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

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 160: Non-OB Surgery in Pregnancy With Dave Berman
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In this 160th episode I welcome Dr. Dave Berman back to the show to discuss anesthesia for non-OB surgery during pregnancy.

CME: https://earnc.me/zVSggO

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

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 159: Postpartum hemorrhage with Juanita Henao
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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.

CME: https://earnc.me/n2JrEJ

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. 

Episode 158: Keywords part 8-hepatic disease for the advanced exam and PACU for the basic exam with Gillian Isaac

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 158: Keywords part 8-hepatic disease for the advanced exam and PACU for the basic exam with Gillian Isaac
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In this 158th episode we return with another keywords episode with Dr. Gillian Isaac. We discuss hepatic disease for the advanced exam and PACU care for the basic exam.

CME: https://earnc.me/rEmBIA

Show Notes by Dr. Brian Park

Random recs:

Cloud Atlas: https://www.amazon.com/Cloud-Atlas-Novel-Liam-Callanan/dp/0385336950

Wolf Hall: https://www.amazon.com/s?k=wolf+hall+by+hilary+mantel&i=stripbooks&crid=2F978D2O2UCW&sprefix=wolf+hall%2Cstripbooks%2C135&ref=nb_sb_ss_i_1_9

Bottle of Lies: https://www.amazon.com/Bottle-Lies-Inside-Story-Generic-ebook/dp/B07JG49BQW/ref=sr_1_1?keywords=bottle+of+lies&qid=1581089047&s=books&sr=1-1

Thanks to Brian Robinson for pointing out: reversal of  rocuronium with Sugammadex can occasionally cause severe bronchospasm, especially in higher doses, and this was one of the reasons its release was delayed in the U.S.

Although most sugammadex hypersensitivity reactions cause mild symptoms such as sneezing, nausea, rash, and urticaria, there is a small but finite risk of anaphylaxis with potentially life-threatening symptoms such as airway edema, bronchospasm, and cardiovascular collapse.
www.apsf.org › article › sugammadex-the-anaphylactic-risk

Episode 157: Intermittent Fasting with Mark Mattson

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 157: Intermittent Fasting with Mark Mattson
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In this 157th episode I welcome Dr. Mark Mattson to the show to discuss the science behind intermittent fasting including in the perioperative period.

CME: https://earnc.me/1dnYNl

Dr. Mattson’s review from NEJM: https://www.nejm.org/doi/full/10.1056/NEJMra1905136

Dr. Mattson’s Tedx Talk: https://www.youtube.com/watch?v=4UkZAwKoCP8

Episode 156: Personal Finance and Burnout with Jimmy Turner

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 156: Personal Finance and Burnout with Jimmy Turner
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In this 156th episode I welcome Dr. Jimmy Turner to the show to discuss the intersection of personal finance and physician burnout.

CME: https://earnc.me/0d07wD

References:

Dr. Turner’s about page: http://thephysicianphilosopher.com/about/

Dr. Turner’s website: https://thephysicianphilosopher.com/

Dr. Turner’s new podcast: http://moneymeetsmedicine.com/

Blogpost about burnout and finance: https://thephysicianphilosopher.com/what-causes-physician-burnout/

How to think about Money book: https://www.amazon.com/Think-About-Money-Jonathan-Clements/dp/1523770813

If You Can free PDF book: https://www.etf.com/docs/IfYouCan.pdf

Leaders Eat Last: https://www.amazon.com/Leaders-Eat-Last-Together-Others/dp/1543614620

Episode 155: Opioid-Free Anesthesia with Michael Manning

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 155: Opioid-Free Anesthesia with Michael Manning
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In this 155th episode I welcome Dr. Michael Manning to the show to discuss opioid-reduced and opioid-free anesthesia. We discuss the downsides of opioid usage and what we can do to reduce our use in our patients or even eliminate it completely.

CME: https://earnc.me/ntZLxe

References:

1. Koepke EJ, Manning EL, Miller TE et al. The rising tide of opioid use and abuse: the role of the anesthesiologist. Perioper Med (Lond) 2018;7:16.

2. Brummett CM, Waljee JF, Goesling J et al. New Persistent Opioid Use After Minor and Major Surgical Procedures in US Adults. JAMA Surg 2017;152:–e170504.

3. Manchikanti L, Helm SI, Fellows B et al. Opioid Epidemic in the United States. Pain Physician 2012;15:ES9–ES38.

4. Gan TJ, Habib AS, Miller TE et al. Incidence, patient satisfaction, and perceptions of post-surgical pain: results from a US national survey. Curr Med Res Opin 2014;30:149–60.

The Road Less Stupid: https://www.amazon.com/Road-Less-Stupid-Keith-Cunningham/dp/0984659269

Armchair Expert Interview with Ira Glass: https://armchairexpertpod.com/pods/ira-glass

Episode 154: EEG monitoring with Dr. Emery Brown

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 154: EEG monitoring with Dr. Emery Brown
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In this 154th episode I welcome Dr. Emery Brown to the show to discuss how we monitor the depth of anesthesia. We discuss the drawbacks to BIS and why Dr. Brown thinks the EEG itself is the best way to go.

CME: https://earnc.me/fbGYsk

References:

EEG reading tutorials: https://eegforanesthesia.iars.org/

Purdon et al: The Ageing Brain: Age-dependent changes in the electroencephalogram during propofol and sevoflurane general anaesthesia

Brown et al: General Anesthesia and Altered States of Arousal: A Systems Neuroscience Analysis. Annu. Rev. Neurosci. 2011.

Brown et al: General Anesthesia, Sleep, and Coma. NEJM. 2010.

Brown et al: Multimodal General Anesthesia: Theory and Practice. A&A 2018.

Purdon et al: Clinical Electroencephalography for Anesthesiologists. Part I: Background and Basic Signatures. Anesthesiology 2015.

Dental Anesthesia info:

Contacts:

Thomas Whitmer: thomas.whitmer.tw@gmail.com

Mana saraghi: msaraghi@gmail.com

References:

https://www.ada.org/en/ncrdscb/dental-specialties/specialty-definitions

http://www.ada.org/~/media/CODA/Files/anes.ashx

American Society of Dentist Anesthesiologists website: https://www.asdahq.org

Virtual tour https://www.youtube.com/watch?v=ZJ1Mo65ah4w&feature=youtu.be



Episode 153: Women in Anesthesiology with Dr. Sasha Shillcutt

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 153: Women in Anesthesiology with Dr. Sasha Shillcutt
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In this 153rd episode I welcome Dr. Sasha Shillcutt to the show to discuss the movement to support and promote the success of women in Anesthesiology. Dr. Shillcutt is on twitter at @sashashillcutt and @RUBraveEnough. Her website is https://www.becomebraveenough.com

CME: https://earnc.me/JlM00P

References:

Check out Sasha’s Upcoming book that we discussed on the episode!

Episode 152: Keywords Part 7: MH and Hepatic Disease for the Basic Exam

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 152: Keywords Part 7: MH and Hepatic Disease for the Basic Exam
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In this 152nd episode I welcome Dr. Gillian Isaac back for another 2 ABA keywords. We discuss malignant hyperthermia and the portion of hepatic disease that is covered by the Basic Exam. We’ll do the portion covered by the Advanced Exam on the next keywords episode.

CME: https://earnc.me/NU3JPS

Malignant Hyperthermia Website: www.mhaus.org

Great review website where Dr. Isaac gets her questions: http://www.anesthesiahub.com

Atlantic Article: https://www.theatlantic.com/entertainment/archive/2012/03/what-do-fact-checkers-and-anesthesiologists-have-in-common/253838/#note

Episode 151: Advanced Practice Providers in the ICU

Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Anesthesia and Critical Care Reviews and Commentary (ACCRAC) Podcast
Episode 151: Advanced Practice Providers in the ICU
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In this 151st episode I welcome Brandon Oto to the show. Brandon is an ICU PA and we discuss the roles and relationships of APPs in the ICU environment.

CME: https://earnc.me/qcZ7cm

Brandon’s blog is http://critcon.org/

Brandon is on Twitter @critconcepts