Category: General Anesthesia

Responsibility for your own health

I was shocked to see that the NHS could ban surgery for the obese and smokers.  That’s socialized medicine.  You take a conglomerate group of people (the UK) on a limited budget for healthcare… and basically find the cheapest most cost-effective way to deliver healthcare.  But in a way, it’s empowering patients to take responsibility

Continue reading

Emergency Checklists

It seems like in today’s day and age, emergencies are occurring everywhere.  From hurricanes to shooters to earthquakes and fires… I think it’s always important to know what to do.  Here are some fabulous checklists I’ve found for getting through those emergencies.  These are not substitutions for knowledge and training.  Clinical judgement warranted. Emergency Manual

Continue reading

Lidocaine infusions for pain

BJA Educ, April 2016. Intravenous lidocaine for acute pain: an evidence-based clinical update Lidocaine Infusion for Perioperative Pain Management – Vanderbilt Cocharane Library, July 2015. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery. Perioperative Use of Intravenous Lidocaine. Anesthesiology 4 2017, Vol.126, 729-737. Open Access Journals, Jan 2017. Lidocaine Infusion: A Promising Therapeutic Approach for

Continue reading

Methadone and acute and chronic pain management

We had a journal club where we discussed this article: Anesthesiology, May 2017; Clinical effectiveness and safety of intraoperative methadone in patients undergoing posterior spinal fusion surgery: a randomized, double-blinded, controlled trial. IV Methadone 0.2 mg/kg vs IV hydromorphone 2mg at surgical closure in 2+ level spinal fusion Decreased postop IV and opioid requirements and

Continue reading

Cardiac Surgery in a Jehovah’s Witness Patient

AVR Brief case summary Literature Search Blood Transfusion: 2011; April 9(2); 189-217.  Recommendations for the transfusion management of patients in the peri-operative period. II. The intra-operative period. BMJ Case Rep. 2012; 2012: bcr1220115403.  Aortic valve replacement in a Jehovah’s Witness: a case of multi-disciplinary clinical management for bloodless surgery. Journal of Cardiothoracic and Vascular Anesthesia,

Continue reading

Left atrial occlusion devices

Our hospital is starting to do more left atrial occlusion devices for people who have afib and aren’t able to tolerate blood thinners. Currently, two types are offered by our cardiologists: Watchman procedure (endocardial) vs Lariat procedure (epicardial). Lariat It look and acts similar to a lariat or lasso.  An external guide wire with a

Continue reading

Minimally invasive mitral valve surgery from an anesthesiologist’s perspective. #cardiac #mitral #tee #minimallyinvasive #robot #anesthesia #meded

Surgically, more and more cases are performed through tiny incisions for minimal scarring.  Don’t let that underestimate the size of the procedure.  For example, mitral valve surgery is still a common procedure that involves a sternotomy (“cracking the chest”) and stopping the heart — it’s a big procedure.  However, surgeons have become adept at making

Continue reading