Category Archives: OB

Episode 273: Anesthesia for Fetal Surgery with Caitlin Sutton

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 273: Anesthesia for Fetal Surgery with Caitlin Sutton
/

In this 273rd episode I welcome Dr. Caitlin Sutton to the show to discuss Anesthesia for fetal surgical procedures. We discuss some common procedures, how the anesthesia is done and why, what can go wrong and how to prepare, and what the future holds.

CME: Link

Dr. Sutton is on Twitter (X) @caitlindsutton and her email is cdsutton@bcm.edu. She would love to help support residents trying to decide between fellowships in peds, OB or both.

Random Recs:

Adult legos

Expanse Series

Episode 270: Dexmedetomidine as an Adjuvant with Drs. Douglas and Soloniuk

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 270: Dexmedetomidine as an Adjuvant with Drs. Douglas and Soloniuk
/

In this 270th episode I welcome Drs. Michael Douglas and Leonard Soloniuk to the show to discuss the use of dexmedetomidine in spinals, epidurals and nerve blocks.

CME: Link

Random Recs:

Sugar Rush

Crokinole

Elder Race

Episode 258: Pro-con debate: Whether to use an existing labor epidural for C-section with Drs. Hofkamp and Sharpe

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 258: Pro-con debate: Whether to use an existing labor epidural for C-section with Drs. Hofkamp and Sharpe
/

In this 258th episode I welcome Dr Emily Sharpe and Dr. Mike Hofkamp back to the show to have a pro-con debate about what to do when a woman in labor with an epidural in place has to go unexpectedly for c-section. Dr. Hofkamp argues for removing the epidural and doing a second neuraxial technique while Dr. Sharpe argues for using the existing epidural.

CME: The CE experience for this Podcast is powered by CMEfy: Link

Dr. Sharpe is on Twitter @emilysharpe and Dr. Hofkamp is on Twitter @Hofkampmichael

Random Recs:

The Exceptions

Wanting

Episode 240: Inadequate Analgesia During C-section with Mike Hofkamp and Emily Sharpe

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 240: Inadequate Analgesia During C-section with Mike Hofkamp and Emily Sharpe
/

In this 240th episode I welcome Drs. Hofkamp and Sharpe to the show to discuss their work investigating whether there may be inadequate analgesia for patients undergoing cesarean delivery.

CME: Link

Dr. Sharpe is on Twitter @emilysharpe

Dr. Hofkamp is on Twitter @hofkampmichael

Random Recs:

Euphoria: Link

Phil Mickelson Biography: Link

What Happend To You: Link

Episode 229: Keywords Part 19: Epidurals

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 229: Keywords Part 19: Epidurals
/

In this 229th episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA keyword. We discuss Epidurals for both the Basic and Advanced Exam.

CME: Link

Random Recs:

Why Read Moby Dick: Link

Paul Simon’s Graceland: Link

References: Barash Clinical Anesthesia 8th edition and Anesthesiahub.com

Episode 216: Intralipid for AFE

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 216: Intralipid for AFE
/

In this 216th episode I discuss case reports of using Lipid Emulsion Therapy for Amniotic Fluid Embolus. Big thanks to Dr. Adam Olson for bringing this to my attention!

CME: Reflect on how this Podcast applies to your day-to-day and earn AMA PRA Category 1 CMEs here: https://earnc.me/sCY01P

References:

Eldor J and Kotlovker V. Intralipid for Amniotic Fluid Embolism (AFE)? Open Journal of Anesthesiology, 2012, 2, 127-133 

Lynch W et al. Lipid Emulsion Rescue of Amniotic Fluid Embolism-Induced Cardiac Arrest: A Case Report. A&A Case Reports. 2017;8:64–66.

Gruzman I et al. INTRALIPID Rescue of Amniotic Fluid Embolism: from Theory to Existence.  Journal of Health Science and Development. 2019: 2:1 (1-4). 

Episode 192: Keywords part 14: Maternal Physiology with Gillian Isaac

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 192: Keywords part 14: Maternal Physiology with Gillian Isaac
/

In this 192nd episode I welcome Dr. Gillian Isaac back to the show to discuss another ABA keyword, maternal physiology.

CME: https://earnc.me/Z3mGJv

References: Barash Clinical Anesthesia 8th edition and Anesthesiahub.com

Episode 172: A Pregnant Patient with Congenital Heart Disease

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 172: A Pregnant Patient with Congenital Heart Disease
/

In this 172nd episode I welcome a panel of experts to discuss the management of a pregnant patient with congenital heart disease. Drs. Hofkamp, Vaught and Meng join me to discuss the preoperative evaluation, obstetric management, and postoperative care.

CME: https://earnc.me/ZY2v27

Episode 168: COVID in Pregnancy with Dr. Nixon

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 168: COVID in Pregnancy with Dr. Nixon
/

In this 168th episode I welcome Dr. Heather Nixon to the show to discuss what is being done for pregnant women and women in labor who have or are suspected to have COVID-19.

CME: https://earnc.me/IqnBVR

The COVID book for kids by Taylor Purvis: https://playatrickonthecoronas.weebly.com/

Link for Anesthesia Toolbox daily online learning session: https://www.anesthesiatoolbox.com/docs/DOC-5178

References:

https://s3.amazonaws.com/cdn.smfm.org/media/2277/SMFM-SOAP_COVID_LD_Considerations_3-27-20_(final)_PDF.pdf

SOAP website: https://soap.org/

Episode 162: Hypertensive Disorders of Pregnancy with Juanita Henao

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 162: Hypertensive Disorders of Pregnancy with Juanita Henao
/

In this 162nd episode I welcome Dr. Henao back to the show to discuss hypertensive disorders of pregnancy and how to manage them.

CME: https://earnc.me/tyN3SI

CLARIFICATIONS:

  1. During our discussion of treatment of eclamptic seizures Dr. Henao said benzos were first line treatment. This is assuming the patient is already getting magnesium. For test questions, the answer for first line treatment should be Mg. In reality, patients will likely get both at the same time.
  2. Serum Mg concentrations can be reported as mmol/L, meq/L or mg/dL. The important ranges to know for testing (though in reality different people may get symptoms at different times) are a therapeutic range of 2-3.5 mmol/L or 4-7 mEq/L or 5-9 mg/dL; A loss of patellar reflexes at >3.5, >7, >9; Respiratory paralysis at >5, >10, >12 and cardiac arrest at >12.5, >25, >30. EKG changes including prolonged PR and widened QRS happen in much the same range as loss of patellar reflexes, maybe a bit before but there is a lot of overlap.

References:

  1. Hofmeyr R, Matjila M, Dyer R. Preeclampsia in 2017: Obstetric and Anaesthesia Management. Best Pract Res Clin Anaesthesiol. 2017 Mar;31(1):125-138.
  2. Dhariwal NK, Lynde GC. Update in the Management of Patients with Preeclampsia. Anesthesiol Clin. 2017 Mar;35(1):95-106.
  3. Aya AG, Mangin R, Vialles N, Ferrer JM, Robert C, Ripart J, de La Coussaye JE. Patients with severe preeclampsia experience less hypotension during spinal anesthesia for elective cesarean delivery than healthy parturients: a prospective cohort comparison. Anesth Analg. 2003 Sep;97(3):867-72.
  4. Roberge S, Nicolaides K, Demers S, Hyett J, Chaillet N, Bujold E. The role of aspirin dose on the prevention of preeclampsia and fetal growth restriction: systematic review and meta-analysis. Am J Obstet Gynecol. 2017 Feb;216(2):110-120.
  5. David Chestnut Cynthia Wong Lawrence Tsen Warwick D Ngan Kee Yaakov BeilinJill Mhyre Brian T. Bateman Naveen Nathan. Chestnut’s Obstetric Anesthesia: Principles and Practice. 5th edition. Chapter 36: Hypertensive Disorders. Pg 825-859

Killers of the Flower Moon (Dr. Henao’s random recommendation): https://www.amazon.com/Killers-Flower-Moon-Osage-Murders/dp/0385534248