Anesthesia, Anesthetic agents, OB, Pharmacology

Episode 51: Labor Analgesia with Jacqueline Galvan

July 24, 2017 ACCRAC Leave a comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

00:00 / 49:35

In this episode, episode 51, I welcome back Dr. Jacqueline Galvan to discuss labor analgesia. We cover opioids including remifentanil, nitrous oxide, neuraxial anesthesia and other nerve blocks.

CME: https://earnc.me/hlwk7u

References:

Hess PE, et al. An association between severe labor pain and cesarean delivery. Anesth Analg. 2000 Apr;90(4):881-6
Van den Bussche E. Why women prefer epidural analgesia during childbirth: the role of beliefs about epidural analgesia and pain catastrophizing. Eur J Pain. 2007 Apr;11(3):275-82.
Varposhti MR et al. Comparison of remifentanil: Entonox with Entonox alone in labor analgesia. Adv Biomed Res. 2013 Nov 30;2:87

Anesthesia, OB, Procedures

Episode 50: CSE vs Epidural Debate with Mike Hofkamp and Jacqueline Galvan

July 13, 2017 ACCRAC Leave a comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 50: CSE vs Epidural Debate with Mike Hofkamp and Jacqueline Galvan

00:00 / 57:08

In this episode, episode 50, I welcome back Dr. Mike Hofkamp, and, for the first time, I welcome Dr. Jacqueline Galvan to the show. Drs. Hofkamp and Galvan go head to head in a debate over which is a better, more evidence-based technique, the traditional epidural or the CSE (combined spinal epidural).

CME: https://earnc.me/lzYspm

All of the articles that were referenced can be found here: References

Uncategorized

Episode 49: High Reliability with Peter Pronovost

June 30, 2017 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 49: High Reliability with Peter Pronovost

00:00 / 44:08

In this episode, episode 49, I welcome Dr. Peter Pronovost to the show to discuss the high reliability movement and how it relates to healthcare. Dr. Pronovost is one of the world’s foremost experts on patient safety and we discuss how a hospital can be as reliably safe as an aircraft carrier and how best to approach an angry patient in the ICU.

CME: https://earnc.me/R5V4ZE

Anesthesia, Cardiac

Episode 48: TAVRs with Clint Tippett

June 28, 2017 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 48: TAVRs with Clint Tippett

00:00 / 39:38

In this episode, episode 48, I welcome Dr. Clint Tippett to the show. Dr. Tippett is a cardiac anesthesiologist with an interest in anesthesia for Transcutaneous Aortic Valve Replacement (TAVR) and we discuss the approach to anesthesia for these cases including preoperative planning, intraoperative management, and post-operative concerns.

CME: https://earnc.me/NVVNUT

Regarding stroke risk here is an editorial (Thanks to Stephen Freiberg for providing this link): http://circinterventions.ahajournals.org/content/8/6/e002801

And Dr. Tippett wanted to add that early studies of the 1st and second generation valves had higher stroke rates than SAVR, however the most current genreration valves(Edwards Sapien 3 and Medtronic Evolut R) both have been shown to have not significantly different stroke rates from TAVR.(Surtavi trial and this observational study http://thelancet.com/pdfs/journals/lancet/PIIS0140-6736(16)30073-3.pdf).

Finally, when discussing benefits of TAVR, we should have mentioned a significantly lower risk of post-op AFib in addition to lower bleeding risk and lower rates of AKI.

Anesthesia, Critical Care, Procedures

Episode 47: Arterial Lines with Stephen Freiberg

June 13, 2017 ACCRAC 11 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 47: Arterial Lines with Stephen Freiberg

00:00 / 50:32

In this episode, episode 47, I welcome back Dr. Stephen Freiberg, one of our chief residents, to discuss all you ever wanted to know about arterial lines. We discuss the indications, contraindications, complications, placement technique, and how to interpret the waveform.

CME: https://earnc.me/P5Z6j5

Slides with figures mentioned in the podcast can be found here: Arterial Line Podcast Images

If you are a regular listener to the show please consider becoming a patron at patreon.com/accrac to help support the costs of making the show. Even just a dollar or two makes a big difference. Thanks so much.

Anesthesia, OB, Pharmacology, Show Notes

Episode 46: Obstetric Pharmacology and Fetal Assessment with Mike Hofkamp

June 8, 2017 ACCRAC 8 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 46: Obstetric Pharmacology and Fetal Assessment with Mike Hofkamp

00:00 / 54:59

In this episode, episode 46, I welcome back Dr. Mike Hofkamp to discuss obstetric pharmacology and fetal assessment.

CME: https://earnc.me/xnT8gE

Outline by Brian Park: Outline

Anesthesia, Critical Care, Neuro, Physiology

Episode 45: Postop Delirium with Charlie Brown

May 24, 2017 ACCRAC 1 Comment

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 45: Postop Delirium with Charlie Brown

00:00 / 29:45

In this episode, episode 45, I welcome Dr. Charlie Brown to the show. Dr. Brown is one of our cardiac anesthesiologists with a research interest in postop delirium. We discuss risk factors, consequences, prevention and treatment of postop delirium.

CME: https://earnc.me/Ckgf63

Anesthesia, Cardiac, Show Notes

Episode 44: Intro to cardiac anesthesia with Megan Kostibas

May 23, 2017 ACCRAC 8 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 44: Intro to cardiac anesthesia with Megan Kostibas

00:00 / 59:12

In this episode, episode 44, I welcome Dr. Megan Kostibas to the show. Dr. Kostibas is trained in cardiac anesthesia and critical care medicine and is an assistant professor here at Hopkins. She is also the associate program director for the cardiac anesthesia fellowship. We discuss the basics of how to prepare, induce and manage difference cardiac pathology as well as how to go on and off cardiopulmonary bypass.

CME: https://earnc.me/WRnhvH

Show Notes by Dr. Brian Park

Anesthesia, OB, Physiology, Show Notes

Episode 43: Maternal Physiology with Mike Hofkamp

May 23, 2017 ACCRAC 5 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 43: Maternal Physiology with Mike Hofkamp

00:00
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45:27

In this episode, episode 43, I welcome Dr. Mike Hofkamp to the show. Dr. Hofkamp is Director of OB Anesthesia at Baylor Scott & White Memorial Hospital and Clinical Associate Professor of Anesthesiology at Texas A&M Health Science Center College of Medicine. We discuss the changes to women’s physiology when they become pregnant and the implications of those changes for anesthetic management.

CME: https://earnc.me/8Blmqr

Outline by April Liu: Episode 43

Anesthesia, Pharmacology, Show Notes

Episode 42: Post-op Nausea and Vomiting (PONV)

May 2, 2017 ACCRAC 2 Comments

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast

Episode 42: Post-op Nausea and Vomiting (PONV)

00:00
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29:21

In this episode, episode 42, I discuss Post-op Nausea and Vomiting (PONV). I discuss risk factors, complications, treatment and prevention and side effects.

CME: https://earnc.me/31KodT

Outline by April Liu: Outline

UPDATE April, 2018: In this episode I mention that the evidence is not good for Midazolam in preventing PONV. However, a good friend and colleague, Dr. Michael Grant, did a nice meta-analysis of available trials which concluded that it actually does work fairly well. Check out his study:

Grant MC, Kim J, Page AJ, et al. The Effect of Intravenous Midazolam on Postoperative Nausea and Vomiting: A Meta-Analysis. Anesthesia & Analgesia: 2016:122(3); 656–663.