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.
CME: https://earnc.me/Ui9inp
Random Recs:
Tuesday Nights Cookbook: Link
Vertellis: https://vertellis.com
In this 180th episode I welcome back Dr. Gillian Isaac for another ABA keyword episode. We review local anesthetics.
CME: https://earnc.me/LzzOvu
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 150th episode I welcome back Dr. Gillian Isaac to do another round of ABA keywords. We discuss 2 additional upper extremity blocks (supraclavicular and axillary) and then benzodiazepines.
CME: https://earnc.me/4aBzu8
In this 139th episode I welcome Dr. Gillian Isaac back to the show to discuss another 2 ABA keywords, succinylcholine and interscalene brachial plexus block.
CME: https://earnc.me/WBEa4s
In this 126th episode I welcome back Dr. Gillian Isaac to discuss 2 more ABA key words: Ketamine and Laryngospasm.
CME: https://earnc.me/GbYGLA
In this 119th episode I welcome Dr. Robert Sawyer to the show. Dr. Sawyer was the PI on the STOP-IT trial comparing a short course of antibiotics versus a longer course for complicated intraabdominal infections. We discuss the trial, the outcomes, and what the future of antimicrobial management in the surgical ICU may look like.
CME: https://earnc.me/jeCfMt
Reference:
STOP-IT Trial: https://www.nejm.org/doi/full/10.1056/NEJMoa1411162
In this 109th episode we pick up where we left off in episode 108 and discuss the intraoperative use of non-opioid adjuncts.
CME: https://earnc.me/k6e6gK
References:
Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.
Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.
Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.
IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710
Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457
Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866
In this 108th episode I welcome Dr. Mike Grant and Dr. Mark Bicket to the show to discuss various non-opioid adjuncts such as esmolol, ketamine, dexmedetomidine, lidocaine, and magnesium, and the role they may play in multimodal anesthesia. In this episode, part 1, we discuss pre and post-op use. Intraop use will be discussed in episode 109.
CME: https://earnc.me/oDhyER
References:
Wick EC, Grant MC and Wu CL. Postoperative Multimodal Analgesia Pain Management With Nonopioid Analgesics and Techniques A Review. JAMA Surg. 2017;152(7):691-697.
Bahr MP, Williams BA. Esmolol, Antinociception, and Its Potential Opioid-Sparing Role in Routine Anesthesia Care. Regional Anesthesia and Pain Medicine. 2018:43(8):815-818.
Grant MC, Ouanes JP, Joshi BL. Perioperative Esmolol and Opioids: Is More Really Less? Regional Anesthesia and Pain Medicine. 2018:43(8):813-814.
IV Lidocaine: https://academic.oup.com/bjaed/article/16/9/292/1743710
Ketamine: https://www.ncbi.nlm.nih.gov/pubmed/29870457
Dextramethorphan: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4755866/ R
In this episode, episode 77, I discuss reversal of neuromuscular blockade. This is a follow up to episode 66 in which I covered neuromuscular blockade.
CME: https://earnc.me/An714h
Outline by Brian Park: NMB Reversal Outline
References:
Miller’s Anesthesia 8th Edition. Reversal (Antagonism) of Neuromuscular Blockade. Murphy GS, de Boer HD, Eriksson LI and Miller RD. Chapter 35, 995-1027.e5.
Appiah-Ankam J, Hunter J. Pharmacology of neuromuscular blocking drugs. Cont Educ Anaesthesia Critical Care & Pain. 2004;4(1):2-7.
Hristovska AM, Duch P, Allingstrup M, Afshari A. Efficacy and safety of sugammadex versus neostigmine in reversing neuromuscular blockade in adults. Cochrane Database Syst Rev. 2017 Aug 14;8:CD012763.
Keating GM. Sugammadex: A Review of Neuromuscular Blockade Reversal. Drugs. 2016 Jul;76(10):1041-52.
McLean DJ, Diaz-Gil D, Farhan HN, Ladha KS, Kurth T, Eikermann M. Dose-dependent Association between Intermediate-acting Neuromuscular-blocking Agents and Postoperative Respiratory Complications. Anesthesiology. 2015 Jun;122(6):1201-13.
Schaller S, Fink H. Sugammadex as a reversal agent for neuromuscular block: an evidence-based review. Core Evidence. 2013;8:57-67.
In this episode, episode 66, I go through an overview of neuromuscular blockers including how they work, how to use them, and what their adverse effects are. Happy New Year!
CME: https://earnc.me/9GRFyG
The dose of glycopyrrolate should be 0.01 to 0.015mg/kg, not 0.1 to 0.15.
Outline by Brian Park: Outline
References:
Miller’s Anesthesia 7th edition: Chapter 29: Pharmacology of Muscle Relaxants and Their Antagonists. Naguib M and Lien C.
Rocuronium vs succinylcholine for rapid sequence induction intubation. https://www.ncbi.nlm.nih.gov/pubmed/26512948
Neuromuscular blockade: what was, is and will be: https://www.ncbi.nlm.nih.gov/pubmed/25622380
Reversal of neuromuscular block: https://www.ncbi.nlm.nih.gov/pubmed/19468024
