Depth of Anesthesia

Depth of Anesthesia is a podcast that critically explores dogmatic practices (we call them claims) in anesthesiology. Join us as we explore the literature around the latest clinical controversies!

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Episodes

10: Is a subjective assessment of functional capacity predictive of perioperative complications?

We investigate the claim that a subjective assessment is an accurate way to measure functional capacity. We also explore whether self-reported ability to climb two flights of stairs is the best subjective method to assess functional capacity and whether exercise tolerance greater than or equal to 4 metabolic equivalents predicts the risk of perioperative complications in any major non-cardiac surgery. Our guests today are Dr. Elisa Walsh and Dr. Laurie Shapiro of the Massachusetts General Hospit...

Nov 22, 2019•29 min

9: Is it safe to peripherally administer norepinephrine?

We investigate the claim that norepinephrine is not safe for peripheral administration. Our guests today are Dr. Katarina Ruscic and Dr. Jamie Sparling of the Critical Care Division of the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com . Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References Cardenas‐Garcia J, Schaub ...

Oct 11, 2019•46 min

8: Does ketorolac increase the risk of bleeding?

We investigate the claim that administering ketorolac (Toradol) increases bleeding and should be avoided in surgeries for which there is concern for bleeding. Claim 1. Administration of intraoperative ketorolac increases the bleeding time due to platelet inhibition Claim 2. Increased bleeding time translates to higher rate of surgical bleeding Claim 3. The magnitude of bleeding propensity attributable to ketorolac is clinically relevant Our guest today is Dr. Jamie Sparling of the Critical Care ...

Sep 20, 2019•35 min

7: How do you reverse neuromuscular blockade? - Part 1 of 2

We investigate claims about reversal of neuromuscular blockade. Claim 1. Location of train-of-four assessment matters Claim 2. Train-of-four is unnecessary with "sufficient" time from the last dose Claim 3. Fade can be discriminated by tactile assessment Our guest today is Dr. Daniel Saddawi-Konefka of the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com . Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please ra...

Aug 19, 2019•30 min

6: Is the sniffing position optimal for viewing the glottic opening?

We investigate the claim that the sniffing position aligns the "axes" and is the optimal position for viewing the glottic opening. Our guest is Dr. Keith Baker, Vice Chair for Education and a thoracic anesthesiologist at the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com . Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- R...

Jul 29, 2019•31 min

5: Do preoperative anxiolytics improve patient satisfaction?

We investigate pro and con positions on preoperative anxiolytics. Pro claim: Preoperative anxiolytics improve patient satisfaction. Con claim: Preoperative anxiolytics delay recovery and discharge. My guest is Dr. Matthew Vanneman, an attending cardiothoracic anesthesiologist at the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com . Recommend a guest or topic at depthofanesthesia@gmail.com or tweet us @DepthAnesthesia. Rate us on iTunes. -- References C. Boncyk,...

Jul 24, 2019•32 min

4: Is it safe to administer cefazolin in penicillin-allergic patients?

We investigate the claim that an alternative antibiotic to cephalosporins (e.g., cefazolin) should be selected for penicillin-allergic patients in the perioperative setting. Claim 1. Alternative antibiotics may be as efficacious in preventing surgical site infections Claim 2. Cephalosporins (e.g., cefazolin) may be unsafe due to cross-reactivity. Claim 3. Administering cephalosporins (e.g., cefazolin) may be against the standard of care. My guest this week is Dr. Matthew Vanneman, an attending c...

Jun 04, 2019•55 min

3: Does morphine cause more nausea than hydromorphone?

We investigate the claim that morphine causes more nausea than hydromorphone. My guest is Dr. Daniel Saddawi-Konefka, program director of the Anesthesia Residency Program at Massachusetts General Hospital. Full show notes available at depthofanesthesia.com . Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References Felden L, Walter C, Harder S, Treede RD, ...

May 16, 2019•24 min

2: Is it necessary to confirm mask ventilation before paralyzing?

We investigate the claim that mask ventilation should be "checked" or "confirmed" before administering paralytics. My guest is Dr. Daniel Saddawi-Konefka, program director of the Anesthesia Residency Program at Massachusetts General Hospital. Full show notes available at depthofanesthesia.com . Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References Chin...

May 02, 2019•36 min

1: Welcome to Depth of Anesthesia!

This is a podcast exploring the depth of our critical thinking around clinical practices. Anesthesia is full of claims. A claim is a practice decision that we either believe is true or is something we default to. We think that for every claim in anesthesia, we should know what is supported or refuted by evidence and what claims have no evidence base but “stand to reason”. We hope you start to see these claims and become less satisfied not knowing what you don’t know. -- Full show notes available...

Apr 27, 2019•1 min

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