@girardDev presents on managing the obese parturient at #OAA3dc2022. He sets the bar high for the future of presentations at #SOAPAM2023, #OAA23, #ASM23SYD: a QR code that links to all his references as well as a pdf of his slide deck - perfect for #OBAnes#SoMe & #FOAMed.
The value of PERI-oxygenation in obesity is not to be ignored. All patients will go blue, perioxygenated ones take 52 seconds longer (how long it feels depends on the sats?). We all remember the troop pillow, but do we remember the stool? Ergonomics of intubation #OAA3dc2022
@mbrrace meeting 10 November. Hope to see some live tweets of key messages @SusannaStanford. “We are ALL part of the solution” #OBAnes and obesity is definitely part of the puzzle, preventing it part of the solution. #OAA3dc2022
@NEJM 2022 review on obesity in pregnancy (@FarberMichaela does Brian Bateman have a handle?) Obesity impacts all aspects of peri-delivery #OBAnes - both mom & baby, pregnancy & long term. Risks of adverse outcomes increased! @ashrafhabib5 gives additional insights #OAA3dc2022
Another @IJOA_Journal looked at neuraxial failure rates in BMI >/= 50: pretty high, catheter migration common. @_Anesthesiology found that epidural catheter migration was associated with patient movement, 4.28 cm from sitting to lateral! #OAA3dc2022
The relationship between BMI & PDPH was looked at by @FeycePeralta@CynthiaAWongMD et al: 17% decrease. @CarvalB looked at ED50/95 for intrathecal bupivacaine in obese parturients: higher doses more success? #OAA3dc2022
Panni & Columb @BJAJournals found the opposite for epidural LA requirements. @josecarvalhoyyz et al @Anaes_Journal looked at ED90 of oxytocin for elective cesarean in obesity: 0.75iu (higher than 0.35iu for non-obese) #OAA3dc2022
Remember to dose sugammadex appropriately for morbidly obese patients (@Anaes_Journal) - guided by NMT is best. @IJOA_Journal retrospective study on neuraxial morphine & respiratory depression in obesity: almost 2x higher in obesity (almost 3x in class 3 obesity) #OAA3dc2022
That QR code again. Thank you @girardDev, I’m sure @OAAinfo and all #OBAnes appreciate this resource for references (leading the way for future presenters?) #OAA3dc2022
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@SQuashie presents an update on anesthesia for operative delivery. Declarations. Methodology and themes. #OAA24ASM #OBAnes
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
@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
@Jamesocarroll presents an Update on Labour and Delivery. Disclosures #OAA24ASM #OBAnes
How the lecture was put together. Screening. Themes. How to interpret the slides. Very Ostheimer-esque @Jamesocarroll #OAA24ASM #OBAnes
@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
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)
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
Introduction, Methods and the 10 questions. #SOAPAM2024 #OBAnes
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
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
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
Dr Ning Nan Wang introduces @harshamd5 to open the chronic pain session: Perioperative use of opioid in the context of Opioid Epidemic. #CASAM2023
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…
Opioid use around the time of surgery. Understanding nociception vs pain. Does eliminating opioids during surgery make a difference - no definitive conclusions. #CASAM2023