The Anesthesia Consultant

MARCH 24, 2022

In July 2020 the Food and Drug Administration (FDA) approved the intravenous benzodiazepine remimazolam (Byfavo, Acacia Pharma) for use in sedation for procedures of 30 minutes or less. remimazolam propofol For use in procedural sedation, remimazolam will not replace Versed, but rather will aim to replace propofol.

Post-Anesthesia 52

Post-Anesthesia General Anesthesia Anesthesia Anesthesiologist 52

The Anesthesia Consultant

MARCH 22, 2019

My aim is to inform my readers, both anesthesia professionals and laypersons, that if Medicare for All becomes reality, there will be a dire consequence regarding anesthesia staffing and services to patients. What happens if every anesthesia patient pays only Medicare rates in a Medicare for All future? 75 X $76) + (.25

Post-Anesthesia 52

Post-Anesthesia Anesthesiologist Anesthesia General Anesthesia 52

The Anesthesia Consultant

DECEMBER 19, 2016

You’re are an experienced practitioner, but not a pediatric anesthesia specialist. One is how to safely perform the open-eye, full stomach anesthetic, and the other is the performance of pediatric anesthesia by non-pediatric anesthesia specialists. A 3-year-old boy is eating a McDonalds Happy Meal on the lawn of the restaurant.

General Anesthesia 52

General Anesthesia Post-Anesthesia Anesthesia Anesthesiologist 52

The Anesthesia Consultant

JULY 25, 2022

This was a landmark paper on the topic of anesthesiologist:CRNA staffing ratios, which documented that having physician anesthesiologists direct three or four operating rooms simultaneously for major noncardiac inpatient surgical procedures increased the 30-day risks of patient morbidity and mortality.

Operating Room 52

Operating Room Anesthesiologist Operation CRNA 52

The Anesthesia Consultant

FEBRUARY 16, 2021

The first surgery today is a procedure devised to treat obstructive sleep apnea, a procedure called a maxillary-mandibular osteotomy. The first surgery today is a procedure devised to treat obstructive sleep apnea, a procedure called a maxillary-mandibular osteotomy. You leave your street clothes in your locker.

Anesthesiologist 52

Anesthesiologist Operating Room Vital Signs Post-Anesthesia 52

The Anesthesia Consultant

JANUARY 19, 2017

I’ve met and worked alongside hundreds of anesthesia colleagues from all corners of the globe. Some were academic professors, some were trainees at a university, and some were community anesthesiologists either in my group or in other anesthesia companies. Learn to perform medical procedures at the highest level.

Anesthesiologist 52

Anesthesiologist Operating Room Post-Anesthesia Anesthesia 52

The Anesthesia Consultant

AUGUST 26, 2015

But nothing is perfect, and anesthesia has one threat which could in time undermine the entire specialty. No, it’s not the nurse anesthetists, nor the stress of covering surgeries in the middle of the night, nor the stress of saving patients who are trying to die in front of our eyes during acute care emergencies.

Nurse Anesthetist 52

Nurse Anesthetist Anesthesiologist Post-Anesthesia Anesthesia 52

The Anesthesia Consultant

APRIL 2, 2016

I work in a private practice setting in Palo Alto, California, and liposuction is one of the most common plastic surgery procedures performed. Early in my career, in the late 1980’s, liposuction was a bloody procedure. Preanesthetic assessment and patient selection are key for safe large-volume liposuction procedures.

General Anesthesia 52

General Anesthesia Post-Anesthesia Anesthesia Anesthesiologist 52

The Anesthesia Consultant

OCTOBER 8, 2019

preparing to remove an endotracheal tube from a patient Every general anesthetic has risk. The conclusion of most general anesthetics requires the removal of a breathing tube. The most invasive type of airway tube used in anesthesia is called an endotracheal tube, or ET tube. In the immortal words of Forrest Gump, “Sh*t happens.”

General Anesthesia 52

General Anesthesia Anesthesia Anesthesiologist Post-Anesthesia 52

The Anesthesia Consultant

JUNE 23, 2016

GENERAL ANESTHESIA FOR DENTAL OFFICES CASE PRESENTATION: A 5-year-old developmentally delayed autistic boy has multiple dental cavities. The dentist consults you, a physician anesthesiologist, to do sedation or anesthesia for dental restoration. Options for anesthesia induction include: Intramuscular sedation.

General Anesthesia 52

General Anesthesia Anesthesia Post-Anesthesia Anesthesiologist 52

The Anesthesia Consultant

JULY 2, 2018

Food and Drug Administration (FDA) is warning that repeated or lengthy use of general anesthetic and sedation drugs during surgeries or procedures in children younger than 3 years or in pregnant women during their third trimester may affect the development of children’s brains. The answer to all these questions is: “It depends.”

General Anesthesia 52

General Anesthesia Post-Anesthesia Anesthesia Anesthesiologist 52

The Anesthesia Consultant

JULY 12, 2021

Major adverse events seldom occur during the middle of a general anesthetic of long duration on a healthy patient. Every anesthesia provider carries a smartphone connected to the internet. Many anesthesia providers carry a laptop or a tablet in their briefcases. Love it or hate it, the EMR is here to stay.

Operating Room 52

Operating Room General Anesthesia Post-Anesthesia Anesthesia 52

The Anesthesia Consultant

NOVEMBER 15, 2017

Let’s look at a case study which highlights a specific risk of general anesthesia at a freestanding surgery center or a surgeon’s office operating room, when the anesthesiologist departs soon after the case is finished. The trachea is intubated, and anesthesia is maintained with 1-1.5% The surgery concludes at 1630 hours.

Anesthesiologist 52

Anesthesiologist Operating Room General Anesthesia Surgery 52

The Anesthesia Consultant

DECEMBER 19, 2016

Control of the airway is the most important clinical priority in anesthesia care. The INTUBATION AFTER INDUCTION OF GENERAL ANESTHESIA section of the Difficult Airway Algorithm is bifurcated into two pathways. The most critical technical skill for an anesthesiologist is. facemask ventilation.

Anesthesiologist 52

Anesthesiologist General Anesthesia Post-Anesthesia Anesthesia 52

The Anesthesia Consultant

OCTOBER 1, 2015

Under anesthesia these reflexes are absent. These fasting guidelines do not apply to surgical procedures under local anesthesia, or to those with no anesthesia. The guidelines do apply for colonoscopies or upper gastrointestinal endoscopy procedures. You don’t have to fast for a dentist office visit, for example.

Anesthesia 52

Anesthesia General Anesthesia Surgery Anesthesiologist 52

The Anesthesia Consultant

MAY 2, 2023

Your patient is in mid-surgery, and you receive a call from the Anesthesia Control Tower that the patient’s blood pressure is too low, your blood transfusion replacement is inadequate, and that the patient is in danger. Louis, Missouri are studying a novel system they call the Anesthesia Control Tower (ACT). What do you do?

Anesthesia 52

Anesthesia Operating Room Post-Anesthesia Anesthesiologist 52

The Anesthesia Consultant

JUNE 12, 2023

I entered three anesthesia consultations into CHATGPT, one preoperative, one intraoperative, and one postoperative. Medications may need to be adjusted or temporarily stopped to minimize potential risks during the procedure. This could indicate a cardiac event or a complication related to the anesthesia.

Anesthesia 52

Anesthesia Post-Anesthesia General Anesthesia Anesthesiologist 52

The Anesthesia Consultant

DECEMBER 29, 2015

How do you feel when you meet your anesthesia provider prior to a surgical procedure? In an abstract presented at the 2015 American Society of Anesthesiologists annual meeting, data from the 2014 National Anesthesia Clinical Outcomes Registry was compiled for every anesthesiologist of known age who performed at least 100 cases.

Anesthesiologist 52

Anesthesiologist Post-Anesthesia General Anesthesia Anesthesia 52

The Anesthesia Consultant

AUGUST 7, 2017

See Robot Anesthesia and Robot Anesthesia II ) AI already influences our daily life. I’m fascinated by the topic of artificial intelligence in medicine. This is the third column in a series regarding robots in medicine. Smartphones verbally direct us to our destination through mazes of highways and traffic.

Post-Anesthesia 52

Post-Anesthesia Anesthesia Operating Room Nurse Practitioner 52

The Anesthesia Consultant

FEBRUARY 11, 2018

The surgical attendings were the kings, the students were the peasants, the nurses and techs were serfs, and the anesthesiologists were the whipping boys for the surgeons. Some people have difficulty seeing the outstanding merits of physician anesthesiology. I understand where these opinions come from, but the phenomenon still bothers me.

Operating Room 52

Operating Room Anesthesiologist Post-Anesthesia General Anesthesia 52

The Anesthesia Consultant

SEPTEMBER 3, 2021

Will it be a nurse or will it be a physician? A 2013 study in Anesthesiology states, “Despite the fact that a surgical procedure may have been performed for the appropriate indication and in a technically perfect manner, patients are threatened by perioperative organ injury. This is an important question. Why do patients die?

Nurse 52

Nurse Nurse Anesthetist Supervision CRNA 52

The Anesthesia Consultant

OCTOBER 4, 2016

The procedure was to be done in the prone position, and required endotracheal intubation. The patient was turned prone, and the procedure commenced. After only 15 minutes of operating time, the gastroenterologist announced that the procedure was over. The trachea was extubated. The nadir oxygen saturation was 49%.

Post-Anesthesia 52

Post-Anesthesia Anesthesia General Anesthesia Anesthesiologist 52

The Anesthesia Consultant

SEPTEMBER 1, 2017

The safety of anesthesia on ASA I and II patients has been compared to the safety record of commercial aviation. A total of 266 cases of brain damage or death during anesthesia care in the operating room under the care of a solo anesthesiologist occurred. But planes do crash, and so do anesthetized patients.

Anesthesia 52

Anesthesia Post-Anesthesia General Anesthesia Operating Room 52

The Anesthesia Consultant

SEPTEMBER 25, 2015

Instead of writing histories, examining patients, making diagnoses, and prescribing medications as interns and internal medicine doctors do, anesthesia residents are rendering their patients unconscious, applying acute pharmacology, and inserting tubes and needles into patients in operating rooms at all hours of the day and night.

Post-Anesthesia 52

Post-Anesthesia Operating Room Anesthesia Anesthesiologist 52

The Anesthesia Consultant

OCTOBER 17, 2019

The study looked at malpractice closed claims and found: 1) Outcomes remained poor in malpractice closed claims related to difficult tracheal intubation; 2) The incidence of brain damage or death at induction of anesthesia was 5.5 A surgical airway is an invasive airway via the front of the patient’s neck into their trachea.

Anesthesiologist 52

Anesthesiologist Post-Anesthesia Anesthesia General Anesthesia 52

The Anesthesia Consultant

APRIL 26, 2018

Norman Shumway MD PhD, a Stanford surgical professor and legend, invented the heart transplantation procedure and performed the first heart transplant in the USA on January 6, 1968 in operating room 13 of Stanford University Hospital. Note that the anesthesia transport team member was only an anesthesia fellow or a resident.

Anesthesia 52

Anesthesia Operating Room Vital Signs Post-Anesthesia 52

The Anesthesia Consultant

JUNE 27, 2017

These alarms would bring a fleet of nurses and/or doctors into the room to try to save the patient. I love the movies, but it can be painful to watch scenes where the facts are distorted, sometimes so much that the storyline is implausible. This film is my Hollywood medical pet peeve, and the movie that motivated me to write this column.

General Anesthesia 52

General Anesthesia Vital Signs Anesthesia Post-Anesthesia 52

The Anesthesia Consultant

FEBRUARY 19, 2016

We’re going to sedate this patient for a medical procedure. The procedure does not require a breathing tube, so we’ll administer the sedation and be vigilant regarding what happens to the patient’s vital signs. Let’s discuss a hypothetical male patient. He is 79 years old, overweight, and has a thick neck.

Blood Oxygenation Levels 52

Blood Oxygenation Levels Post-Anesthesia Anesthesia General Anesthesia 52

The Anesthesia Consultant

AUGUST 16, 2018

If something dire goes wrong during anesthesia and surgery and the flow of oxygen to the brain is cut off, an anesthesia practitioner has about five minutes to diagnose the cause of the problem and treat it. The good news is that catastrophic events causing sudden drops in oxygen levels are very rare during anesthesia.

Post-Anesthesia 52

Post-Anesthesia Anesthesia Anesthesiologist General Anesthesia 52

The Anesthesia Consultant

MAY 5, 2025

I was providing a general anesthetic to a patient for bilateral blepharoplasties (eyelid lifts) in a plastic surgery center operating room recently, and I asked the surgeon how frequently she performed this surgery in her office under local anesthesia without an anesthesia professional. What is a troche?

Anesthesia 96

Anesthesia General Anesthesia Post-Anesthesia Vital Signs 96