Main Written Summaries Listing Audio-Digest Foundation: Archived Written Summaries: Anesthesiology: 2007 CARDIOVASCULAR MANAGEMENT UPDATE Audio-Digest Anesthesiology Volume 49, Issue 24 December 21, 2007 The present and future of perioperative cardiovascular management – Joel A. Kaplan, MD Perioperative cardiac risk and noncardiac surgery – David M. Roth, MD, PhD Click here to read an abstracted written summary of this program. From Anesthesiology Update 2007, Sponsored By The Department Of Anesthesiology, University Of California, San Diego, School Of Medicine ANESTHETIC DELIVERY AND TECHNIQUE Audio-Digest Anesthesiology Volume 49, Issue 23 December 7, 2007 Anesthetic delivery: I can’t believe they’re pushing propofol?!? – Jeffrey L. Apfelbaum, MD Anesthetic technique: what modifications are really indicated in the elderly? – Jacqueline M. Leung, MD, MPH Click here to read an abstracted written summary of this program. POSTANESTHESIA RECOVERY Audio-Digest Anesthesiology Volume 49, Issue 22 November 21, 2007 Pediatric issues in the PACU – Emad Mossad, MD, PhD Orthopedic issues in the PACU – John E. Tetzlaff, MD Click here to read an abstracted written summary of this program. From Survey Of Current Issues In Surgical Anesthesia, Sponsored By The Division Of Anesthesiology, Critical Care Medicine, And Comprehensive Pain Management, Cleveland Clinic Foundation, Cleveland, OH PERINEURAL ANALGESIA/MANAGEMENT OF SHOCK Audio-Digest Anesthesiology Volume 49, Issue 21 November 7, 2007 Perineural analgesia and catheters – F. Kayser Enneking, MD Advances in the management of shock – Ronald Pearl, MD, PhD Click here to read an abstracted written summary of this program. OPHTHALMIC ANESTHESIA PERSPECTIVES Audio-Digest Anesthesiology Volume 49, Issue 20 October 21, 2007 Obstructive sleep apnea – Howard D. Palte, MB, ChB Cardiac disease – Marc Allan Feldman, MD Click here to read an abstracted written summary of this program. From The 20th Annual Scientific Meeting Of The Ophthalmic Anesthesia Society, Jointly Sponsored By The Cleveland Clinic Foundation Center For Continuing Education And The Ophthalmic Anesthesia Society HIV AND AIDS Audio-Digest Anesthesiology Volume 49, Issue 19 October 7, 2007 HIV update – Mark H. Katz, MD Additional thoughts on HIV – Jeffrey T. Kirchner, DO Click here to read an abstracted written summary of this program. KEEPING CURRENT ON OBSTETRIC ANESTHESIA Audio-Digest Anesthesiology Volume 49, Issue 18 September 21, 2007 Preeclampsia: update on an old subject – Robert R. Gaiser, MD Implications of the ASA/ACOG guidelines – Joy L. Hawkins, MD Click here to read an abstracted written summary of this program. CHRONIC PAIN/CPR UPDATE Audio-Digest Anesthesiology Volume 49, Issue 17 September 7, 2007 Current trends and new developments in chronic pain management – Mark S. Wallace, MD Cardiopulmonary resuscitation update – Benjamin S. Abella, MD Click here to read an abstracted written summary of this program. Points of Care– Changes in CPR Guidelines: Chest compressions: Hallstrom study found improved survival in group that received chest compression alone (ie, no gaps in compression for rescue breaths), compared to standard CPR (≈15% vs ≈10%); results may be due to easier mechanics rather than gaps in chest compression; another study indicates that details of CPR important for hemodynamics and ultimately survival; 2 recent studies have shown that CPR may actually be more important than defibrillation under certain circumstances (survival improved when defibrillation delayed to give CPR first); speaker's study recommended chest compression rate of 100/min; common deficiencies in CPR performance include frequent pauses, shallow compressions, and hyperventilation Dr. Wallace spoke at Anesthesiology Update 2007, Jan 3-6, 2007, in San Diego, CA, by the Univ of Calif, San Diego, Sch of Med, Dept of Anes, Dr. Abella, at Challenges for Clinicians, Dec 1-3, 2006, in Chi, IL, by the Univ of Chicago Pritzker Sch of Med, Dept of Anes and Critical Care. OPTIMIZING ACUTE PAIN MANAGEMENT Audio-Digest Anesthesiology Volume 49, Issue 16 August 21, 2007 Acetaminophen and NSAIDs: should I use them? – Scott S. Reuben, MD Using regional techniques as multimodal pain therapy – Paul H. Willoughby, MD Click here to read an abstracted written summary of this program. Points of Care– Preventive analgesia; multimodal analgesics recomended preoperatively and postoperatively; A delta (adelta) and C fibers carry pain; A β fibers carry innocuous sensations; pathologic pain occurs during surgery; Adelta and C fibers become sensitized, lowering pain threshold at site of injury and resulting in persistent pathologic pain; controlling inflammatory mediators peripherally and centrally important for pain management ... Meta-analysis: NSAIDs, COX–2 inhibitors, and acetaminophen assiciated with morphine-sparing effect (15% to 55%); NSAIDs–decrease pain intensity at 24 hr; reduce incidence of nausea and vomiting; associated with less sedation; associated with risk for bleeding From the 60th Postgraduate Assembly in Anesthesiology, by the New York State Soc of Anesthesiologists, NY, NY. THE BARIATRIC SURGERY PATIENT Audio-Digest Anesthesiology Volume 49, Issue 15 August 7, 2007 Anesthetic implications – Ashish C. Sinha, MD, PhD What should be included in a preoperative assessment? – Michael H. Wall, MD Click here to read an abstracted written summary of this program. CLINICAL PEDIATRIC ANESTHESIOLOGY Audio-Digest Anesthesiology Volume 49, Issue 14 July 21, 2007 Malignant hyperthermia–susceptible diseases: who deserves a nontriggering technique? – Ronald S. Litman, DO Multimodal therapy for postoperative pain in children – Michael H. Joseph, MD Click here to read an abstracted written summary of this program. Points of Care– McCaffery's definition of pain: "whatever the experiencing person says it is, existing whenever he or she says it does" Psychologic strategies: ... "good customer service”; providing education to family also reduces fear; distraction techniques–eg, bubbles, pinwheels, deep breathing, toys; music therapy and animal-assisted therapy also effective at reducing pain; positive reinforcement– important ("most children view their interactions with the health care environment as punitive"); enhances self-esteem and mastery; encourages similar behavior; facilitates child's (and parents') effort to cope; relaxation and imagery – have patient take 10 slow deep breaths and imagine pain going into lungs and leaving body as he or she breathes out; reduces acute fear and anxiety; self-hypnosis–using videotape; shown to decrease postoperative pain From The 45th Annual Clinical Conference in Pediatric Anesthesiology, by the Pediatric Anes Foundation, Childrens Hospital Los Angeles, CA ISSUES IN PEDIATRIC AND ADULT OUTPATIENT CARE Audio-Digest Anesthesiology Volume 49, Issue 13 July 7, 2007 "Off–site" pediatric anesthesia – Joseph D. Tobias, MD The adult outpatient and cardiac rhythm devices – Barbara S. Gold, MD Click here to read an abstracted written summary of this program. AIRWAY MANAGEMENT Audio-Digest Anesthesiology Volume 49, Issue 12 June 21, 2007 Supraglottic airway devices – Terrence L. Trentman, MD Obstructive sleep apnea – Bhargavi Gali, MD Airway management in the acute trauma setting – D. John Doyle, MD, PhD Click here to read an abstracted written summary of this program. CHALLENGES FOR THE ANESTHESIA PROVIDER Audio-Digest Anesthesiology Volume 49, Issue 11 June 7, 2007 Anesthesia informatics – David L. Reich, MD Do–not–resuscitate status and advanced directives – Gavin D. Divertie, MD Click here to read an abstracted written summary of this program. PERIOPERATIVE INFECTIONS/ENDOCRINE DISORDERS Audio-Digest Anesthesiology Volume 49, Issue 10 May 21, 2007 Perioperative infections and the anesthesia provider – Mark T. Keegan, MD Anesthesia for endocrine disorders – Roger E. Hofer, MD Click here to read an abstracted written summary of this program. From The 16th Annual Current Topics In Anesthesia, Presented By Mayo Clinic College Of Medicine, Jacksonville, FL THERMOREGULATION AND OXYGEN MONITORING Audio-Digest Anesthesiology Volume 49, Issue 09 May 7, 2007 Temperature and its effect on perioperative outcomes – Daniel I. Sessler, MD New developments in oxygen monitoring – Steven J. Barker, MD Click here to read an abstracted written summary of this program. REGIONAL ANESTHESIA: TREATMENT MODALITIES AND PRACTICAL SUGGESTIONS Audio-Digest Anesthesiology Volume 49, Issue 08 April 21, 2007 New modalities for the treatment of back pain – James P. Rathmell, MD Tricks of the trade – Michael F. Mulroy, MD Click here to read an abstracted written summary of this program. Points of Care–(Tricks of the Trade) Prepare outside operating room (OR): "the more you can externalize that work outside the OR, the more successful you're going to be" in placing blocks on time, getting good solid block, and having high surgical acceptance; have patient arrive at preanesthesia clinic in advance of surgery; explain block and procedure, and answer questions (reduces anxiety on day of surgery [patient knows what to expect]); if no preanesthesia clinic available, call patients on day before surgery; review history, anesthetic needs, and explain anesthetic plan From Regional Anesthesia 2006, Presented By Virginia Mason Medical Center And The Mayo Clinic, August 4-6, 2006 AVOIDING COMPLICATIONS IN REGIONAL ANESTHESIA: PART 2 Audio-Digest Anesthesiology Volume 49, Issue 07 April 7, 2007 Neuraxial complications of spinal and epidural anesthesia – Denise J. Wedel, MD Transient neurologic complications – Julia E. Pollock, MD Click here to read an abstracted written summary of this program. From Sleepless In Seattle, Hold The Mayo: Regional Anesthesia 2006, August 4-6, 2006 AVOIDING INFECTIOUS AND NEUROLOGIC COMPLICATIONS ASSOCIATED WITH REGIONAL ANESTHESIA, PART 1 Audio-Digest Anesthesiology Volume 49, Issue 06 March 21, 2007 No pus: avoiding infectious complications – James R. Hebl, MD No pain: avoiding neurologic complications – Joseph M. Neal, MD Click here to read an abstracted written summary of this program. From The American Society Of Anesthesiologists' 2006 Annual Meeting, October 14-18, 2006 COAGULATION UPDATE: MEDICAL AND SURGICAL PERSPECTIVES Audio-Digest Anesthesiology Volume 49, Issue 05 March 7, 2007 A practical approach to periprocedural anticoagulation – Robert C. Pendleton, MD The "must knows" of heparin–induced thrombocytopenia – Dr. Pendleton New agents for treating coagulopathy – Robert C. Mackersie, MD Click here to read an abstracted written summary of this program. PROTECTING PERIOPERATIVE VISION Audio-Digest Anesthesiology Volume 49, Issue 04 February 21, 2007 Ischemic events in the posterior eye, and optic nerve compartment syndrome – Steven Roth, MD Does fluid matter? – John C. Drummond, MD ASA postoperative visual loss registry – Lorri A. Lee, MD Click here to read an abstracted written summary of this program. From The American Society Of Anesthesiologists' 2006 Annual Meeting, October 14-18, 2006 ADVANCES IN ANESTHETIC PHARMACOLOGY Audio-Digest Anesthesiology Volume 49, Issue 03 February 7, 2007 Dexmedetomidine – John B. Leslie, MD, MBA Clinical application of intravenous anesthetics – Talmage D. Egan, MD Click here to read an abstracted written summary of this program. Points of Care–(Intravenous Anesthetics) Approaches for controlling drug effect: Surfing analogy: useful in conceptualizing approaches to rational drug selection and administration; concentration-effect relationship like wave; as drug concentration increases, effect rises rapidly then levels off; target upper portion of steep part of wave because in this portion of concentration-effect relationship, relatively small changes in concentration translate into bigger changes in effect From The Calif Soc of Anesthesiologists and the Univ of Calif, San Diego, Sch of Med's Annual Meeting and Anesthesiology Review Course OPIOIDS, ADDICTION, AND PAIN Audio-Digest Anesthesiology Volume 49, Issue 02 January 21, 2007 Opioids and addiction – Paul Kreis, MD Treating pain – Steven Richeimer, MD Click here to read an abstracted written summary of this program. Points of Care– (Treating Pain) Treatment agreements (opioid contracts): useful, but limiting; educational tool to teach patients what is expected of them; speaker also uses for consent process; increasingly common requirement for patient consent when placed on opioid therapy (may also be verbal); famous case (patient suicide) of physician not documenting new treatment plan with rationale; speaker advises 1) document any change in treatment plan, and 2) write agreements to be educational tools without indicating any clinical actions (course of action should only be in treatment plan) From Review and Update of Pain and Palliative Medicine, by the Univ of Calif, Davis, Sch of Med THE OBESITY EPIDEMIC: ANESTHESIA IMPLICATIONS Audio-Digest Anesthesiology Volume 49, Issue 01 January 7, 2007 Physiologic and anesthetic considerations in morbidly obese patients – Jay B. Brodsky, MD Obstructive sleep apnea and airway management – David A. Zvara, MD Postoperative management of the bariatric patient – Jon D. Samuels, MD Click here to read an abstracted written summary of this program. From The 59th Postgraduate Assembly In Anesthesiology, Presented By The New York State Society Of Anesthesiologists, Inc.