Episode 161: Dual Training in Anesthesiology and Emergency Medicine

In this 161st episode I welcome Drs. Regan and Lester to the show to discuss the country’s first combined Anesthesiology and Emergency Medicine dual training program.

Website for the program: https://www.hopkinsmedicine.org/emergencymedicine/combined-residency/

Episode 160: Non-OB Surgery in Pregnancy With Dave Berman

In this 160th episode I welcome Dr. Dave Berman back to the show to discuss anesthesia for non-OB surgery during pregnancy.

References:

1. Practice Guidelines for Obstetric Anesthesia: An Updated Report by the American Society of Anesthesiologists Task Force on Obstetric Anesthesia and the Society for Obstetric Anesthesia and Perinatology. Anesthesiology 2016;124(2):270–300.

2. Nonobstetric Surgery During Pregnancy – ACOG [Internet]. [cited 2019 Jul 18];Available from: https://www.acog.org/Clinical-Guidance-and-Publications/Committee-Opinions/Committee-on-Obstetric-Practice/Nonobstetric-Surgery-During-Pregnancy?IsMobileSet=false

3. Tolcher MC, Fisher WE, Clark SL. Nonobstetric Surgery During Pregnancy. ObstetGynecol 2018;132(2):395–403.

4. UpToDate [Internet]. [cited 2019 Jul 18];Available from: https://www.uptodate.com/contents/management-of-the-pregnant-patientundergoing-nonobstetric-surgery

5. Upadya M, Saneesh PJ. Anaesthesia for non-obstetric surgery during pregnancy. Indian J Anaesth 2016;60(4):234–41.

6. Reitman E, Flood P. Anaesthetic considerations for non-obstetric surgery duringpregnancy. Br J Anaesth 2011;107 Suppl 1:i72–8.

7. Nejdlova M, Johnson T. Anaesthesia for non-obstetric procedures during pregnancy. Contin Educ Anaesth Crit Care Pain 2012;12(4):203–6.

8. Mazze RI, Källén B. Reproductive outcome after anesthesia and operation during pregnancy: a registry study of 5405 cases. Am J Obstet Gynecol 1989;161(5):1178–85.

9. Committee on Obstetric Practice and the American Society of Anesthesiologists. Committee Opinion No. 696: Nonobstetric Surgery During Pregnancy. Obstet Gynecol 2017;129(4):777–8.

10. Wilcox AJ, Weinberg CR, O’Connor JF, et al. Incidence of early loss of pregnancy. N Engl J Med 1988;319(4):189–94.

11. Davidson AJ, Disma N, de Graaff JC, et al. Neurodevelopmental outcome at 2 years of age after general anaesthesia and awake-regional anaesthesia in infancy (GAS): an international multicentre, randomised controlled trial. Lancet 2016;387(10015):239–50.

12. Sun LS, Li G, Miller TLK, et al. Association Between a Single General Anesthesia Exposure Before Age 36 Months and Neurocognitive Outcomes in Later Childhood. JAMA 2016;315(21):2312–20.

13. Center for Drug Evaluation, Research. FDA Drug Safety Communication [Internet]. U.S. Food and Drug Administration. 2019 [cited 2019 Jul 21];Available from: http://www.fda.gov/drugs/drug-safety-and-availability/fda-drug-safety-communicationfda-review-results-new-warnings-about-using-general-anesthetics-and

14. Huang S-Y, Lo P-H, Liu W-M, et al. Outcomes After Nonobstetric Surgery in Pregnant Patients: A Nationwide Study. Mayo Clin Proc 2016;91(9):1166–72.

Episode 159: Postpartum hemorrhage with Juanita Henao

In this 159th episode I welcome Dr. Juanita Henao to the show to discuss prevention and management of postpartum hemorrhage.

One CORRECTION: At about minute 4:30 Dr. Henao states that in women with PPH the mortality rate is 10% but what she meant to say is that PPH accounts for 10% of maternal deaths in the United States.

References:

Thorneloe, J.C.A. Carvalho, K. Downey,M. Balki. Uterotonic drug usage in Canada: a snapshot of the practice in obstetric units of university-affiliated hospitals. Int J Obstet Anesth. 2019 Feb;37:45-51.

Hian Yan Voon , Haris Njoo Suharjono , Asrul Akmal Shafie , Mohamad Adam Bujang Carbetocin versus oxytocin for the prevention of postpartum hemorrhage: A meta-analysis of randomized controlled trials in cesarean deliveries. Taiwan J Obstet Gynecol. 2018 Jun;57(3):332-339.

WOMAN trial collaborators. Effect of early tranexamic acid administration on mortality, hysterectomy, and other morbidities in women with post-partum haemorrhage (WOMAN): an international, randomised, double-blind, placebo-controlled trial. Lancet. 2017 May 27;389(10084):2105-2116.

Main EKGoffman DScavone BMLow LKBingham DFontaine PLGorlin JBLagrew DCLevy BSNational Partnership for Maternal SafetyCouncil on Patient Safety in Women’s Health Care.National Partnership for Maternal Safety: Consensus Bundle on Obstetric Hemorrhage. Obstet Gynecol. 2015 Jul;126(1):155-62.

Duffield A1McKenzie CCarvalho BRamachandran BYin VEl-Sayed YYRiley ETButwick AJ. Effect of a High-Rate Versus a Low-Rate Oxytocin Infusion for Maintaining Uterine Contractility During Elective Cesarean Delivery: A Prospective Randomized Clinical Trial. Anesth Analg. 2017 Mar;124(3):857-862

David H. Chestnut, Cynthia A Wong, Lawrence C Tsen, Warwick D Ngan Kee, Yaakov Beilin, Jill Mhyre. Chestnut’s Obstetric Anesthesia: Principles and Practice. Fifth edition. Chapter 38, Anterpartum and Postpartum, Hemorrhage.