The Anesthesia Consultant

MARCH 22, 2023

How will astronauts conduct general anesthesia and surgery in outer space? If an astronaut requires general anesthesia, one must assume the patient has a full stomach and is at risk for aspiration. GENERAL ANESTHESIA General anesthesia has the advantages of a quick and reliable onset.

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The Anesthesia Consultant

MARCH 31, 2015

An anesthesia emergency occurs without warning. Your patient’s vital signs are dropping. You need the ultimate anesthesia emergency guidebook. That ultimate guidebook is the S tanford Emergency Manual of Cognitive Aids for Perioperative Critical Events S , written by the Stanford Anesthesia Cognitive Aid Group.

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The Anesthesia Consultant

MARCH 4, 2022

The Glidescope, sugammadex, ultrasound-guided blocks, and the time-consuming Electronic Medical Record arrived, but we typically administer the same medications, use the same airway tubes, and watch the same vital signs monitors as we did in the 1990s. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

AUGUST 14, 2015

My career has bridged clinics, operating rooms, intensive care units, emergency rooms, and helicopter trauma medicine. In the 21 st century operating room practice of anesthesiology, we typically have ten minutes to talk to a patient prior to rendering them unconscious. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

JANUARY 30, 2024

Perioperative” means “the time around an operation”—specifically the preoperative, postoperative, and intraoperative times. Inexperienced anesthesiologists may only contemplate a recipe of anesthesia drugs, instead of seeing his or her role as the management of the patient’s medical problems prior to, during, and after surgery.

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The Anesthesia Consultant

JUNE 18, 2019

Data exists that intravenous caffeine may be effective in assisting the awakening of patients following general anesthesia. Will a shot of IV espresso be the stimulus for you to return to consciousness after your general anesthetic? I tried it on several of my patients who had prolonged awakening after general anesthesia.

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The Anesthesia Consultant

JULY 12, 2021

Vigilance regarding a sleeping patient’s vital signs was always paramount, but the constant effort to be vigilant could be mind-numbing. Anesthesiologists could chat with the surgeons and/or nurses, make an occasional phone call, and at times read materials they brought with them into the operating room.

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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 patient enters the operating room at 0730 hours. The patient consents.

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The Anesthesia Consultant

MARCH 28, 2024

The brain, encased in the dura, is freed from the cranial vault and base, and a robotic scoop with retractable tines would be brought into the operating field. The patient is expected to emerge from post-transplant-induced anesthesia with cranial nerve function already present or rapidly recovering.

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The Anesthesia Consultant

OCTOBER 8, 2019

The most invasive type of airway tube used in anesthesia is called an endotracheal tube, or ET tube. At the onset of general anesthesia anesthesiologists place an ET tube through the mouth, past the larynx (voice box), and into the trachea (windpipe). The patient’s vital signs remained normal and the ET tube was removed.

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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. Potent inhalation anesthesia (sevoflurane). What do you do?

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The Anesthesia Consultant

OCTOBER 11, 2020

Perioperative” means “around the time of operations.” An anesthesia machine, with the vital signs monitor screen on the left, and the electronic medical records computer screen on the right. IN THE OPERATING ROOM: Mr. Doe will be asleep for the surgery, and Dr. A will be present the entire time. The BP is 100/50.

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The Anesthesia Consultant

AUGUST 7, 2017

Anesthesiologists work in operating rooms and intensive care units—acute care settings which demand vigilance, steady hands, and quick thinking. These arenas will be: 1) diagnosis of images, 2) clinics, and 3) operating rooms/intensive care units. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

JUNE 15, 2022

Morton performed the first public demonstration of general anesthesia at Harvard’s Massachusetts General Hospital on October 16, 1846. The patient was fully conscious during the operation. Comment: Dr. Bier was the father of regional anesthesia, an important tool in the repertoire of a modern anesthesiologist.

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The Anesthesia Consultant

SEPTEMBER 6, 2019

I don’t tout myself as an expert in AI technology, but I am an expert in taking care of patients, which I’ve done in clinics, operating rooms, intensive care units, and emergency rooms at Stanford and in Silicon Valley for over 30 years. Operating rooms: Anesthesia robots fall into two groups: manual robots and pharmacological robots.

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The Anesthesia Consultant

NOVEMBER 28, 2017

You believe the patient is high risk in terms of his airway, his breathing, his cardiac status, and his potential for post-operative complications. Propofol infusions are typically used to make our patients sleep, and most propofol infusions cross the American Society of Anesthesiologists line into general anesthesia.

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The Anesthesia Consultant

MAY 2, 2023

Louis Imagine this: You’re an anesthesiologist in the operating room at a busy hospital. 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.

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The Anesthesia Consultant

NOVEMBER 4, 2021

On physical exam, her vital signs are normal, her lungs are clear, and her heart exam is positive for the clicking sound of a mechanical valve and a 2/6 systolic murmur. The surgeon says he will only need to operate for 15 minutes. Vital signs remain normal with BP=110/70, P=80, and oxygen saturation=99%.

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The Anesthesia Consultant

JUNE 12, 2023

INTRAOPERATIVE DECISION A 60-year-old man with a history of hypertension is having a knee arthroscopy surgery under general anesthesia. The surgical team will be assembled, and the child will be transferred to the operating room for further assessment and management. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

FEBRUARY 6, 2019

In an anesthesia care team, a physician anesthesiologist supervises up to four operating rooms and each operating room is staffed with a certified registered nurse anesthetist (CRNA). In a university hospital, a faculty member may supervise two operating rooms each with a resident anesthesiologist-in-training in attendance.

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Radius Anesthesia

MAY 17, 2023

For cancer patients undergoing surgery, regional anesthesia and general anesthesia with propofol should be favored, while volatile agents should not be used in order to prevent cancer patients from perioperative immunosuppression that can increase the risk of cancer recurrence. Anesthesia and radiotherapy suite.

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The Anesthesia Consultant

APRIL 4, 2021

His vital signs are normal, and his oxygen saturation is 96% on room air.You are six months out of anesthesia training and new to this hospital. The surgeon—a 60-year-old male with the brash confidence of General Patton—is an iconic and respected figure at this medical center.

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The Anesthesia Consultant

FEBRUARY 23, 2018

The remaining operating rooms would proceed without oximetry. The situation was better at Stanford University Hospital, where each operating room included a pulse oximeter—but there were no oximeters in the PACUs, preoperative units, or intensive care units. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

JUNE 27, 2017

Then he injects her IV with a syringe of adrenaline, and leaves the vital signs monitor on. The vital signs monitor shows her heart rate suddenly change to zero as she dies. The vital signs monitor continues to emit a soft high-pitched tone, but there’s no one else around to hear it. You can relax.

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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. At this point my work began. We’d climb in and ride at top speed back to Stanford. At this point I went home.

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Anaesthesia News

FEBRUARY 29, 2024

Sympathetic stimulation occurs secondary to surgical stress, general anesthesia, hypoxia, hypotension, pain, severe bleeding, and strenuous exercise. Blood volume status may be estimated by comparing body weight before and after hemodialysis and measuring vital signs with particular attention to orthostatic hypotension or tachycardia.

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The Anesthesia Consultant

MAY 23, 2023

Fentanyl was introduced in the 1960s when it was first patented under the brand name Sublimaze , and fentanyl quickly became the most commonly administered narcotic by anesthesia providers. In operating room anesthesia, the narcotic fentanyl is a clear liquid usually marketed in vials of two milliliters or five milliliters.

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The Anesthesia Consultant

SEPTEMBER 1, 2017

The study analyzed the United States Anesthesia Closed Claims Project database of 10,546 malpractice claims between 2001-2013. 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. Be extra wary when attending to obese patients.

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The Anesthesia Consultant

AUGUST 16, 2018

His preoperative vital signs were normal with an oxygen saturation of 98%. Anesthesia was induced with propofol 250 mg, fentanyl 100 micrograms, and rocuronium 50 mg IV. His preoperative vital signs were normal. 4 This patient had head and neck surgery, and was at risk for post-operative airway problems.

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The Anesthesia Consultant

APRIL 8, 2025

You learn to inject propofol and intubate a patient in the first few months, but its a lifetime journey to master the medical aspects of evaluating and treating the heart, lungs, brain, kidneys and vital signs during anesthesia care. The goal is to be a perioperative (around the time of operation) doctor, not a technician.

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The Anesthesia Consultant

JANUARY 6, 2025

Electronic Medical Records (EMR) in the operating room. In the 1990s we were documenting all anesthesia care with pen on paper. Today hospital anesthesia medical records are recorded into computer software. Why Did Take Me So Long To Wake From General Anesthesia? Will I Have a Breathing Tube During Anesthesia?

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The Anesthesia Consultant

MARCH 2, 2020

Can an anesthesia machine in an operating room be used as an ICU ventilator? An operating room can be converted into an ICU room with the anesthesia machine ventilator keeping the patient alive. Why Did Take Me So Long To Wake From General Anesthesia? Will I Have a Breathing Tube During Anesthesia?

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The Anesthesia Consultant

FEBRUARY 3, 2022

. * * Here’s the Anesthesia Consultant analysis of the medical circumstances in The Rescue : In an operating room, anesthesia is typically delivered as a gas (e.g. Neither gas anesthesia nor intravenous anesthesia is possible in an underwater cave rescue. Why Did Take Me So Long To Wake From General Anesthesia?

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