Anesthesia and Critical Care Reviews and Commentary
In this 188th episode I discuss the approach to Anesthesia for patients having thoracic surgery including highly tested concepts for board exams.
Reference:
Clinical Anesthesia. 2017. 8th Ed. Barash, Paul G.; Cullen, Bruce F.; Stoelting, Robert K.; Cahalan, Michael K.; Stock, M. Christine; Ortega, Rafael; Sharar, Sam R.; Holt, Natalie F.
Publisher: Lippincott Williams & Wilkins (LWW).
In this 187th episode I welcome Dr. Gabe Tharp to the show to discuss his recent article in Anesthesiology: “Body Habitus and Dynamic Surgical Conditions Independently Impair Pulmonary Mechanics during Robotic-assisted Laparoscopic Surgery.” We discuss his findings and whether we should be using much higher levels of PEEP than we currently do.
Gabe’s group is on Twitter: @uvmanesthesia
References:
Tharp et al. Body Habitus and Dynamic Surgical Conditions Independently Impair Pulmonary Mechanics during Robotic-assisted Laparoscopic Surgery. Anesthesiology 2020. PMID: 32675698
Ball L, et al. Br J Anaesth. 2018. PMID: 30236252
Ferrando, et al Lancet Respir Med. 2018. PMID: 29371130
PROBESE committee JAMA. 2019. PMID: 31157366.
Grassi et al. Anesthesiology. 2020. PMID: 32011342
In this 186th episode I welcome Dr. Jennifer Meeker to the show to discuss the increased use of cannabis in the general population and what that means for anesthesiologists taking care of patients who may have acute or chronic use.
Random Recs:
Tuesday Nights Cookbook: Link
Vertellis: https://vertellis.com
In this 185th episode I welcome back Dr. Lee Goeddel to discuss assessment of fluid responsiveness in the operating room.
References:
Michard F. Changes in Arterial Pressure during Mechanical Ventilation. Anesthesiology. 2005;103(2):419-428. doi:10.1097/00000542-200508000-00026
Using Dynamic Variables to Guide Perioperative Fluid Management
Azriel Perel, M.D.
Anesthesiology October 2020, Vol. 133, 929–935. https://doi.org/10.1097/ALN.0000000000003408
In this 184th episode I welcome back Drs. Kara Segna and Hassan Rayaz to discuss truncal blocks. We discuss rectus sheath, transversus abdominis plane, quadratus lumborum and erector spinae plane blocks.
Random Recs:
The Wirecutter: https://www.nytimes.com/wirecutter/
How to be an anti-racist: Link
Instant Hotel: https://www.netflix.com/title/81023011
Love Island Australia: https://en.wikipedia.org/wiki/Love_Island_Australia
In this 183rd episode I welcome back Dr. Gillian Isaac to do another keyword episode where we review the ABA keyword topics of Thyroid for the Basic Exam and Thyroid for the Advanced Exam.
References:
Barash Clinical Anesthesia 8th edition
American Board of Anesthesiology Website
Anesthesiahub.com
Random Recs:
Serious Eats Brown Butter Cookie Dough Recipe: Link
The Dragon Prince: https://en.wikipedia.org/wiki/The_Dragon_Prince
In this 182nd episode I welcome the president of the ASA medical student component, Stacia Griebahn, and the president-elect, Abigail Schirmer to the show to discuss what medical students applying in anesthesiology are concerned about this year and the responses that PDs have to those concerns.
ASA medical student component webpage: https://www.asahq.org/education-and-career/asa-medical-student-component
Abigail is on twitter: @abigailschirmer
Stacia is on twitter: @StaciaGriebahn
Random recs:
Do no harm: Link
War Doctor: Surgery on the front line: Link
Zwift: https://zwift.com
Give Back Yoga Foundation: https://givebackyoga.org
The Drive Podcast: https://peterattiamd.com/podcast/
In this 181st episode I welcome Dr. Dave Berman back to the show to discuss what the evidence tells us about how to effectively teach in the perioperative arena.
References:
Chickering AW, Gamson ZF. Seven principles for good practice in undergraduate education. Biochem Educ 1989;17(3):140–1.
Knowles MS. The modern practice of adult education. New York: Cambridge, The Adult Education Company; 1980.
Carraccio CL, Benson BJ, James Nixon L, Derstine PL. From the Educational Bench to the Clinical Bedside: Translating the Dreyfus Developmental Model to the Learning of Clinical Skills [Internet]. Academic Medicine. 2008;83(8):761–7. Available from: http://dx.doi.org/10.1097/acm.0b013e31817eb632
Brzezinski M, Mitchell J. Advanced Teaching Skills for the Fast-paced OR. ASA Refresher Courses in Anesthesiology 2015;43(1):49–57.
Back AL, Arnold RM, Baile WF, Tulsky JA, Fryer-Edwards K. Approaching Difficult Communication Tasks in Oncology [Internet]. CA: A Cancer Journal for Clinicians. 2005;55(3):164–77. Available from: http://dx.doi.org/10.3322/canjclin.55.3.164
In this 180th episode I welcome back Dr. Gillian Isaac for another ABA keyword episode. We review local anesthetics.
Also check out Episode 41 for an in-depth episode on local anesthetics
CORRECTION: At 28:58 I state that hyperventilation increases the seizure threshold. This is incorrect, it DECREASES the seizure threshold.
Reference: Barash Clinical Anesthesia 8th edition: Chapter on Local Anesthetics
Outline by Brian Park, MD
Local anesthetics block nerve conduction by?
a. Closing calcium channels
b. Decreasing intracellular sodium concentration
c. Decreasing K conductance
d. Causing extrusion of intracellular K
e. Inhibiting cellular influx of sodium
Discussion (4:44)
In this 178th episode I welcome back Dr. Stephen Freiberg to discuss how to manage the patient in the post cardiopulmonary bypass period.
Dr. Freiberg’s social media:
thedadesthesiologist.com
Instagram: @thedadesthesiologist
Twitter: @dadesthesia
Tik Tok: @thedadesthesiologist