Yale Anesthesiology

In this episode, Dr. Yavor Metodiev delves into the anesthetic considerations that should be taken when caring for a patient with oncological disease during pregnancy. Dr. Metodiev and colleagues concisely summarize the complexities of treating patients with oncological disease, emphasizing the crucial balance between maternal and fetal safety. With the increasing incidence of oncological disease...

In this episode, Dr. Blake Mergler, Dr. Reid Mergler, and Dr. Caoimhe Duffy examine the crucial role of anesthesiologists in recognizing and addressing trauma during labor. Their thorough narrative review highlights the importance of trauma-informed care, which shifts the focus from “what is wrong with the patient” to “what has happened to the patient.” The trio discusses how anesthesiologists can...

In this episode, we explore the concept of a highly functional team, its characteristics, and the importance of fostering interdisciplinary teamwork among healthcare professionals such as anesthesiologists, obstetricians, nurses, and others. Dr. Girnius emphasizes that such collaboration enhances communication and efficiency and improves patient outcomes. Additionally, we discuss the process of id...

In this episode, we discuss the importance of following intravenous access recommendations for cesarean deliveries with Dr. Scott Seki at his institution. How do Dr. Seki and his colleagues define adequate intravenous access? Which patients are more or less likely to receive the recommended IV access? What are the patient implications if we fail to provide the recommended IV access? These are some...

In this episode, Dr. Landau, a renowned expert and researcher in the topic of pain, delves into the evolution of our understanding of this topic. We explore how the research and its definition have changed over the past few decades. Additionally, we discuss her study titled “Pain during cesarean delivery: a patient-related prospective observational study assessing the incidence and risk factors fo...

In this episode, Dr. Mark I. Zakowski delves into the pressing issue of pain during cesarean delivery. During our interview, we explore how our societies (ASA and SOAP) are collaborating to provide practitioners with valuable insights into managing this problem that affects approximately 15-20% of cesarean delivery patients. The ASA approved the “Statement on Pain during Cesarean Delivery” from th...

Dr. Allana Munro and Dr. Ronald George are two obstetric anesthesia experts whose research is focused on labor analgesia. Two years ago, they demonstrated that “achieving desired pain relief” is of utmost importance to our patients. The question remains: How can we safely achieve this while minimizing workload and side effects? In this episode, they discuss their study titled “An Innovative Approa...

In this episode, Dr. de Carvalho discusses his article, Efficacy and safety of ultrasound-guided versus landmark-guided neuraxial puncture: a systematic review, network meta-analysis and trial sequential analysis of randomized clinical trials. Dr. de Carvalho’s work reiterates that using ultrasound-guided neuraxial anesthesia results in a more efficient neuraxial placement. Ultrasound-guided...

In this episode, Dr. Lawrence Tsen discusses the findings of his paper on Labor Analgesia Initiation with Dural Puncture Epidural (DPE) Versus Conventional Epidural Techniques. The paper presents a randomized biased-coin sequential allocation trial to determine the effective dose for 90% of patients of Bupivacaine. We explore the benefits of using the DPE technique, if any, along with criticisms f...

In this episode, Dr. Holly Ende discusses her article, Implementation of an Epidural Rounding Reminder in the Electronic Medical Record Improves Performance of Standardized Patient Assessments during Labor. Dr. Ende’s work underscores the necessity of regular assessments of the effectiveness of neuraxial labor analgesia. This proactive approach is crucial for the timely identification of mal...

In this episode, Dr. Rachel Kearns discussed the findings from her study -Epidural analgesia during labour and severe maternal morbidity: population-based study. This study solidifies that anesthesiologists bring more to the table than “just” labor pain management. Epidural analgesia during labour and severe maternal morbidity: population-based study. https://www.bmj.com/content/385/bm...

In this episode, Dr. Vishal Uppal and Allana Munro discussed with us the findings from their study -The Incidence and Predictors of Failed Spinal Anesthesia After Intrathecal Injection of Local Anesthetic for Cesarean Delivery: A Single-Center, 9-Year Retrospective Review. https://pubmed.ncbi.nlm.nih.gov/37014966/ Anesthesia-Related Maternal Mortality in the United States: 1979–2002 https://pubmed...

In this episode, Dr. Allison Mootz, an obstetric anesthesiology fellow at Brigham and Women, discusses her thought-provoking article titled- The Accuracy of ChatGPT-Generated Responses in Answering Commonly Asked Patient Questions About Labor Epidurals: A Survey-Based Study. https://pubmed.ncbi.nlm.nih.gov/38180897/ Comparing Physician and Artificial Intelligence Chatbot Responses to Patient Quest...

In this episode, Dr. Ron George provides a tour de force of our past and present labor analgesia management. We discuss his recent publication, Modern Labor Epidural Analgesia: Implications for Labor Outcomes and Maternal-Fetal Health. https://pubmed.ncbi.nlm.nih.gov/37164496/ The Most Influential Publications in Obstetric Anesthesiology, 1998–2017: Utilizing the Delphi Method for Expert Consensus...

In this episode, Dr. David Bishop, a Specialist Anesthesiologist and Head of the Clinical Unit of Anaesthesia at Edendale Hospital in Pietermaritzburg talks about a vital topic and his recent publication, Tranexamic acid at cesarean delivery: drug-error deaths. Tranexamic acid at cesarean delivery: drug-error deaths https://pubmed.ncbi.nlm.nih.gov/36300729/ Spinal tranexamic acid – a new kil...

In this episode, Dr. Thomas Klumpner, whose research interests involve using technology to detect childbirth complications before they become life-threatening, discusses with us his research titled: Use of a Novel Electronic Maternal Surveillance System and the Maternal Early Warning Criteria to Detect Severe Postpartum Hemorrhage Use of a Novel Electronic Maternal Surveillance System and the Mate...

In this episode, Dr. Vishal Uppal, whose primary research interests are improving the safety and efficacy of regional anesthesia techniques in high-risk patient populations, discussed his article Consensus Practice Guidelines on Postdural Puncture Headache From a Multisociety, International Working Group: A Summary Report. Consensus guidelines https://pubmed.ncbi.nlm.nih.gov/37581893/ Atypical hea...

In this episode, Dr. Tracey Vogel, an obstetric anesthesiologist who is very well-versed in a topic we should all know about, discusses trauma-informed care. What is trauma-informed care, and how can we become a trauma-informed care unit? These and many more questions are addressed during this Podcast. “A service that is not trauma-informed is trauma denied.” Trauma-Informed Care on La...

In this episode, Dr. Mark Rollins and Dr. Chatterjee, two leading experts in anesthesia for maternal-fetal intervention, share their knowledge with us. Specifically, we discussed fetal benefits and preoperative, intraoperative, and postoperative management for this delicate procedure in which two patients are undergoing surgical intervention under our care. Should we provide analgesia directly or...

In this episode, Dr. B Amnon Berger shared the results of his study – Epidural catheter replacement rates with dural puncture epidural labor analgesia compared with epidural analgesia without dural puncture: a retrospective cohort study. Besides, we discussed the benefits of a dural puncture epidural technique and how it differs from the combined spinal-epidural technique. Dr. Ammon study ht...

In this episode, Dr. Grace Lim, Associate professor and the Chief of the Obstetric Anesthesia division at the University of Pittsburgh, whose research is aimed at eliminating pain and suffering in special populations, optimizing perioperative medication use, and personalizing patient care, discussed with us two of her articles related to pain management of patients with and without opioid use diso...

In this episode, Dr. Katrina Furey, a board-certified adult psychiatrist who offers psychotherapy, medication management, and expert consultation for women with depression, anxiety, premenstrual dysphoric disorder (PMDD), perinatal mood and anxiety disorders (including OCD), birth trauma, and menopausal mood and anxiety disorders. Besides, she is part of Access Mental Health for Moms CT. This cons...

In this episode, Dr. Sharon Reale shares with us the results of her study titled Frequency and Risk Factors for Difficult Intubation in Women Undergoing General Anesthesia for Cesarean Delivery: A Multicenter Retrospective Cohort Analysis. As Dr. Reale pointed out during this Podcast, most of the available literature regarding the obstetric airway comes from data outside of the United States. Dr....

In this episode, Dr. Jennifer Dominguez, a leading expert in topics related to morbid obesity, particularly Obstructive Sleep Apnea (OSA), talks with us regarding the importance of early recognition and management of OSA during Pregnancy. To guide our discussion, we conversed regarding the recently published consensus statement titled- The Society of Anesthesia and Sleep Medicine and the Society f...

In this episode, Dr. Pervez Sultan, a leading expert in creating obstetric Patient Reported Outcome Measurements (PROMs), including the validated Obstetric quality of recovery (OBsQoR-10), discusses their future in our field. And let me tell you, their future is PROMising, from using it as a benchmark score to compare amongst institutions to analyzing results between obstetricians and anesthesiolo...