Psychological Therapies Can Reduce Pain Catastrophizing After Breast Cancer Surgery Anesthesiology News
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Category Archives: Anesthesiology
How Some Hospitals Joined Forces to Reduce Anesthesia-Related Emissions – Anesthesiology News
How Some Hospitals Joined Forces to Reduce Anesthesia-Related Emissions Anesthesiology News
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How Some Hospitals Joined Forces to Reduce Anesthesia-Related Emissions - Anesthesiology News
Hospitals with higher ratio of female surgeons, anaesthetists have better patient outcomes: Study – University of Toronto
Greater sex diversity in hospital anaesthesia-surgery teams is associated with better post-operative outcomes for patients, according to a study fromICES,Sunnybrook Research Instituteand the University of Toronto.
The study, published in theBritish Journal of Surgery, found that teams with more than 35 per cent female anesthesiologists and surgeons were associated with a three per cent reduction in odds of post-operative complications in the three months following surgery.
This is one of the first studies to focus on sex diversity of operating room teams, building on past work that has compared the impact of individual surgeon and anesthesiologist characteristics on patient outcomes.
We wanted to challenge the binary approach of comparing female and male clinicians and rather highlight the importance of diversity as a team asset or bonus in enhancing quality care, sayslead authorJulie Hallet, a scientist with ICES and Sunnybrook Research Institute, and associate professor ofsurgeryat U of Ts Temerty Faculty of Medicine.
The study includes population-based, health-care data on 709,899 adult patients undergoing major in-patient surgeries in Ontario between 2009 and 2019.
Sex diversity of surgical teams was defined as the percentage of female anesthesiologists and surgeons among all anesthesiologists and surgeons working in the hospital each year. The primary outcome was 90-day major morbidity, which the researchers analyzed with a standardized classification scale to identify severe post-surgical complications.
The findings showed that reaching a critical mass of more than 35 per cent female anesthesiologists and surgeons was linked to lower odds of severe complications.
The association between greater sex diversity and reduced post-surgical complications was even greater for patients treated by female anesthesiologists and female surgeons which aligns with previous studies comparing outcomes of male to female surgeons.
These results are the start of an important shift in understanding the way in which diversity contributes to better quality care around the time of surgery, says Hallet. Ensuring a critical mass of female anesthesiologists and surgeons in operative teams is crucial to performance. Below a critical mass, female clinicians may withhold their perspectives, such that the benefits of diversity can only be achieved once minimum representation is reached.
One limitation of the study is that the data did not include gender as a social construct. It is possible that gender roles, behaviours and attitudes would have influenced the strength of the association.
The studys authors noted further research is also needed to explore diversity based on other sociodemographic variables, including but not limited to race and ethnicity.
Nevertheless, this study is the first to show a robust positive association between team sex diversity, patient outcomes and quality care.
We hope that these results will encourage hospitals to intentionally foster sex diversity in operating room teams to reduce poor health outcomes, which, in turn, can improve patient satisfaction and promote sustainability of health systems,saysGianni Lorello, staff anesthesiologist atToronto Western Hospital, University Health Network and an associate professor in Temerty Medicinesdepartment of anesthesiology and pain medicine.
Ensuring sex diversity in operative teams will require intentional effort for recruitment and retainment policies for female physicians, structural interventions such as minimum representation on teams, and monitoring and reporting of teams composition to build institutional accountability in existing systems. The research was supported by the Sunnybrook Alternate Funding Plan Innovation Fund.
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Anesthesiology house officers present research at GME Symposium – University of Nebraska Medical Center
Anesthesiology residents and fellows presented their research including both poster and oral formats at the sixth annual Graduate Medical Education Research Symposium on Monday, April 22.
The symposium provides the opportunity for house officers to present their research in all areas, including clinical outcomes, basic science, education, business, health policy and humanities.
Peter Ricci Pellegrino, MD, PhD, received an award for his oral presentation on Sympathetic Vasomotion Correlates With the Magnitude of Hemorrhage in Conscious Rabbits.
Chandra Are, MBBS, the UNMC College of Medicines associate dean of Graduate Medical Education, said close to 120 research abstracts were presented at the event, nearly 50 more than when the symposium first premiered in 2018.
UNMC Department of Anesthesiology presenters at the event included:
Patrick Barone, MD, pediatric anesthesiology fellow Incompatible Batteries With Potential Hazard in MRI Environment
Mark Cheney, MD, critical care anesthesiology fellow Mind the Gap! Unexpected Euglycemic Ketoacidosis in a Case of Apparent Volume Overload
Nate Goergen, MD, PhD, resident NextSTAT: A Low-Cost Lot Based Paging Solution to Request Urgent Help in the or Using Amazon AWS Cloud A Novel, In-House, Rapid Response Solution to a Critical Supply Crisis Affecting Hyperbaric Oxygen Therapy Centers Nationwide Jenkins: An Anesthesia Intra-Op Voice Assistant to Improve Patient Outcomes and Situational Awareness in the OR
Peter Ricci Pellegrino, MD, PhD, pain medicine fellow Sympathetic Vasomotion Correlates With the Magnitude of Hemorrhage in Conscious Rabbits
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Anesthesiology resident inducted into the Alpha Omega Alpha Medical Honor Society – University of Nebraska Medical Center
Theodore (Teddy) Black, MD, a UNMC Department of Anesthesiology resident, was inducted into the Alpha Omega Alpha Medical Honor Society in April.
Founded in 1902,Alpha Omega Alpha is dedicated to the belief that in the profession of medicine, we will improve care for all by:
Members may be elected throughout their career and epitomize professionalism, leadership, academic and clinical excellence, research, community service and being worthy to serve the suffering.
Incoming resident Mariah Tessin, MD, also received an award for her senior honors thesis titled, The Role of RASP Inhibitors in Preventing MAA-Modified Proteins from Initiating Pro-inflammatory Cytokines in Macrophages.
I am incredibly grateful to have found a research environment that provides me with the opportunity to navigate the entire research process from start to finish, Dr. Tessin said. It is an honor to have my thesis recognized by AOA.
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Debating Anesthesia’s Role, Responsibility in Reducing Its Environmental Impact – Anesthesiology News
Robert Stephens MD Spotlights Anesthesiologists’ Role in Patient-Centered Care – openPR
In an extensive feature published by the San Francisco Post Dr. Robert Stephens, MD, discusses the vital role of anesthesiologists in enhancing patient-centered care within the healthcare system In an extensive feature published by the San Francisco Post Dr. Robert Stephens, MD, discusses the vital role of anesthesiologists in enhancing patient-centered care within the healthcare system. The article titled "Robert Stephens MD Spotlights Anesthesiologists' Role in Patient-Centered Care" explores the comprehensive involvement of anesthesiologists in patient care, from preoperative assessment to postoperative recovery.
Dr. Stephens, a dedicated Anesthesiologist based in Southern California, emphasizes the significant yet often overlooked contributions anesthesiologists make beyond the operating room. "Our job starts long before and goes far beyond the OR," Dr. Stephens explains. "We play a crucial role in patient assessments, where we develop individualized care plans, and continue our care through vigilant intraoperative management and postoperative recovery strategies."
The feature details how anesthesiologists like Dr. Stephens prioritize effective communication with patients to demystify surgical procedures, alleviate anxiety, and enhance patient autonomy in decision-making processes. This approach not only fosters trust but also improves overall patient outcomes.
Further highlighting the multi-faceted role of anesthesiologists, the article discusses their advocacy for patient safety and involvement in implementing best practices across healthcare settings. Dr. Stephens shares insights into the evolution of anesthesiology with innovations such as non-opioid anesthetics and precision medicine, underscoring anesthesiology's pivotal role in the future of patient-centered care.
Dr. Stephens' dedication to the field and his patients is evident as he continues to push for advancements in anesthesiology to better serve patient needs and enhance the quality of care provided. His work and commitment exemplify the critical impact anesthesiologists have on the healthcare system, ensuring that patient well-being remains at the core of medical practice.
The full article can be accessed on the *San Francisco Post* website and is an essential read for healthcare professionals and anyone interested in understanding the integral role of anesthesiology in patient-centered care.
To read the full Article, click here [https://sanfranciscopost.com/robert-stephens-md-spotlights-anesthesiologists-role/].
About Dr. Robert Stephens, MD
Dr. Robert Stephens, MD, is a distinguished Anesthesiologist with over a decade of experience in the field. His dedication to patient care, continuous learning, and contribution to the evolving field of anesthesiology mark him as a leading figure in his profession. Media Contact Company Name: Robert Stephens MD Email: Send Email [http://www.universalpressrelease.com/?pr=robert-stephens-md-spotlights-anesthesiologists-role-in-patientcentered-care] City: San Diego State: California Country: United States Website: https://www.robertstephens.net/
This release was published on openPR.
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Robert Stephens MD Spotlights Anesthesiologists' Role in Patient-Centered Care - openPR
Anesthesiologist in Glenwood Springs charged with 4 counts of unlawful sexual contact – Denver 7 Colorado News
GLENWOOD SPRINGS, Colo. An anesthesiologist in Glenwood Springs has been charged with multiple counts of unlawful sexual contact.
Mark R. Young, 54, of Glenwood Springs, was arrested on three charges of unlawful sexual contact and one charge of unlawful sexual contact of an at-risk person.
On Dec. 20, 2022, officers with the Glenwood Springs Police Department took a report about a potential sexual assault that happened at APEX Ketamine Therapy. A woman reported that after more than two years of ketamine infusion treatments with Young, "he made sexually inappropriate comments and made unlawful sexual contact after administration of her medication on her last visit," the police department said. The department added that in total, five females of unknown ages were victimized in this case.
Following an investigation, an arrest warrant was issued for Young.
Denver 7+ Colorado News Latest Headlines | April 5, 11am
He was booked into the Garfield County Jail on April 1 on the four charges.
The police department said based on a multitude of factors including the location, history and more they are working to talk with anybody else who may have been victimized. Those individuals can call the police department at 970-384-6500.
According to his most recent licensing documentation from the Colorado Department of Regulatory Agencies, he is board certified in anesthesiology. That document reads that he received disciplinary action in 2012 in Colorado and a restriction or suspension in 2023, though the details on both are unknown.
No other details were immediately available.
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What Exactly Is an Anesthesia ‘Cocktail’? – Medpage Today
Anesthesiology resident Max Feinstein, MD, discusses common medications used in anesthesia and their effects.
Following is a transcript:
Feinstein: Anesthesiologists sometimes tell patients that they are getting a "cocktail" of medications prior to their procedure, which can sound mysterious and intriguing, when in reality this cocktail is typically just comprised of a single medication called midazolam.
My name is Max Feinstein and I'm an anesthesiologist filming here at the Mount Sinai Hospital in New York City and in this video I demystify the medications that are administered to patients prior to procedures. If you find this video interesting or helpful, I'd really appreciate it if you liked it and subscribe to the channel. Let's dive in.
Before we get too far, just a quick reminder that this video does not contain medical advice; it's just a YouTube video. If you need medical advice, you should talk to your doctor.
Midazolam has several very important properties, which are why anesthesiologists use it. The first of those properties is anxiolysis, which is just a way of saying that it can reduce a person's anxiety. This is, of course, very helpful coming into the operating room if a person is nervous about getting surgery, which is very often the case for understandable reasons.
Another useful property of midazolam is that it can cause anterograde amnesia, meaning that patients won't remember anything after they have received the medication. There is an important distinction between anterograde amnesia, which means not remembering something after the medication has been administered, versus retrograde amnesia, which means not remembering something prior to the medication being administered. Midazolam only causes anterograde amnesia, and even then it doesn't necessarily cause amnesia in all patients. It can depend on the dose of medication that's given as well as patient factors like how much they weigh and whether they consume alcohol, which can have cross-tolerance with midazolam.
Midazolam can be used as a primary anesthetic in cases of light or moderate sedation where the goal is to have the patient still conscious and breathing on their own, but just very relaxed. Midazolam is also used frequently as a precursor to general anesthesia where a patient is completely unconscious and not aware of anything that's going on at all. The amount of midazolam that would need to be administered to produce a depth of general anesthesia is impractical in most cases, and so for that reason when patients do receive general anesthesia, there are other agents that are used such as propofol and sevoflurane.
In a small number of cases, there are other medications that can be administered either in lieu of or in conjunction with midazolam. One of those medications that anesthesiologists sometimes reach for is an opioid called fentanyl, which is also short-acting. Generally speaking, anesthesiologists like to reach for short-acting medications because that can help us maintain fine control over physiologic parameters like heart rate, blood pressure, and respiratory status.
When we do include fentanyl as part of the anesthesia cocktail, that's typically because the patient might be in pain and that might be the reason that they are coming in for surgery, for example, if they broke a bone. Anesthesiologists do have to use caution when mixing midazolam with opioids because together those can cause significant amount of respiratory suppression. If the plan is for the patient to undergo general anesthesia, where they're going to be intubated and mechanically ventilated, then respiratory suppression is kind of a moot point, but it is very important for patients to be able to breathe on their own in the time period immediately prior to undergoing general anesthesia.
Another medication that can be used as part of the anesthesia cocktail is a very low dose of propofol, which when given in 10 or 20 mg increments, won't produce general anesthesia in an adult but will actually just produce anxiolysis and perhaps a bit of amnesia. Having said that, propofol can irritate the vein where it's injected, which can be a reason to avoid giving more propofol to an awake patient than they need.
When I mentioned that midazolam is fast-acting, I mean onset can be 2 minutes or less when given through the IV. It typically won't last for more than an hour, although again that also varies depending on the patient. For adult patients, midazolam is typically administered through an IV, which is placed of course while the patient is completely awake. But for pediatric patients who won't tolerate having an IV placed while they are awake, then we can actually administer an oral form of midazolam, but it has a longer time of onset closer to around 20 minutes or so, again depending on the dose and the patient.
One of the common misconceptions around the anesthesia cocktail is that it's a sort of truth serum that causes patients to just blurt out their deepest darkest secrets. In reality, midazolam typically just causes patients to feel relaxed, chill out, maybe giggle a little bit about things that otherwise aren't that funny, and only extremely rarely do patients become disinhibited enough to start saying things that perhaps they wouldn't have said prior to receiving midazolam.
David: I... I feel funny. Is this going to be forever?
Feinstein: But honestly, I have never had a patient actually disclose anything really that embarrassing while they have been under the effects of midazolam or any other anesthetic agent. It's pretty uncommon.
I mentioned that some patients don't remember much, or anything, after they receive midazolam and I think it's really important for anesthesiologists to make patients understand that that may or may not happen once the medication goes in. Expectation setting is a really important part of the patient experience after all.
By the same token, I think it's very important for anesthesiologists to tell patients when they are receiving midazolam or any other medication that's going to change the way that they feel. I don't think it's really fair to surprise patients with medications through their IV without first telling them that they are about to get something that will change the way they feel. While the vast majority of patients who receive midazolam will feel pretty chilled out, there is a small proportion of patients who have what's called a paradoxical reaction where they become hyper-energetic after receiving the medication.
David's Dad: Stay in your seat.
David: [OUTBURST]
Feinstein: If you're a patient watching this video and you're wondering will you receive midazolam or any other medication as part of the anesthesia cocktail before your procedure, the answer is it depends.
Certain aspects of anesthesia practice can vary pretty considerably depending on factors like who your anesthesiologist is, what procedure you're coming in for, what medications and monitoring are available for patients prior to going into the operating room, and so forth. For these reasons, it wouldn't be surprising to me to know that a patient who is coming in for, say, a laparoscopic appendectomy at a certain hospital would probably not be offered midazolam unless there were extenuating circumstances. Whereas a different hospital that has different practice norms would routinely offer midazolam to patients who are coming in for the same procedure.
I do think this variation in practice begs an important philosophical question about the involvement that patients have with regard to the specific medications that they get for their anesthesia and also the extent to which anesthesiologists are involving patients in the decision about what medications will be administered.
On the one hand, I think there is a lot of benefit for anesthesiologists and their patients to have an open conversation about what medications will be administered and why, but then on the other hand that's also not entirely feasible, especially if a patient is under general anesthesia. And there is also an argument to be made for the fact that it can be overwhelming for patients to have to make medical decisions about the specifics of exactly what they are receiving as part of their anesthetic plan that might overall make the experience more anxiety-inducing than it needs to be, as opposed to simply leaving the decisions to the anesthesiologist about how best to produce the outcome that the patient desires, for example, feeling relaxed or being completely unconscious for a procedure.
If you are a patient and you do have any questions or concerns about any part of your anesthesia plan, then it's important to bring it up with your own physician before you undergo your procedure.
Max Feinstein, MD, is a PGY-4 anesthesiology resident at the Mount Sinai Hospital in New York City, where he is also chief resident of teaching. His YouTube channel focuses on perioperative medicine, especially the role of the anesthesiologist.
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