OpenAnesthesia is dedicated to promoting evidenced based medicine in anesthesiology, critical care, and pain management.

Easing the transition from trainee to attending with Matthew Hire

Direct download: 202009OB.mp4
Category:general -- posted at: 9:49am PDT

Fetal anesthesia

Direct download: 202009SPA.m4a
Category:general -- posted at: 12:33pm PDT

PONV in Pediatrics with Aditee Ambardekar

Direct download: 202009Peds.mp4
Category:general -- posted at: 12:24pm PDT

Enhanced Recovery after Cesarean Delivery with Emily McQuaid-Hanson

Direct download: 202008OB.mp4
Category:general -- posted at: 2:22pm PDT

Drs. Aditee Ambardekar and Daniel Rubin discuss “Development and Pilot Study of an iOS Smartphone Application for Perioperative Functional Capacity Assessment” in the September 2020 issue of Anesthesia & Analgesia.

Direct download: AotM_Sep2020.mp3
Category:general -- posted at: 12:00pm PDT

Bioethics

Direct download: 202008ask.m4a
Category:general -- posted at: 11:42am PDT

Tonsillectomy with Jina Sinskey

Direct download: 2020-08Peds.mp4
Category:general -- posted at: 11:36am PDT

Drs. Thomas R. Vetter and Brett A. Simon discuss “Complex Cancer Surgery in the Outpatient Setting: the Josie Robertson Surgery Center” in the September 2020 issue of Anesthesia & Analgesia.

Direct download: AA_September2020_Podcast1.mp3
Category:general -- posted at: 12:00pm PDT

Drs. James A. DiNardo and Caleb Ing discuss “Exposure to Surgery and Anesthesia in Early Childhood and Subsequent Use of Attention Deficit Hyperactivity Disorder Medication” in the September 2020 issue of Anesthesia & Analgesia.

Direct download: AASeptember2020_Podcast2.mp3
Category:general -- posted at: 12:00pm PDT

Drs. Rebecca Minehart and Aaron Hess discuss “Health Numeracy and Relative Risk Comprehension in Perioperative Patients and Physicians” in the August 2020 issue of Anesthesia & Analgesia.

Direct download: AotM_August2020.mp3
Category:general -- posted at: 9:06am PDT

Drs. Jean-Francois Pittet and Detlef Obal discuss “A Guide to Understanding “State-of-the-Art” Basic Research Techniques in Anesthesiology” in the August 2020 issue of Anesthesia & Analgesia.

Direct download: AA_August2020_Podcast2.mp3
Category:general -- posted at: 3:44pm PDT

Drs. Jean-Francois Pittet and Tong J Gan discuss “4th Consensus Guidelines for the Management of Postoperative Nausea and Vomiting” in the August 2020 issue of Anesthesia & Analgesia.

Direct download: AA_August2020_Podcast1.mp3
Category:general -- posted at: 3:36pm PDT

Renal Disease in Pregnancy with Jacqueline M. Galvan

Direct download: 202007OBL.mp4
Category:general -- posted at: 11:17am PDT

Update on the SPA

Direct download: 202007Lalwani.mp3
Category:general -- posted at: 1:36pm PDT

Ketogenic Diet with Debnath Chatterjee

Direct download: 202007Peds.mp4
Category:general -- posted at: 1:27pm PDT

Battle Buddies: Rapid Deployment of a Psychological Resilience Intervention for Healthcare Workers during the COVID-19 Pandemic

Direct download: 202007Albott.mp3
Category:general -- posted at: 1:10pm PDT

Atrial Myxoma

Direct download: 202007TEEl.mp4
Category:general -- posted at: 12:56pm PDT

Simulation Education

Direct download: Ask_the_Expert_David_Young.mp3
Category:general -- posted at: 8:45am PDT

Drs. Ken Johnson and Karsten Bartels discuss “Neostigmine versus Sugammadex for Reversal of Neuromuscular Blockade and Effects on Re-Intubation for Respiratory Failure or Newly Initiated Non-Invasive Ventilation: An Interrupted Time Series Study Design” in the July 2020 issue of Anesthesia & Analgesia.

Direct download: AA_July2020_Podcast2_copy.mp3
Category:general -- posted at: 8:19am PDT

Drs. Nikolaos Skubas and Marta Kelava discuss “Regional Anesthesia in Cardiac Surgery: an Overview of Fascial Plane Chest Wall Blocks” in the July 2020 issue of Anesthesia & Analgesia.

Direct download: AA_July2020_Podcast1_copy.mp3
Category:general -- posted at: 8:14am PDT

Airway, Breathing, Cellphone with Tom Klumper

Direct download: 202008OBL.mp4
Category:general -- posted at: 3:17pm PDT

Heart Failure after CABG

Direct download: 202006TEEL.mp4
Category:general -- posted at: 12:56pm PDT

Drs. Robert Whittington and Daniel McIsaac discuss “Frailty for Perioperative Clinicians: a Narrative Review” in the June 2020 issue of Anesthesia & Analgesia.

Direct download: June_2020_AotM_2.mp3
Category:general -- posted at: 4:13pm PDT

Drs. Robert Whittington and Shahzad Shaefi discuss “Frailty in Critical Care Medicine: A Review” in the June 2020 issue of Anesthesia & Analgesia.
 
Direct download: June_2020_AotM_1.mp3
Category:general -- posted at: 4:12pm PDT

Drs. Maxime Cannesson and Cédrick Zaouter discuss “Autonomous systems in Anesthesia –Where do we stand in 2020? A narrative review” in the May 2020 issue of Anesthesia & Analgesia.

Direct download: May_2020_AotM_2.mp3
Category:general -- posted at: 4:09pm PDT

Drs. Drs. Maxime Cannesson and Ira Hofer discuss “Realistically Integrating Machine Learning into clinical practice: a road map of opportunities, challenges, and a potential future” in the May 2020 issue of Anesthesia & Analgesia.

Direct download: May_2020_AotM_1.mp3
Category:general -- posted at: 4:07pm PDT

Drs. James DiNardo and Lizabeth Martin discuss “Perioperative Management of Pediatric Patients with Type 1 Diabetes, Updated Recommendations for Anesthesiologists” in the April 2020 issue of Anesthesia & Analgesia.

Direct download: April_2020_AotM.mp3
Category:general -- posted at: 4:03pm PDT

Drs. Honorio Benzon and Bradley H. Lee discuss “Educating Patients Regarding Pain Management and Safe Opioid Use After Surgery: A Narrative Review” in the March 2020 issue of Anesthesia & Analgesia.

Direct download: AA_March2020_Podcast1.mp3
Category:general -- posted at: 3:56pm PDT

Drs. Robert Whittington and Brian O'Gara discuss “Prevention of Early Postoperative Decline: A Randomized, Controlled Feasibility Trial of Perioperative Cognitive Training” in the March 2020 issue of Anesthesia & Analgesia.

Direct download: AA_March2020_Podcast2.mp3
Category:general -- posted at: 3:55pm PDT

Drs. Maxime Cannesson and Kathryn H. Bridges discuss “To Infinity and Beyond: The Past, Present, and Future of Tele-Anesthesia” in the February 2020 issue of Anesthesia & Analgesia.

Direct download: ANE_OAP_123_011520.mp3
Category:general -- posted at: 3:49pm PDT

Drs. Maxime Cannesson and Kathryn H. Bridges discuss “To Infinity and Beyond: The Past, Present, and Future of Tele-Anesthesia” in the February 2020 issue of Anesthesia & Analgesia.

Direct download: ANE_OAP_123_011520.mp3
Category:general -- posted at: 3:49pm PDT

Drs. Honorio T. Benzon and Lisa J. Stearns discuss “Intrathecal Drug Delivery Systems (IDDS) for Cancer Pain: Analysis of a Prospective Multicenter Product Surveillance Registry” in the February 2020 issue of Anesthesia & Analgesia.
 
Direct download: ANE_OAP_124_011520.mp3
Category:general -- posted at: 3:45pm PDT

Drs. Avery Tung and Kunal Karamchandani discuss “Atrial Fibrillation: Current Evidence and Management Strategies During the Perioperative Period” in the January 2020 issue of Anesthesia & Analgesia.
 
Direct download: ANE_OAP_121_122019.mp3
Category:general -- posted at: 3:35pm PDT

Drs. Ken Johnson and Jonathan H. Chow discuss “Reversal of Vasodilatory Shock: Current Perspectives on Conventional, Rescue, and Emerging Vasoactive Agents for the Treatment of Shock” in the January 2020 issue of Anesthesia & Analgesia.

Direct download: ANE_OAP_122_122019.mp3
Category:general -- posted at: 3:30pm PDT

Pectus Excavatum with Aditee Ambardekar

Direct download: 202005PedsL.mp4
Category:general -- posted at: 1:51pm PDT

Opioid Use Disorder in Pregnancy: implications of Anesthetic Care with Britany Raymond

Direct download: 202005OL.mp4
Category:general -- posted at: 1:26pm PDT

Perioperative Management of Pediatric Patients on a Ketogenic Diet

Direct download: 202005SPA.m4a
Category:general -- posted at: 12:39pm PDT

Postoperative Apnea with Faith Ross

Direct download: 202005PedsLibsyn.mp4
Category:general -- posted at: 12:09pm PDT

Motherhood and Anesthesiology: A Survey of the American Society of Anesthesiologists

Direct download: 202005Kraus.mp3
Category:general -- posted at: 12:07pm PDT

COVID-19 and Crisis Resource Management with Rebecca Minehart

Direct download: 202004OB.m4v
Category:general -- posted at: 10:25am PDT

HeartMate III LVAD

Direct download: 042020TEEL.mp4
Category:general -- posted at: 11:39am PDT

Hemoglobin structure and function
Oxygen-Hemoglobin binding
Oxygen-Hemoglobin Dissociation Curve
Factors influencing left and rightward shift

Direct download: Keys_to_the_Cart__April_1_2020.m4v
Category:general -- posted at: 12:00pm PDT

Cerclage and indications for cerclage: Anesthetic techniques and Dermatomes

Direct download: Keys_to_the_Cart__March_15_2020.m4v
Category:general -- posted at: 12:00pm PDT

ROTEM for Management of Coagulopathy in Pregnancy with Shubhangi Singh

Direct download: 202003OB.m4v
Category:general -- posted at: 9:56am PDT

Ambulatory Surgery: Patient Selection
Ambulatory Surgery; Fast Track Criteria
Ambulatory Surgery: Discharge Delays
Outpatient Surgery Contraindications

Direct download: Keys_to_the_Cart__March_1_2020.m4v
Category:general -- posted at: 12:00pm PDT

Ultrasound-Assisted Versus Landmark-Guided Spinal Anesthesia in Patients With Abnormal Spinal Anatomy: A Randomized Controlled Trial

Direct download: 202003Park.mp3
Category:general -- posted at: 3:32am PDT

Nitrous Oxide: Mechanism of action, Use in obstetric anesthesia, Side Effects and Contraindications
Occupational Exposure

Direct download: Keys_to_the_Cart__February_15_2020.m4v
Category:general -- posted at: 12:00pm PDT

Pediatric Supraventricular Tachycardia with Faith Ross

Direct download: 202002SPA2.m4v
Category:general -- posted at: 1:15pm PDT

Pediatric cardiomyopathy

Direct download: 202002SPA.m4a
Category:general -- posted at: 12:56pm PDT

I Tweet, Therefore I Learn: An Analysis of Twitter Use Across Anesthesiology Conferences

Direct download: 202002AOM.mp3
Category:general -- posted at: 3:45am PDT

Carcinoid syndrome: Definition, symptoms, and diagnosis
Carcinoid syndrome: Anesthetic considerations

Direct download: Keys_to_the_Cart__February_1_2020.m4v
Category:general -- posted at: 12:00pm PDT

Woman's Empowerment and Leadership Initiative

Direct download: 202001Peds.mp3
Category:general -- posted at: 10:09am PDT

ASRA Guidelines: Herbal Supplementation
ASRA Guidelines Epidural Catheter Removal

Direct download: Keys_to_the_Cart__January_15_2020.m4v
Category:general -- posted at: 12:00pm PDT

Bariatric Surgery with Debnath Chatterjee

Direct download: 202001Peds.m4v
Category:general -- posted at: 7:19am PDT

ACOG/SMFM Level of Maternal Care 2019 with Mark Zakowski

Direct download: 202001OBB.m4v
Category:general -- posted at: 12:06pm PDT

Transcatheter aortic valve replacement (TAVR)

Direct download: 202001TEE.m4v
Category:general -- posted at: 9:58am PDT

Lung Isolation in Patients with Tracheostomies Undergoing Lung Transplantation

Direct download: Keys_to_the_Cart__January_1_2020.m4v
Category:general -- posted at: 12:00pm PDT

Impact of Caffeine Ingestion on the Driving Performance of Anesthesiology Residents After 6 Consecutive Overnight Work Shifts

Direct download: 202001Huffmyer.mp3
Category:general -- posted at: 4:33am PDT

Wiggles, Squiggles, and Drugs: Neuromonitoring with Michael Puglia

Direct download: 201912SPAVGR.m4v
Category:general -- posted at: 1:49pm PDT

Low Tidal Volume Ventilation: Lung protective effect

Direct download: Keys_to_the_Cart__December_15_2019.m4v
Category:general -- posted at: 12:00pm PDT

Forced Care During Pregnancy with Julie Cantor

Direct download: 201912OB.m4v
Category:general -- posted at: 7:09am PDT

The Pediatric Difficult Airway

Direct download: 201912SPA.m4a
Category:general -- posted at: 5:24am PDT

Pulmonary Hypertension and Liver Transplantation

Direct download: 201912TEE.m4v
Category:general -- posted at: 11:45am PDT

Neonatal Respiratory Distress Syndrome with Aditee Ambardekar

Direct download: 201912Peds.m4v
Category:general -- posted at: 7:38am PDT

Does Adherence to World Health Organization Hand Hygiene Protocols in the Operating Room Have the Potential to Produce Irritant Contact Dermatitis in Anesthesia Providers?

and 

Targeted Use of Alcohol-Based Hand Rub on Gloves During Task Dense Periods: One Step Closer to Pathogen Containment by Anesthesia Providers in the Operating Room

Direct download: 201912Birnbach.mp3
Category:general -- posted at: 7:33am PDT

Vasopressin; Arginine Vasopressin: Mechanism of Action; CV Effects of Vasopressin

Direct download: Keys_to_the_Cart__December_1_2019.m4v
Category:general -- posted at: 12:00pm PDT

Arginine Vasopressin

Direct download: Keys_to_the_Cart__November_15_2019.m4v
Category:general -- posted at: 12:00pm PDT

Obstetric Critical Care with Jennifer Hofer

Direct download: 201911OB.m4v
Category:general -- posted at: 1:26pm PDT

Placental transfer: anesthetic drugs

Direct download: Keys_to_the_Cart__November_1_2019.m4v
Category:general -- posted at: 12:00pm PDT

Rescue TEE and Pulmonary Embolus

Direct download: 201911TEE.m4v
Category:general -- posted at: 1:21pm PDT

Caring for Patients with Congenital Heart Disease

Direct download: 201911SPA.m4a
Category:general -- posted at: 6:28am PDT

Congenital Heart Disease Associated with Genetic Syndromes with Faith Ross

Direct download: 201911Peds.m4v
Category:general -- posted at: 6:20am PDT

ABA Manuscript Series November 2019

Direct download: 201911Warner.mp3
Category:general -- posted at: 5:35am PDT

Transfusion-related Immunomodulation (TRIM); Transfusion: Leukoreduction

Direct download: Keys_to_the_Cart__October_15_2019.m4v
Category:general -- posted at: 12:00pm PDT

Neurologic Complications in Obstetric​ Anesthesia with Christine Warrick

Direct download: 201910OB.m4v
Category:general -- posted at: 2:40pm PDT

Global health

Direct download: 201910Newton.mp3
Category:general -- posted at: 4:31am PDT

Laryngomalacia with Debnath Chatterjee

Direct download: 201910peds.m4v
Category:general -- posted at: 5:21am PDT

Pregnancy: DIC

Direct download: Keys_to_the_Cart__October_1_2019.m4v
Category:general -- posted at: 12:00pm PDT

Red Blood Cell Transfusion in Pediatric Orthotopic Liver Transplantation: What a Difference a Few Decades Make

Direct download: 201910Davis.mp3
Category:general -- posted at: 10:39am PDT

Non-Compaction Cardiomyopathy

Direct download: 201910TEE.m4v
Category:general -- posted at: 6:31am PDT

Pregnancy: DIC

Direct download: Keys_to_the_Cart__September_15_2019.m4v
Category:general -- posted at: 12:00pm PDT

Building a Career in Academia with Arvind Palanisamy

Direct download: OB201909.m4v
Category:general -- posted at: 7:56am PDT

Heart Failure and Mechanical Circulatory Support

Direct download: 201909TEE.m4v
Category:general -- posted at: 5:04am PDT

Anesthetic Implications for Pediatric Patients Undergoing Scoliosis Repair with Denise P. Chang

Direct download: 201909VGR.m4v
Category:general -- posted at: 4:01am PDT

One-lung ventilation in children

Direct download: templeton2019.m4a
Category:general -- posted at: 3:51am PDT

Post-op Cardiac Event: Risk Factors; Pre-anesthesia Eval: Cardiac

Direct download: 8.m4v
Category:general -- posted at: 12:00pm PDT

Necrotizing enterocolitis (NEC) with Aditee Ambardekar

Direct download: 201909Peds.m4v
Category:general -- posted at: 5:25am PDT

Do You Really Mean It? Assessing the Strength, Frequency, and Reliability of Applicant Commitment Statements During the Anesthesiology Residency Match

Direct download: 2019-09Moran.mp3
Category:general -- posted at: 3:00pm PDT

ACC/AHA Guidelines: Stents; Old MI: Perioperative Risk Assessment

Direct download: 7.m4v
Category:general -- posted at: 12:00pm PDT

Impacting the Labor and Delivery Floor Using Quality and Patient Safety Metrics with Klaus Kjaer

Direct download: 201908OB.m4v
Category:general -- posted at: 11:25am PDT

Pediatric One-lung ventilation with Debnath Chatterjee

Direct download: 201908Peds.m4v
Category:general -- posted at: 11:15am PDT

Perioperative management of sickle cell disease

Direct download: 201908Haberkern.m4a
Category:general -- posted at: 1:47pm PDT

Lambert-Eaten Physiology; Myasthenic Syndrome vs Myasthenia Gravis: Sx

Direct download: 6.m4v
Category:general -- posted at: 12:00pm PDT

American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Perioperative Opioid Minimization in Opioid-Naive Patients

Direct download: 201908Wu.m4a
Category:general -- posted at: 12:00pm PDT

Intracardiac Mass

Direct download: 201908TEE.m4v
Category:general -- posted at: 5:15am PDT

Erector Spinae Plane Block

A novel inter-fascial plane block first described in 2016. This technique has been used for analgesia for the following procedures:

- Video-assisted thoracoscopic surgery (VATS)

- Pulmonary lobectomy

- Thoracic rib and sternal fractures

- Mastectomy

- Axillary sentinel lymph node biopsy

- Abdominal surgery

- Hip surgery

- Thoracic neuropathic pain relief

 

Unique Contraindications:

- Localized active infectious process at injection site

- Extensive tissue depth between skin and transverse process limiting visualization of transverse process

 

Unique Complications:

- Pneumothorax

- Lower extremity motor weakness if performed at lower thoracic level

 

Technique:

- Transverse probe at midline of the spine and identify spinous process, lamina, transverse process and rib

- Slide probe laterally and center view over transverse process

- Rotate probe 90 degrees to parasagittal view of transverse process

- Insert needle from cranial to caudal direction and contact transverse process

- Inject local anesthetic aiming for pooling above transverse process and lifting of erector spinae muscle.  For this video, 30 ml of Ropivacaine 0.5% was used.

 

Tips:

- Other postural positions (i.e. prone or lateral) may facilitate placement

- Although the T5 transverse process had been the traditional plane of insertion, the block can be performed at any level

- Rostral spread 2-3 levels and approximately 5 levels caudally

- Ultrasound identification/differentiation of the target transverse process and its transition to its adjacent rib can ensure injection at the correct site

- Transverse process appears as blunt and flat while the rib is seen as round on ultrasound with pleura clearly seen in close proximity

- Constant visualization of the needle along its entire length until its contact to the transverse process may decrease the likelihood of a pneumothorax

- Consider use of weight-appropriate dose of local anesthetic to decrease the likelihood of LAST

 

Block Anesthesiologist:  Gloria Shih Cheng, M.D.

Synopsis:  Jose Enrique Lagueras Garcia, M.D.

Production: Sandy Thammasithiboon, M.D. / ST Film

 

 

References:

  1. Altiparmak B, et al. 2019. Comparison of the effects of modified pectoral nerve block and erector spinae plane block on postoperative opioid consumption and pain scores of patients after radical mastectomy surgery: a prospective, randomized, control trial. J Clin Anesth. 54:61-65.
  2. Altinpulluk EY, et al. 2019. Bilateral postoperative ultrasound-guided erector spinae plane block in open abdominal hysterectomy: a case series and cadaveric investigation. Rom J Anaesth Intensive Care. 26(1): 83-88.
  3. Ahiskalioglu, et al. 2018. Erector spinae plane block for bilateral lumbar transverse process fracture in emergency department: a new indication. Am J Emerg Med. 36(10)1927.
  4. Ciftci B, et al. 2019. Ultrasound-guided single shot preemptive erector spinae plane block for postoperative pain management.J Cardiothorac Vasc Anesth. 33(4): 1175-1176.
  5. Elkoundi A, et al. 2019. Erector spinae plane block for pediatric hip surgery-a case report. Korean J Anesthesiol. 72(1):68-71.
  6. Ince I, et al. 2018. Erector spinae plane block catheter insertion under ultrasound guidance for thoracic surgery: case series of three patients. Eurasian J Med. 50(3)204-205.
  7. Jadon A, et al. 2018. Flouroscopic-guided erector spinae plane block: a feasible option. Indian J Anaesth. 62(10):806-808.
  8. Jones MR, et al. 2019. Confirmation of erector spinae plane block analgesia for 3 distinct scenarios: a case report. A A Pract. 12(5): 141-144.
  9. Luis-Navarro JC, et al. 2018. Erector spinae plane block in abdominal surgery: case series. Indian J Anaesth. 62(7): 549-554.
  10. Kumar, A, et al. 2018. The use of liposomal bupivacaine in erector spinae plane block to minimize opioid consumption for breast surgery: a case report. A A Pract. 10(9)239-241.
  11. Nath S, et al. 2018. USG-guided continuous erector spinae block as a primary mode of perioperative analgesia in open posterolateral thoracotomy: a report of two cases. Saudi J Anaesth. 12(3): 471-474.
  12. Petsas D, et al. 2018. Erector spinae plane block for postoperative analgesia in laparoscopic cholecystectomy. J Pain Res. 11: 1983-1990.
  13. Tulgar S, et al. 2019. Ultrasound-guided erector spinae plane block: indications, complications, and effects on acute and chronic pain based on a single-center experience. Cureu 11(1): e3815.
Direct download: 201908Block.m4v
Category:general -- posted at: 6:49am PDT

Latex allergy: Fruits; Anaphylaxis: Epinephrine Treatment; Latex Allergy: Treatment

Direct download: 5.m4v
Category:general -- posted at: 12:00pm PDT

Beyond the Binary: Caring for Sexual and Gender Minority Patients on the Birth Unit

Direct download: 201907OB.m4v
Category:general -- posted at: 9:56am PDT

Pediatric ECMO with Faith Ross

Direct download: 201907Peds.m4v
Category:general -- posted at: 11:27am PDT

Sugammadex (Bridion®), Pharmacology. Warnings and precautions, and Reintubation considerations after use

Direct download: 4.m4v
Category:general -- posted at: 12:00pm PDT

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