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Simon Ash Profile picture
@OBsleepmerchant
Jun 26, 2022 • 25 tweets • 29 min read • Read on X
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@ValZaph kicks off the last #OBAnes session of #CASAM2022 with the introduction of @Ron_George and @ammunro2.
@Ron_George leads the way #OBAnes #CASAM2022
How many epidurals fail? Depends on what you consider failure… #OBAnes #CASAM2022
Depends how you ask the question… #OBAnes #CASAM2022
May all be about patient satisfaction #OBAnes #CASAM2022
Factors affecting failure… #OBAnes #CASAM2022
CSE ≠ untested catheter - may even allow for earlier detection #OBAnes #CASAM2022
How you administer the drugs makes a difference - PIEB is just that good #OBAnes #CASAM2022
Who’s doing what? #OBAnes #CASAM2022
You have to manage the catheter… having a plan/ algorithm helps #OBAnes #CASAM2022
Evaluation and adjustment should be guided by practice patterns #OBAnes #CASAM2022
How to use a stepwise algorithm… #OBAnes #CASAM2022
What about adjuncts? 1/ #OBAnes #CASAM2022
What about adjuncts? 2/ #OBAnes #CASAM2022
Summary from @Ron_George, and on we go to @ammunro2 #OBAnes #CASAM2022
Conversion of LEA for cesarean section #OBAnes #CASAM2022
Factors affecting conversion 1/ #OBAnes #CASAM2022
Slides paused?!? #CASAM2022
I think we lost some slides as the virtual audience… now looking at how we would manage the failing catheter… #OBAnes #CASAM2022
What surveys have found… #OBAnes #CASAM2022
Algorithmic approach to manager of failed LEA conversion #OBAnes #CASAM2022
Options: pros v cons #OBAnes #CASAM2022
Tiger territory - spinal anesthesia. High spinal is something you don’t forget #OBAnes #CASAM2022
Wrapping up… #OBAnes #CASAM2022
And the last #OBAnes panel discussion/ Q&A … don’t they look good? #CASAM2022

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More from @OBsleepmerchant

Simon Ash Profile picture
May 9
@SQuashie presents an update on anesthesia for operative delivery. Declarations. Methodology and themes. #OAA24ASM #OBAnes

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Gastric USS. Oral rehydration has benefits over NPO wrt vasopressor use. #siptilsend safe, noting some patients have increased gastric volumes irrespective of starvation status. #OAA24ASM #OBAnes
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@SQuashie continues at a rapid pace. To DPE or not to DPE remains a question - 16min vs 19 min, is that 3 min clinically relevant? Esketamine for supplemental analgesia - >95% had psych effects, read @rjharrison79 editorial. #OAA24ASM #OBAnes
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Read 16 tweets
Simon Ash Profile picture
May 9
@Jamesocarroll presents an Update on Labour and Delivery. Disclosures #OAA24ASM #OBAnes

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How the lecture was put together. Screening. Themes. How to interpret the slides. Very Ostheimer-esque @Jamesocarroll #OAA24ASM #OBAnes


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@Jamesocarroll Clinical practice theme: intrathecal catheters & ADP. Intrathecal catheters: No decrease in PDPH, but reduction in EBP. 10mL intrathecal saline decreased PDPH & need for EBP. Of note, the percentage of epidurals requiring multiple attempts. #OAA24ASM #OBAnes

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Read 17 tweets
Simon Ash Profile picture
May 5
8am-ish in Denver and time for a much anticipated session: PDPH beyond the guidelines. Moderated by Dr Lisa Leffert, featuring @Ropivacaine, @euklaas, @sharonOzynger and @WouterSchievink at #SOAPAM2024 #OBAnes

(HT: @Ropivacaine, bless his heart, he knows I hate missing out)

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Hot off the Press? August 2023! @JAMANetworkOpen with quite an illustrious team including @Ropivacaine @robin_russell1 @KalagaraHari @LimGrapes @claralexlobo @noolslucas @NarouzeMD (please tag others if you have their handles?) #SOAPAM2024 #OBAnes

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Introduction, Methods and the 10 questions. #SOAPAM2024 #OBAnes

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Read 11 tweets
Simon Ash Profile picture
Jun 12, 2023
Next up at #CASAM2023 - fittingly keeping the most important academic session to last: #OBAnes
@ValZaph moderating the Maternal Experience and Outcomes: Improving the care we provide. @DrWesleyEdwards

Bookends the 1st #OBAnes session, on intrapartum pain at cesarean section… twitter.com/i/web/status/1… Image
Dr Christina Lamontagne kicks off the session with: Use of Dexmedetomidine in improving maternal experience and outcomes. Nothing to disclose. Then an important disclosure: All indications discussed are OFF LABEL in Canada. Objectives.
#OBAnes #CASAM2023 ImageImageImageImage
Why does Dr Lamontagne use a lot of dexmedetomidine (not only in #OBAnes mind)? Clinical pharmacology of dexmedetomidine (1): highly selective alpha-2 agonist; sedation WITHOUT amnesia at locus coeruleus. #CASAM2023 ImageImageImage
Read 9 tweets
Simon Ash Profile picture
Jun 11, 2023
Dr Ning Nan Wang introduces @harshamd5 to open the chronic pain session: Perioperative use of opioid in the context of Opioid Epidemic. #CASAM2023 ImageImageImage
The opioid crisis isn’t new - China probably remembers the Opium wars that helped establish a British foothold on the continent. Opioids and OUR crisis. Is what we fear the real crisis? Are opioid-related deaths due to surgical prescriptions? No, mostly due to street fentanyl.… twitter.com/i/web/status/1… ImageImageImage
Opioid use around the time of surgery. Understanding nociception vs pain. Does eliminating opioids during surgery make a difference - no definitive conclusions. #CASAM2023 ImageImageImage
Read 11 tweets
Simon Ash Profile picture
Jun 10, 2023
@DrLucieFilteau introduces @CMA_Docs president @AlikaMD for his keynote address at #CASAM2023 Image
@AlikaMD starts with the state of the 🇨🇦 health system, including a little history. #CASAM2023 ImageImage
The 🇨🇦 health system approach to problems, creating new problems as a result with a dangerous lack of interoperability. #CASAM2023 ImageImageImage
Read 12 tweets

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