Weekly Anesthesia Topics

Every Friday, our Education Chiefs will be selecting a theme of the week to residents and teaching faculty with the goal of stimulating discussion in the OR the following week. The weekly topics/themes will have related research/review articles (or an occasional podcast) as well as corresponding frequently missed keywords from the 2019 ITE. Obviously, any teaching relevant to the current case will take priority; however, the goals of this project are to provide an answer to the “what teaching topic would you like to discuss for today?” question that inevitably arises and to build residents that are well-versed in primary literature. 

If you have any suggestions for future papers and topics, please send them over to anesthesiaeducation.ucsd@gmail.com

Week 11: Anesthesia Emergencies

Resources:

  1. Anesthesia Emergencies: iOS App created by Tony Clark, UCSD Alum
  2. Stanford Anesthesia Emergency Manual

Keywords (starred topics were highly on the ITE):

  1. Presenting Signs of MH*
  2. Management of Hemorrhagic Shock*

Week 10: Preoxygenation

Resources:

  1. Nimmagadda: Preoxygenation: Physiologic Basis, Benefits, and Potential Risks
  2. Benumof: Critical hemoglobin desaturation will occur before return to an unparalyzed state following 1 mg/kg intravenous succinylcholine

Week 9: Intubation & Airway Management

Resources:

  1. Benumof: Qualitative Improvement in Laryngoscope View by Optimal External Laryngeal Manipulation
  2. Dr Robbin’s Airway Lecture

Keywords (starred topics were highly on the ITE):

  1. Airway Trauma, Larynx*
  2. Laryngeal Innervation*
  3. Neck Anatomy: Ultrasound

Week 8: RBC Transfusion

Resources:

1. Six-Month Outcomes after Restrictive or Liberal Transfusion for Cardiac Surgery

Keywords (starred topics were highly on the ITE):

  1. Transfusion: leukoreduction*
  2. Hemorrhagic shock management*

Week 7: Lumbar Drains

Resources

  1. Perioperative Management of Adult Patients With External Ventricular and Lumbar Drains: Guidelines From the Society for Neuroscience in Anesthesiology and Critical Care (this is more lengthy, but it is from the SNACC and can be helpful the night before a case if you know your patient has an EVD or LD)
  2. Lumbar Cerebrospinal Fluid Drainage for Thoracoabdominal Aortic Surgery: Rationale and Practical Considerations for Management (specific to TEVAR’s)
  3. EVD Training Module

Week 6: Local Anesthetic Systemic Toxicity (LAST)

Resources:

  1. ASRA Practice Advisory on Local Anesthetic Systemic Toxicity (Executive Summary, 2017)
  2. ASRA Checklist for Treatment of Local Anesthetic Systemic Toxicity (2018)
  3. Management of Local Anesthetic Systemic Toxicity (LAST) by Dr. Suresh

Keywords (starred topics were highly missed on the ITE):

  1. Epinephrine effects on LA duration*
  2. LAST treatment*

Week 5: Obstructive Sleep Apnea

Resources:

  1. Singh: Point of Care Ultrasound for Obstructive Sleep Apnea Screening
  2. AARAC Podcast 90: OSA

Keywords (starred topics were highly missed on the ITE):

  1. Obstructive lung disease: PFTs
  2. OSA: classifications*
  3. Lung compliance: calculation*

Week 4: Intravenous Fluids

Resources:

  1. SOLAR Trial (in the latest issue from “Anesthesiology”)
  2. ASA Choosing Wisely (see number 5 regarding colloids for fluid resuscitation)

Keywords (starred topics were highly missed by UCSD residents on the ITE):

  1. Normal Saline Administration: Lab Findings*
  2. Plasma Osmolality: Determinants*
  3. Fluid Management: Pulse Pressure Variation

Week 3: Depth of Anesthesia

Resources: 

  1. Landmark paper: Saidman. Effect of nitrous oxide and of narcotic premedication on the alveolar concentration of halothane required for anesthesia.
  2. AARAC Podcast 154: EEG Monitoring with Dr Emery Brown can be found via AARAC podcast or online.

Keywords (starred topics were highly missed on the ITE):

  1. TIVA: Advantages
  2. Depth of Anesthesia: EEG Findings *

Week 2: Standard Monitors in Anesthesia

Resources: 

  1. Landmark paper: Eichhorn. Standards for Patient Monitoring During Anesthesia. 
  2. Cochran Review: Lewis. BIS for Improving Intraoperative Awareness and Early Postop Recovery in Adults.

Keywords (starred topics were highly missed on the ITE):

  1. ASA monitoring standards
  2. Temperature monitoring sites*

Week 1: Neuromuscular Blockade

Resources:

  1. Griffith. The Use of Curare in General Anesthesia.
  2. Naguib. The Myth of Rescue Reversal in “Can’t intubate, Can’t Ventilate” Scenarios.

Keywords (starred topics were highly missed on the ITE):

  1. Extrajunctional ACh receptors*
  2. ESRD NMB*
  3. Glycopyrrolate: side effects*
  4. Neostigmine: side effects