The Anesthesia Consultant

FEBRUARY 16, 2021

Anesthesia is not the career for you if you like to sleep late—surgery always begins at 0730 hours). The first surgery today is a procedure devised to treat obstructive sleep apnea, a procedure called a maxillary-mandibular osteotomy. The surgery will take approximately three hours. I’ll remove the tube when you wake up.

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The Anesthesia Consultant

MARCH 31, 2015

A hard copy of the Emergency Manual of Cognitive Aids for Perioperative Critical Events hangs in the central operating room hallway at the surgery center in Palo Alto where I am the Medical Director. The most popular posts for laypeople on The Anesthesia Consultant include: How Long Will It Take To Wake Up From General Anesthesia?

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The Anesthesia Consultant

JUNE 26, 2022

All physician anesthesiologists graduate from medical school, where they rotate through clerkships in surgery, pediatrics, obstetrics-gynecology, internal medicine, emergency medicine and psychiatry, as well as electives in surgical or medicine subspecialties of their choice. The answer: internal medicine. What is Perioperative Medicine?

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The Anesthesia Consultant

MAY 22, 2018

I stay with the child until the anesthetic depth has dissipated, the breathing tube is removed, and the child is awake and safe with the recovery room nurse in the Post Anesthesia Care Unit. Your reward for becoming a doctor will arrive years later, when you feel what I feel when I reunite parents with their child after surgery.

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The Anesthesia Consultant

JANUARY 30, 2024

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. in the context of what the surgery and the anesthetic medications do to these diseases. It’s a symbiotic relationship.

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The Anesthesia Consultant

MAY 10, 2016

Sugammadex reversal can make the duration of a rocuronium motor block almost as short acting as a succinylcholine motor block, and sugammadex can also eliminate complications in the Post Anesthesia Care Unit due to residual postoperative muscle paralysis. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

JANUARY 19, 2017

Their patients are obtunded on arrival to the Post Anesthesia Care Unit (PACU) after surgery, and they rely on the PACU nursing staff to complete the job of anesthesia wake up. Enjoy your 10 minutes with each patient prior to surgery. Why Did Take Me So Long To Wake From General Anesthesia?

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The Anesthesia Consultant

OCTOBER 18, 2017

You utilize the current multimodal strategies for operating room anesthesia and postoperative pain reduction, including an ultrasound-guided adductor canal block with 0.5% 300 mg of morphine, and a light general anesthetic using 1-1.5% The patient does well, and is discharged from the Post Anesthesia Care Unit in excellent condition.

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The Anesthesia Consultant

MARCH 2, 2018

Prior to surgery your patient tells you, “I always get a hangover after general anesthesia. Listen to them and adjust your care. Hangover after general anesthesia (HAGA) describes a patient who has a safe general anesthetic, but who then feels hungover, sedated, and wasted for a time period exceeding two hours afterwards.

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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 anesthesiologist meets the patient prior to the surgery, reviews the chart, and examines the patient.

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The Anesthesia Consultant

NOVEMBER 28, 2017

You’re wrong to cancel his surgery.” You believe the patient is high risk in terms of his airway, his breathing, his cardiac status, and his potential for post-operative complications. Just do MAC (Monitored Anesthesia Care) anesthesia for this case, but make sure he’s asleep.

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The Anesthesia Consultant

NOVEMBER 15, 2023

We extended the apnea times of 25 patients with difficult airways who were undergoing general anesthesia for hypopharyngeal or laryngotracheal surgery. I believe many smaller hospitals and outpatient facilities such as ambulatory surgery centers do not own the required equipment.

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The Anesthesia Consultant

NOVEMBER 8, 2022

The patient suffers an acute cardiac arrest fifteen minutes after the induction of general anesthesia. The EMR shows standard of care anesthetic management. A 36-year-old woman is scheduled for emergency surgery at 3 a.m. The patient receives general anesthesia for the case and has a cardiac arrest mid-surgery.

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The Anesthesia Consultant

MAY 2, 2023

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. A press article describing the ACT states: “Surgery is a big insult to the human body. A lot can go wrong.

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The Anesthesia Consultant

OCTOBER 11, 2020

Anesthesiologists are responsible for your medical care before, during, and after surgeries. Today I’ll walk you through an example anesthetic which shows how an anesthesiologist approaches the challenges of a difficult surgical problem: emergency non-cardiac surgery in a patient with heart disease.

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The Anesthesia Consultant

MAY 4, 2016

If a patient suffers a bad outcome after anesthesia, did the anesthesiologist commit malpractice? If there was an anesthesia error, was it anesthesia malpractice? There are risks to every anesthetic and every surgery, and if a patient sustains a complication, it may or may not be secondary to substandard anesthesia care.

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The Anesthesia Consultant

AUGUST 17, 2020

As the surgery is ending, her blood pressure skyrockets to 220/160 and her pulse rate rises to 165 beats per minute. She is resuscitated and transferred to the Intensive Care Unit (ICU). This hampers care improvement. At a smaller facility such as a surgery center, Adverse Event Reports are filed on paper forms.

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The Anesthesia Consultant

NOVEMBER 15, 2018

Its original primary use was as an anesthetic for cardiac surgery. I practiced cardiac anesthesia from 1985 until 2000. In the 1980s, cardiac anesthesia was achieved by high dose narcotic techniques, specifically with high dose fentanyl (100 micrograms/kg) techniques. Intravenous sufentanil was FDA-approved in 1984.

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The Anesthesia Consultant

APRIL 8, 2025

Youre a physician who must become expert in all aspects of medical care before, during, and after a surgical procedure. When emergencies or complications occur in anesthesia care during induction, during surgery, or after surgery, always think Airway-Breathing-Circulation in that order.

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The Anesthesia Consultant

NOVEMBER 25, 2024

A recent study, “Hormonal basis of sex differences in anesthetic sensitivity,” published in 2024 in the journal Neuroscience , presented data that females recover from general anesthesia faster than males. Wasilczuk from the Department of Anesthesiology and Critical Care at the University of Pennsylvania led the study.

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