University (BMU). BMU itself traces its origins to the former Institute of Post Graduate Medicine & Research (IPGMR), established in December 1965. In 1998, the Government of Bangladesh converted IPGMR into a Medical University, with the goal of expanding postgraduate medical education and clinical research. This was later named as Bangladesh Medical University (BMU)
Within this institutional transformation, the Department of Anaesthesia became embedded as a full-fledged academic and clinical unit, aligning with BMU’s mission of delivering tertiary-level care, teaching postgraduate degrees (MD/MS) and conducting research.
Early Years and Growth
In the early decades, anaesthesia services in the region were limited by resources, equipment and manpower. As described in the national context, until in late sixties of 20th century anaesthesia in Bangladesh relied on ether, with very limited monitoring or inadequate specialist manpower.
During its initial period, the Institute of Postgraduate Medicine & Research (IPGMR), performed surgical procedures using Dhaka Medical College Hospital (DMCH) facilities. Professor K.A.S.M.A. Qader, who was then the head of the Department of Anaesthesia (also known as ‘father of Bangladesh Anaesthesia’) at DMCH, was responsible for overseeing the anesthesia services. He managed these crucial duties in addition to his own regular commitments at DMCH, before IPGMR established its own dedicated anaesthesia department.
The first dedicated anesthesiologist post was reportedly created in 1968. Dr. Moazzem Hossain Mostafa FRCA, FFARCSI joined as an Associate Professor and head of the department after returning from the UK. An administrative rearrangement was made, where a number of anesthesiologists from the Dhaka Medical College Hospital (DMCH) were assigned to the Institute of Post Graduate Medical Education and Research (IPGMR) on deputation, even though they continued to work within the same shared operating suite.
In 1970, Dr. Mostafa departed for UK on a scholarship and the department once again came under supervision of Prof Quader until Dr. Selima Rahman DA (UK) was appointed as Assistant Professor and Headed the department.
Following were the problems and limitations: she had to face.
Lack of Independent Facilities: The new department had no separate physical location or infrastructure,
Limited Services: Anesthesia services were offered only for a very few, selective cases. Shared Resources: Equipment, including the anesthesia machine, anesthetic agents, and other essential materials, were shared with the existing resources of the DMCH department.
After the Institute of Postgraduate Medicine and Research (IPGMR) moved into the converted Hotel Shahbag building following the liberation of Bangladesh, the Department of Anaesthesiology established its own office, personnel, and administration on the 3rd floor, situated adjacent to the operating suite.
Historically, this floor played a central role in the hospital's specialized clinical functions:
Location: The department's separate administrative space was positioned next to the operating suite to facilitate direct coordination between anesthetic management and surgical procedures.
Context: Following 1971, the government formalized the use of the former Hotel Shahbag as a permanent home for IPGMR (now renamed Bangladesh Medical University) The former Hotel Shahbag building was acquired by the government in 1965 for the establishment of the IPGMR, which began operating in the building after the 1971 Liberation War. The neighborhood itself got its name from the hotel
Here too, new challenges emerged which were usually typical of conditions of a developing department, but managed to find resilience despite having extremely limited resources.
Specific constraints:
Equipment Limitations
Redundant Circle Systems: Without soda lime, circle absorbers cannot safely remove carbon dioxide. If used without an absorbent, they must be run at high fresh gas flows (equal to or greater than minute ventilation) to wash out CO2, essentially functioning as an inefficient non-rebreathing system. These were scarce or absent, and remained so for a long time.
Resilience Strategies
High-Flow Anesthesia: To compensate for the lack of CO2 absorption, clinicians utilized high fresh gas flows. While this ensures patient safety, it also rapidly depleted oxygen from cylinders and volatile anesthetic agents.
Low-Dose Protocols: When accessories were scarce, clinicians often pivoted to modified Total Intravenous Anesthesia (TIVA) using drugs like Ketamine, diazepam or intermittent narcotics. Nalorphine used to be available for some odd reasons and that was a relief in performing narcotic-based anaesthesia. Once in a while, Infiltration Anesthesia were applied by the surgeons themselves in selected cases to bypass the need for general anesthesia and ventilator circuits entirely.
Manual Monitoring: In the absence of advanced digital monitors, clinicians relied on "precordial stethoscopes" and manual palpation of the pulse (finger on the pulse) to ensure patient stability.
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The scenario, where thiopentone sodium and halothane were the only choices for general anesthesia induction and maintenance, and suxamethonium (succinylcholine) and gallamine were the only available muscle relaxants, reflects the state of anaesthetic practice in that particular setting of a resource-limited environment. These agents were usually associated with a range of side effects and limitations.
Academic scenario
However, despite significant shortages of facilities immediately following the Liberation War, there was great enthusiasm and dedication to start academic course.
In 1974, Dr. Fukhrunnissa and Dr. Dilip Das made history as the first individuals to receive the Diploma in Anesthesiology (DA) qualification from the newly independent Bangladesh.
Key milestones of their achievement include:
First Batch Pioneers: They were admitted into the very first batch of DA candidates following the country's independence in 1971.
Dr. Fukhrunnissa and Dr Das’s Landmark: Dr. Fukhrunnissa holds the distinction of being the first female DA holder in Bangladesh while Dr. Das became the first male DA qualifier in Bangladesh anaesthetic history.
Establishment of Excellence: Their graduation marked a foundational step in formalizing anesthesia education and professional standards within the nation's healthcare system.
Afterwards, at one stage, Dr. Selima Rahman left her post of Associate Professor in the department for Saudi Arabia.
Key highlights of this transition include:
Leadership Vacancy: Following the departure of Associate Professor Dr. Selima Rahman, the departmental head position remained vacant until 1978.
Return of Dr. M.A. Rashid: The vacancy was filled by Dr. M.A. Rashid FRCA, who returned from UK to lead the department as Associated Professor.
The Post Exchange: Prof. Shafiqur Rasul was supposed to occupy professorial chair in IPGMR. But due to Professor Rasul’s refusal to engage in postgraduate teaching at IPGMR, a rare administrative maneuver was executed. The newly created Professor's post at IPGMR was temporarily exchanged for an Associate Professor's post at Sir Salimullah Medical College that Dr. Rashid filled in IPGMR.
Faculty Expansion: During this same period, an additional Associate Professor position was established at IPGMR, which was filled by Dr. Fukhrunnissa.
Dr. Rashid and Dr. Fukhrunnissa are credited with introducing modern anaesthetic techniques during a period of severe resource constraints. Their leadership at a major medical institution like IPGMR was characterized by several key developments:
Staffing & Resource Management: They managed a minimal team of "health service appointed" anesthesiologists and Diploma in Anaesthesiology (DA) students. This model was used to cover multiple operating rooms, including three in the main suite and specialized rooms for ophthalmology and otolaryngology.
Modernization Efforts: Despite performing pre-anesthetic check-ups in modified areas of "dingy store rooms," they introduced modern touches to improve service quality.
Introduction of Epidural Anaesthesia: A major milestone of their tenure was the introduction of epidural anesthesia by Dr. M A Rashid. This technique allowed surgical teams to bypass general anesthesia and breathing circuits entirely, which was critical in an environment with limited specialized equipment.
Pioneering Roles: They operated in a landscape where anesthesia was often overshadowed by other surgical specialties, working to professionalize the field through dedicated training and the adoption of regional anesthesia techniques.
Renal Transplant
Following the first attempt in January 1982 at the Institute of Postgraduate Medicine and Research (now BMU), which was led by Nephrologist Prof. Matiur Rahman, Surgeon Prof. Golam Rasul, and Anaesthesiologist Dr. M. A. Rashid, the program underwent significant developments:
Temporary Hold and Resumption: Due to the initial failure caused by hyperacute rejection, kidney transplantation did not become a regular medical practice in Bangladesh until 1988.
Dr. Rashid was transferred to DMC on the last week of January 1982 and Dr. K. M. Iqbal FRCA, FFARCSI who recently returned from the UK, joined as the Associate Professor and Head of the Department. Dr. Fukhrunnissa remained in her post at the time.
Significant upgrading of existing Anaesthetic service was planned.
To address the difficulties in controlled ventilation caused by irregular soda lime supply, the following upgrades and modifications were implemented:
Procurement of Existing Equipment: A search in the Central Sterile Services Department (CSSD) yielded two Manley ventilators and an older model cardiac monitor, which were installed for use in neurosurgery and general operating theaters (OTs).
Alternative Ventilation for Other OTs: To maintain controlled ventilation in other OTs despite the soda lime shortage, Mapleson D circuits were introduced using locally made modified T-pieces funded by a private budget.
Efficiency of Mapleson A: Mapleson A units (Magill systems) remained highly effective for spontaneously breathing adults. This system is the most efficient for this purpose because the required fresh gas flow (FGF) to prevent rebreathing is approximately equal to the patient's minute ventilation.
Role of Mapleson D: In contrast, the Mapleson D circuit is the preferred choice for controlled ventilation in adults, particularly when the circle system's soda lime supply is compromised. It was easy to convert Mapleson A to D with addition of a t piece and fresh gas flow tube. Indeed, it became interconvertible with D circuit.
Scrub suit: A brand-new set of scrub suits for all OT staff were also tailored through a privately raised fund.
Some more Renal transplants were done but acute rejections forced the programme to stop for the second time. For labour analgesia, Entonox was introduced in the labour room but could not be continued, for non-compliance of patient and irregular supply of Entonox. The project fell apart.
Still In 1982, approximately eight months after initial administrative shifts, Professor Afzalunnesa, DA (UK), was appointed as the first Professor of Anaesthesia at the Institute of Post-Graduate Medicine and Research (IPGMR).as professorial post from SSMCH was returned.
Key details of this transition included:
Background: Professor Afzalunnesa had joined the health service in early 1967 and was previously serving as a Professor at Dhaka Medical College (DMC).
Leadership: Her extensive experience provided a stabilizing "umbrella" for the department's developing clinical and academic activities.
Staff Adjustments: During this period, Dr. K.M. Iqbal remained as Associate Professor at IPGMR, while Dr. Fukhrunnessa transferred to Sir Salimullah Medical College Hospital (SSMCH) to head their anesthesia department as an Associate Professor.
This reshuffle marked a significant step in the formalization of anesthesia as a specialized academic department at IPGMR
FCPS course
First FCPS student was Dr. S M Jahangir, who joined the department after passing his part I exam. He worked for his dissertation under the guidance of Dr. KM Iqbal. Dr.Jahangir obtained his FCPS in 1983, becoming the first person in Bangladesh's anesthesiology history to do so
Weekly clincal and academic meeting
In 1983, the first academic meeting for anaesthesiologists in Dhaka was convened at the Institute of Postgraduate Medicine and Research (IPGMR). This initial gathering brought together all anesthesiologists in the city and evolved from a series of weekly case discussions into a formal weekly journal club.
Key developments in the organization's history include:
BSA Program Integration: The Bangladesh Society of Anaesthesiologists (BSA) subsequently took over the program as an official BSA initiative. Despite this change in administrative oversight, the venue for these meetings remained at IPGMR.
Journal Publication: The first official journal of the BSA, known as the Journal of the Bangladesh Society of Anaesthesiologists (JBSA), was published in 1987.
First Editor: Dr. K.M. Iqbal served as the inaugural editor of the journal.
Preparation to Move to block C.
Significant infrastructural stagnation only partially ended with the transition to the 10-story building (Block C).
Prior to this move, the department faced critical operational and academic constraints:
Clinical & Infrastructure Challenges
Lack of Critical Facilities: The department operated without a dedicated ICU or a proper recovery room, making the management of critical surgical procedures extremely difficult and high-risk.
Limited Space: There was no designated "on-call" room for staff or any common meeting space for junior anesthesiologists to coordinate care or rest during shifts.
Frustrating Conditions: The absence of basic clinical infrastructure was a constant source of frustration, as it hindered the ability to provide safe perioperative care despite the faculty's expertise.
Academic & Teaching Environment
Makeshift Classrooms: There was no official classroom for residents or students. Academic sessions and lectures were typically held in the private offices of the faculty members.
Teaching Staff: Education was delivered by a combination of internal departmental faculty and visiting professors from other medical institutes, maintaining academic standards despite the poor physical environment.
Departmental Evolution: These challenges persisted until the relocation to the modern 10-story block, which allowed for the eventual establishment of the Department of Anaesthesia, Analgesia, and Intensive Care Medicine as it exists today at BSMMU
Historical Operational Constraints
On-Call Facilities: There were no dedicated on-call rooms within the hospital premises. Consequently, anesthesiologists were permitted to remain at home and were summoned only when emergency cases arose.
Ambulance Service: Emergency transportation for on-call staff was provided by the hospital, though it was notoriously inefficient and unreliable.
Limited Emergency Scope: At the time, IPGMR lacked the facilities to handle a broad range of emergencies. Surgical interventions were largely restricted to:
Caesarean sections
Occasional head injury surgeries
Academic Continuity: Despite these logistical challenges and limited emergency services, academic and training activities remained unhindered and continued as a core function of the institute.
In 1987, Professor U.H. Shahera Khatun became the first female fellow of the Bangladesh College of Physicians and Surgeons (BCPS) in Anaesthesiology. Following her landmark achievement, she later served as an assistant professor. In the department.
The BCPS subsequently implemented major reforms to the FCPS Anaesthesia syllabus to align it with international standards, specifically the UK’s FRCA (Fellowship of the Royal College of Anaesthetists) program.
These updates included:
Introduction of Physics and Statistics: Added to ensure candidates mastered clinical measurement and data interpretation, similar to the FRCA Primary MCQ requirements.
Updated Anatomy and Pathology: The syllabus for these foundational subjects was modernized to better reflect clinical application in anaesthesia.
Increased Enrollment: These improvements in education standards and global comparability led to a significant rise in the number of students choosing to specialize in anaesthesiology in Bangladesh.
Realizing the growing need it was felt the students of FCPS part I could use some extra help in the area of physics, a collaborative effort was undertaken by the department to offer a private course to the students to teach physics related to anaesthesia. Objective was to attract more enthusiastic people in anesthesiology and inspire to sit for FCPS examinations. The response was overwhelming. This combined effort eventually encouraged teachers to include other subjects of part I and students complied. This was the first of its kind in the Bangladesh Anaesthesiology history.
Key Highlights of the Initiative
Physics-Focused Origin: The program began by addressing a critical gap in student knowledge of physics related to anesthesia. Physics is a core component of the curriculum, covering applied physics and clinical measurement essential for anesthesia practice.
Inter-Institutional Collaboration: In a first for the field, the department integrated teachers from various institutions who volunteered their private time to mentor students.
Primary Objectives: The initiative aimed to attract more medical professionals to the specialty and inspire them to sit for the challenging FCPS examinations.
Evolution and Success: Due to an overwhelming student response, the curriculum was expanded to include all other subjects required for the Part I examination, such as anatomy, pharmacology, and physiology.
Impact: This effort significantly contributed to the structured teaching culture now prevalent in Bangladesh's medical postgraduate training, eventually leading to more organized weekend courses and specialized coaching by institutions like the Bangladesh College of Physicians & Surgeons (BCPS).
This program set the precedent for modern FCPS preparation, where specialized guidance is now a standard part of the anesthesiology training journey in Bangladesh.
Milestones & Development
Shifting of the department to Block C.
Based on the historical progression of various developments, here are the key figures and milestones
The key highlights of this development include:
Relocation to the 10th Floor: Upon completion of the new hospital block C, the department moved to the 10th floor. Initially, space was limited to a few offices for professors and a small sitting room for junior staff.
Strategic Expansion: To accommodate a growing workforce, the department expanded into vacant rooms on the same floor that had been earmarked for Surgery. This was done with the "tacit support" of the then-director of the hospital. Couple of rooms for Paediatric surgery were not include
Kosaka Pain Clinic: A dedicated pain clinic was established and named the Kosaka Pain Clinic in honor of Professor Yoshihiro Kosaka Shimane University, Japan.
International Training and collaboration: Professor Kosaka played a pivotal role in the department's development by arranging specialized training in chronic pain management for several Bangladeshi anesthesiologists. Later other university professors of Japan joined in.
These combined efforts solidified a steady training partnership between the department and Japanese universities.
Dr. Manjurul H. Lashkar is recognized as the first anaesthesiologist from the department to receive this specialized training in Japan under Professor Kosaka's guidance.
Dr. Shafiq Junaid: After completing his PhD in Japan, he joined the department in 1993, as honorary consultant. He was instrumental in establishing the outdoor clinic, which was made possible through a collaboration with Prof. Din Mohammad, (a prominent neurologist), who shared his clinic space, a two bedded indoor facility was established in 2005 by the combined efforts of everyone working in pain clinic.
Dr. Lutful Aziz: Joined the department in 1995 after obtaining a PhD from Japan. He contributed significantly to the pain management programme while completing his FCPS Part II.
Dr. Moinul Hossain: During his training in Japan, he secured a Super Lizer machine, enhancing the department's technical capabilities for pain treatment.
All of these above-mentioned personnel (except Dr. Lashkar) are now big names in pain medicine. Dr. Lashkar did not pursue his career in this particular discipline.
However, the clinic's development followed these key phases:
Initial Role: It began as a specialized referral center managed by personnel specifically trained through the project.
Academic Collaboration: A steady training program was maintained with Japanese universities to enhance the skills of medical staff.
Infrastructure Expansion: The addition of both outdoor and indoor facilities transformed it from a limited referral point into a comprehensive medical and educational hub.
Departmental Milestone: These advancements established the clinic as a centerpiece of the department, often serving as a symbol of bilateral friendship and a model for medical education in the region.
In the 1990s, the MD in Anaesthesia was introduced under Dhaka University, with Dr. Abdul Hye becoming its first student. This period marked a significant expansion in the academic and physical infrastructure of the department:
Dr. Akhtaruzzaman who is now a pioneering figure in pain medicine in Bangladesh, joined as MD student and took the initiative to address Acute Pain Services (APS) in a limited way and advancing neuraxial techniques along with other workers..
: During his MD at the IPGMR now BMU, Dr. Akhtaruzzaman focused his research (thesis) on continuous epidural analgesia for labor. At the time, neuraxial labor analgesia faced significant logistical and cultural obstacles in Bangladesh, including a lack of specialized monitoring equipment and skepticism from fellow clinicians regarding the safety and necessity of pain-free labor.
Overall, clinicians promoting pain medicine had unending obstacles:
Establishment of Pain Services:
Acute Pain Service: Despite initial limitations in resources and staffing, a great deal of success was achieved
Inpatient Facilities: combined efforts led to the eventual allotment of two indoor beds (2005) on the ground floor of Block D at BMU, marking a critical step in providing dedicated inpatient care for patients requiring complex pain interventions.
Impact: Through persistent education and clinical success, acceptance of the departmental protocols grew among surgeons and obstetricians, eventually making epidural labor analgesia a more recognized option in tertiary hospitals across Dhaka.
Academic Tutoring:
Afternoon tutoring evolved from a free service to one requiring a nominal fee from students. This change allowed the department to include basic science teachers for additional support; while these science teachers received a token remuneration, the anaesthesiology faculty continued to teach for free.
Physical Facilities:
A vacant room, originally intended for drying OT linens, was repurposed as the department’s first dedicated classroom following a shift in facilities.
Seating was improvised, with chairs borrowed from faculty offices and the doctors' sitting room to accommodate students.
Student Initiatives: Students from various institutions joined the program. Trainees from the Institute of Post-Graduate Medicine and Research (IPGMR)—now known as BMU—were themselves instrumental in organizing these academic activities. The success of these classes led to the establishment of a second classroom for Diploma in Anesthesiology (DA) students. This space eventually became the Kosaka Pain Clinic.
Course Discontinuation: Despite these successes, the private DA course was eventually discontinued due to a lack of sufficient enrollment.
Prof Iqbal was known for conducting highly interactive academic sessions for postgraduate medical students (FCPS/MD). These sessions were characterized by several key features:
Strict Discipline: The sessions often utilize a sharp 7:30 am cut-off time, which serves both as a pedagogical tool and an administrative measure to ensure that students are present and ready for their Operating Theater (OT) duties on time.
Interactive Format: Moving away from traditional lectures, these sessions encourage active participation and critical thinking on topics essential for surgery and medical practice.
Mentorship and Guidance: His approach was recognized for fostering clinical excellence and a sense of responsibility toward patient safety among trainees.
These sessions are particularly influential in the context of the Bangladesh College of Physicians and Surgeons (BCPS), and the medical university where Prof Iqbal was considered a distinguished figure in medical education.
Restart of the renal transplant Programme
In 1988, a significant milestone in renal transplantation was achieved through a government-initiated program that brought Professor A.P. Pandey from the Christian Medical College (CMC) Vellore, India, to lead a specialized transplant team.
Key details of this initiative include:
Collaborative Team: The team consisted of surgeons and anesthesiologists from the Institute of Postgraduate Medicine and Research (IPGMR)—now Bangabandhu Sheikh Mujib Medical University (BSMMU)—and the Combined Military Hospital (CMH).
Scale of Operations: During Professor Pandey's one-month stay, approximately 12 transplantations were performed across both IPGMR and CMH venues.
Long-term Impact: These operations achieved acceptable success rates and established the foundation for renal transplantation to become a regular medical event in the region.
By 1996, the total number of renal transplantations performed in the country had reached 92, with a one-year graft survival rate of 96%. These early efforts eventually led to further advancements, such as the country's first successful posthumous (deceased donor) kidney transplants in early 2023.
Proposal for the Establishment of the ICU
1. Background & Relocation
The initial proposal for an Intensive Care Unit was submitted to the former Director prior to the facility’s relocation. Following the successful move to the 10th floor, the project transitioned into the implementation phase.
2. Initial Strategy: Combined ICU/CCU
To optimize resources and shared infrastructure, the original plan involved a combined ICU and Coronary Care Unit (CCU) in the second floor. During this phase, two dedicated ICU ventilators were acquired and temporarily housed within the CCU premises.
3. Site Selection & Infrastructure
Following further review with the governing authority, the west-side recovery room was selected as the permanent location for the ICU. This site was chosen due to its existing medical gas pipeline facilities, which significantly streamlined the setup process.
4. Equipment & Resource Allocation
The unit was inaugurated with the following core assets:
Ventilation: Two ICU ventilators (transferred from the CCU).
Monitoring: Installation of a Central Monitoring System for real-time patient observation.
Furniture: Procurement of specialized ICU beds.
5. Clinical Implementation & Scope
The ICU phased its intake to ensure high standards of care:
Phase I: Focused on high-risk neurosurgical and complicated general surgical post-operative patients.
Phase II: Expanded services to accommodate critical cases from all medical and surgical disciplines.
The unit was originally designated as the Quader ICU, named in honor of Professor K.M.S.A. Quader, a pioneering figure in medical care. However, during the second expansion of the facility, the commemorative plaque bearing his name was removed and has not been restored since.
Key Context and History
Initial Dedication: The ICU was named after Prof. K.M.S.A. Quader to recognize his significant contributions to the field.
Removal of the Plaque: The removal occurred during the unit's second major expansion phase to accommodate more beds and updated medical equipment.
Current Status: Despite the historical naming, the physical plaque was not reinstalled after the construction was completed, leading to the unit being commonly referred to by generic institutional names in current administrative record
Prof. Iqbal initially was involved in Intensive Care Unit (ICU) activities, in collaboration with clinicians of "feeding departments" until Dr. Shafiqur Rahman, FFARCSI an anesthesiologist who played a significant role in developing clinical training and supervision within his department after returning from the United Kingdom.
Role in Department: Upon his return from the UK, he joined as an honorary consultant to address a shortage of expert anesthesiologists.
Key Contributions:
Conducted teaching sessions for junior medical staff.
Supervised junior anesthesiologists directly in operating rooms to ensure patient safety and improve clinical standards.
His presence was considered vital for the department due to his advanced expertise gained abroad.
In May 1989, a significant reshuffle occurred within the department, leading to the promotion and transfer of Dr. Iqbal to Chittagong Medical College as a Professor.
He was replaced by Dr. Khalilur Rahman FFARCSI, who had previously served as an Associate Professor at the National Institute of Cardiovascular Diseases (NICVD). Prof.Afzalunnesa Continued as the head of the department until her retirement. Following which, Dr. Iqbal could return to the department to fill her vacant pos as HOD. His return marked the resumption of the private academic course, which had been suspended during his absence.
The transition to the new facility, specifically during the 1990s, marked a significant era of modernization for the department, particularly in neuroanesthesia and critical care.
Key clinical and logistical improvements included:
Pharmacological Advances:
Muscle Relaxants: Pancuronium replaced gallamine, and the later introduction of atracurium provided a safer alternative for patients with chronic kidney disease (CKD) and those undergoing renal transplants.
Induced Hypertension/Hypotension: While smuggled tubocurarine and trimethaphan (Arfonad) were used for blood pressure management, the market availability of sodium nitroprusside (Nipride) revolutionized neuroanesthesia.
Induction & Analgesia: Midazolam became a standard co-induction agent, and the introduction of remifentanil provided a highly controllable opioid option for neurological procedures.
Technological Upgrades: All operating theaters (OTs) were equipped with modern anesthetic machines featuring integrated ventilators and standardized minimal monitoring facilities.
ICU Expansion: Under the leadership of Dr. Shafiqur Rahman, who took over from Prof. K.M. Iqbal after being newly appointed as Associate Professor of the department, the ICU saw significant upgrades, including new ventilators, advanced monitoring systems, and the addition of on-site diagnostic tools like autoanalyzers and blood gas analyzers.
Dr. Khalilur Rahman was in charge of all clinical activities which he ran very professionally putting all his previous experience in order to achieve some standard in the practice despite unavoidable challenges. He shared responsibilities in running various courses as well as supervising some of the running Dissertations of the department.
In the middle of 1993, Dr. Khalilur Rahman was promoted to the position of Professor and got posted in RIHD and later, he became The Head and Prof of DMC until the retirement.
In 1998, a significant personnel change occurred at IPGMR involving the following transitions:
Dr. Shafiqur Rahman was transferred from his post in IPGMR to NICVD and Dr. Fazlur Rahman: replaced Dr. Shafiqur Rahman and was given charge of the Intensive Care Unit. Dr. Fazlur Rahman had earned his FCPS from IPGMR and been working in NICVD as Associate Professor
Historical context of Samad Seminar Room/ Afzalunnesa Library, Azmal Museum
Samad Seminar Room
Samad seminar room was named in honor of Professor S. N. Samad Choudhury another senior Prof. of Anaesthesia who dedicated his career in upholding the image of Anaesthesiology, home and abroad and had been a long-term president of BSA. He was the founder president of SACA. (Now SAARC-AA)
• Seminar Room Construction:
The creation of this facility is recognized as a landmark of self-reliance and collective action:
• Establishment via Collective Effort: The seminar room was built through a dedicated departmental initiative to convert a previously vacant west-side space on the 10th floor into a functional academic facility.
• Funding and Resources: Uniquely, the project was funded entirely through personal donations from faculty members and alumni, rather than standard institutional grants.
Dr. Nezamuddin Ahmed (then MD student) should be recognized for playing a vital volunteer role in the physical and logistical creation of the space.
Activities:
• This room eventually became a central hub for the department's academic seminars, symbolizing a successful "friendly space" approach through internal negotiation and shared commitment.
Beyond regular classes and administrative meetings, the venue now serves as a key location for inter-departmental seminars.
Afzalunnesa Library
Naming: In recognition of her contributions and the first rack she provided, the facility was named the Afzalunnesa Library.
Initial Funding: A grant was secured from UNESCO through the personal connections of Professor Iqbal.
First Equipment: This grant funded the procurement of the library's very first desktop computer.
Furniture Donations: The library's physical infrastructure was built through community (students, faculties and others) support; Professor Afzalunnesa personally purchased the first book rack, while other individuals donated reading desks and additional racks
Collection Growth: The book and journal collections were built through:
A tradition where graduating students were encouraged to donate at least one book. Back issues of academic journals were gathered from educators across various institutions, with a focus on regular current issue contributions from Non-Resident Bangladeshis (NRBs). Key contributors to this collection include: Dr. Lutful Aziz from Japan, Dr. Hasan Sarwar from USA’
This collaborative effort highlights the role of the academic diaspora in enriching institutional resources through shared scholarly publications.
Azmal Museum
(specifically the Anaesthesia Museum) is a specialized academic museum located within the library of the Department of Anaesthesia
Key Contributions & Origins
The museum was established through the initiative and financing of Dr. M. Azmal Ali, a consultant anaesthetist based in the NHS, UK
Purpose: It was designed to serve as an educational and research resource for students, integrated directly into the department's library.
Philanthropy: Dr. Ali consistently contributed modern medical sundries and equipment during his visits to Dhaka to ensure the department stayed updated with contemporary practices.
Exhibits: The museum housed a reasonable collection of antique anaesthesia apparatus and personal equipment donated by senior anaesthesiologists. This collection highlighted the evolution of the field from traditional to modern techniques. It had been formally recognized as a museum by the National Museum Committee (often functioning under the Bangladesh National Museum or Ministry of Cultural Affairs).
There was decision in the department to name PACU as Rashid PACU after the name of Prof. M A Rashid, but it was not materialized
Start of the medical University
In 1998, the Institute of Postgraduate Medical Research (IPGMR) was upgraded into Bangladesh's first public medical university through a Medical University Act, 1998. This conversion transitioned the institution from a government-controlled research center into an autonomous establishment.
Significant changes following the 1998 transition include:
Establishment and Renaming: IPGMR became Medical University on April 30, 1998. Of course, as of March 2025, the government has officially approved renaming the institution to Bangladesh Medical University(BMU).
Departmental Evolution: The Department of Anaesthesia was renamed the Department of Anaesthesia, Analgesia, and Intensive Care Medicine to reflect its expanded clinical and academic scope.
Leadership: Prof. K.M. Iqbal,then a prominent figure in the field of anesthesiology, was appointed as the university's first Treasurer as part of its new administrative structure. Later, he also acted as Pro VC of the university.
Academic and Clinical Reshaping: The university reorganized into multiple faculties, including Medicine, Surgery, and Basic Science, and began awarding its own postgraduate degrees. It currently functions as a tertiary-level healthcare center and the apex institution for medical research in the country
Organizational Placement: At institutions like Medical University, the department is officially categorized under the Faculty of Surgery along with other surgical subspecialties.
Scope of Practice: The department was responsible for total perioperative care, including:
Anaesthesia: Managing patient safety and pain relief during surgical procedures.
Analgesia: Addressing acute and chronic pain management.
Intensive Care Medicine: Managing critical emergency care and specialized units (ICUs).
Expansion of academic activities and recruiting new faculties
Following the redesign and transformation of the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at Medical University, a significant workforce expansion was undertaken to support its modern academic and clinical goals.
Key developments during this expansion phase included:
Academic Growth: The department admitted a new batch of MD students, establishing a robust foundation for postgraduate specialized training.
Faculty Strengthening: A new group of assistant professors was appointed to enhance academic and clinical activities in order to create a ‘strong frontier’
The "Strong Frontier" team refers to a group of influential faculty members, primarily from the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at Medical University in Bangladesh. Historically, these individuals were part of a recruitment cohort of assistant professors who later became leading figures (professors and chairmen) in their respective sub-specialty of choice.
The newly recruited members of this team included the following names in alphabetical order:
Dr. A.K.M. Akhtaruzzaman: A prominent Professor of Neuroanaesthesiology and former Course Coordinator at BMU, specializing in Pain Medicine and Emergency Anaesthesia.
Dr. Debabrata Banik: A Professor and former Dean of the Faculty of Nursing and Medical Technology at BMU, with expertise in Neuro-Anesthesiology and Intensive Care.
Dr. Debashish Banik: An Ex-Professor and Chairman of the Department of Anaesthesia, Analgesia, and Intensive Care Medicine at BMU.
Dr. Lutful Aziz: A highly regarded worker in the field of Anaesthesiology, specialized in Pain Medicine and Regional Anaesthesia. He is now HOD of Anaesthesia department of Evercare Hospital
Dr. Nezamuddin Ahmed: A pioneer of Palliative Medicine in Bangladesh and an
Ex-Professor at BMU.
Dr. Moinul Hossain: An Ex-Professor of Anaesthesiology at BMU a devoted worker in Pain Medicine.
Operational Impact: This cohort took on diverse assignments that bridged clinical services and academic research, creating a formidable leadership presence in the field of anesthesiology within Bangladesh.
In July 2000, the visit of Dr. Graham Arthurs, OBE, a consultant anaesthetist and visionary in hospice care in UK, served as the catalyst for the formal establishment of palliative care in Bangladesh.
The Visit led to several key developments:
Professional Inspiration: Dr. Arthurs visited from UK as an examiner for the Fellowship of the College of Physicians and Surgeons (FCPS) examinations. During this time, he mentored Dr. Nezamuddin Ahmad, who was then working in the Department of Anaesthesiology.
Concept Introduction: Dr. Arthurs shared his extensive experience in palliative medicine—having founded the Nightingale House Hospice in Wrexham, UK—and infused the idea of specialized care for the terminally ill into the local medical framework.
Institutional Foundation: Inspired by this interaction, Dr. Nezamuddin Ahmad spearheaded the movement to integrate these practices, eventually leading to the creation of the first Palliative Care Unit at Bangabandhu Sheikh Mujib Medical University (BSMMU).
Lasting Legacy: Dr. Arthurs' vision of "comfort, dignity, and expert care" became the guiding principle for the growth of the discipline in the region, transitioning from a small clinical interest to a recognized medical specialty.
More changes
In 2002, the Department of Anaesthesiology underwent significant clinical and structural expansion
Dr. Lutful Aziz was promoted to the position of Associate professor and that allowed him to undertake more responsibilities. But he left his position at Medical University in 2004, Dr. Lutful Aziz later joined Apollo Hospital Dhaka (now rebranded as Evercare Hospital Dhaka).
During his stay in the Medical University, and before transitioning to the private sector, he was the Academic Coordinator for postgraduate studies in the Department of Anaesthesia, Analgesia, and Intensive Care Medicine.
Cardiac Anaesthesia Unit was established in Block D to provide specialized care for cardiac procedures, It was led by Prof. Shafiqur Rahman, who brought expertise from the National Institute of Cardiovascular Diseases (NICVD).
For, Intensive Care Unit (ICU), a dedicated head was needed and appointed, with Prof.S M.Jahangir (formerly of Dhaka Medical College) taking the role.
The Department of Anaesthesia, Analgesia and Intensive Care Medicine at Bangabandhu Sheikh Mujib Medical University (BSMMU) became a leading center for specialized medical care and academic excellence in Bangladesh.
The department’s formidable shape at the time was characterized by several key developments:
Clinical Infrastructure & Equipment: The department oversaw more expanded critical facilities including a large Intensive Care Unit (ICU). the department utilized advanced monitoring and life-support technologies.
Academic Programs: The department continues to offer and manage prestigious postgraduate programs, including:
MD in Anaesthesiology ( which was subsequently revised)
Diploma in Anaesthesiology (DA). Later, a revised course had been introduced
Specialized Fellowships and training in Regional Anaesthesia and Pain Medicine.
Research Output: The department maintained a reasonable research profile with both MD and FCPS final year students wereworking on their dissertations under faculty supervision.
Introduction of OSCE
First tried in DA as a part of clinical examination. Then it was eventually introduced in FCPS part II examination.
Departure of Prof. Iqbal and Prof. Jahangir
However, in late 2005, Prof K M Iqbal took a voluntary retirement and after few months, Prof Jahangir also left the department in early 2006.
After the departure of prof Iqbal Prof Shafiqur Rahman became the new Chaiman of the department.
