Podcasts about Anesthetic

This podcast was created using NotebookLM. This podcast explores the claim that repeated short-acting nerve blocks can reset central sensitization in chronic pain. Dr. Glenn Clark argues that this idea is unlikely due to the complex neurobiological changes involved in established chronic pain. Research suggests that while nerve blocks can prevent sensitization, they are less effective at reversing it because central sensitization involves receptor modifications, genetic changes, structural remodeling, and glial activation, which are not easily reversed by temporary input blockage. 

Mark Morton Talks Chester Bennington, Solo Album Without The Pain & Lamb Of God's Future On The Loaded Radio Podcast TL;DR: Lamb Of God guitarist Mark Morton joins the Loaded Radio Podcast to talk about his soulful new solo album Without The Pain, collaborating with late Linkin Park frontman Chester Bennington, the creative process in Lamb Of God, and his honest thoughts on both current and former bandmates. Mark Morton Unleashes His Blues-Driven Side With Without The Pain Mark Morton isn't just the riff-slinging guitar beast from Lamb Of God. On this week's episode of the Loaded Radio Podcast, the guitarist pulls back the curtain on his newest solo release Without The Pain, a record steeped in blues, southern rock, and emotional depth. Released via Rise Records, Without The Pain features a diverse lineup of guests, including Cody Jinks, Neil Fallon (Clutch), Grace Bowers, Jason Isbell, Charlie Starr (Blackberry Smoke), and Jaren Johnston (The Cadillac Three). It's a sharp turn from the punishing rhythms of Lamb Of God, yet unmistakably Mark Morton. During the podcast, Morton explains how the album was years in the making, allowing him to fully explore the stylistic roots that shaped his musical identity long before he ever set foot on a metal stage.  Collaborating With Chester Bennington: The Story Behind “Cross Off” One of the most emotionally resonant points of the podcast is Morton's reflection on working with late Linkin Park singer Chester Bennington. The two teamed up on “Cross Off,” a standout track from Morton's 2019 debut solo album Anesthetic. Morton opens up about the power of that collaboration — how Bennington brought a raw intensity to the track, and how the session still resonates with him today. Lamb Of God, Sobriety, And Looking Forward Of course, no conversation with Mark Morton is complete without diving into Lamb Of God. In this episode, he shares honest reflections on the band's internal dynamics — both past and present. Morton touches on his long journey with sobriety, how it's impacted his creative process, and how the band's chemistry continues to evolve after more than two decades of making heavy music together. Morton also hints at what's ahead for Lamb Of God, suggesting that while his solo work is a vital creative outlet, there's plenty of fuel left in the fire when it comes to the band's future output. Listen To The Full Interview Want to hear Mark Morton discuss songwriting secrets, guest collaborations, Lamb Of God's legacy, and his love of southern blues? Hit play on the podcast episode below and get the full story straight from the man himself. FAQ Q: What is Without The Pain by Mark Morton? A: It's Mark Morton's second solo album, exploring blues and southern rock influences with a range of guest musicians. Q: Who features on Without The Pain? A: The album includes appearances by Cody Jinks, Neil Fallon, Grace Bowers, Jason Isbell, Jaren Johnston, and more. Q: Did Mark Morton work with Chester Bennington? A: Yes, on the track “Cross Off” from his first solo album Anesthetic in 2019. Q: Is Mark Morton still in Lamb Of God? A: Absolutely. Morton continues to be a key creative force in Lamb Of God while exploring other musical avenues through solo work. Q: What did he say about Chris Adler? A: Morton remains reluctant to discuss the former Lamb Of God drummer and the reasons behind his departure. Mark Morton Bio Mark Morton is the longtime lead guitarist for the Grammy-nominated groove metal band Lamb Of God. Known for his tight, aggressive riffing and technical solos, Morton has been a core part of the band since its early days as Burn the Priest. Outside of Lamb Of God, Mark has carved out a distinct solo identity that explores blues, southern rock, and deeply personal themes. His 2019 debut solo album Anesthetic featured collaborations with artists like Chester Bennington and Jacoby Shaddix, while his 2025 release Without The Pain leans further into heartfelt, roots-driven territory. Morton is also open about his sobriety and personal growth, often using music as a vehicle for emotional expression. He remains one of heavy metal's most versatile and thoughtful guitarists.

This AI-generated episode of RAPM Focus discusses the May 2024 publication of “Single-bolus Injection of Local Anesthetic, With or Without Continuous Infusion, for Interscalene Brachial Plexus Block in the Setting of Multimodal Analgesia: A Randomized Controlled Unblinded Trial” by Dr. Patrick Rhyner et al.” For anyone facing shoulder surgery, pain management after the procedure is crucial. In this paper, Rhyner et al. question whether or not a continuous infusion of pain medication through a catheter is better than giving a patient a single injection after having shoulder surgery. The paper discusses a multimodal approach of pain management—dethamexazone, magnesium, acetaminophen, and ketorolac. In this study, patients undergoing two common shoulder surgeries—shoulder arthroplasty or arthroscopic rotator cuff repair—were divided into two groups, in which one group received a continuous infusion of medication via catheters, or a single dose of pain relief. Results were measured by how much morphine patients needed through a patient-controlled analgesia pump during the first 24 hours after surgery. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, LinkedIn @ Regional Anesthesia & Pain Medicine, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

Susy and Barbara discuss ways to set up your day when you work alone, and Barbara shares her experiences with doing dentals.  There is a little Brush talk in the beginning of the show, too.

The OMS Foundation Daniel M. Laskin Award recognizes authors of the most outstanding article published in the Journal of Oral and Maxillofacial Surgery during the previous year. The Journal Editorial Board selected “Is Recreational Marijuana Use Associated With Changes in the Vital Signs or Anesthetic Requirements During Intravenous Sedation?”  Disclaimer 

Wes & Erin continue their discussion the 1970 classic “M.A.S.H,” and whether irony ought always to be our anesthetic, when confronted with traumas that are otherwise unspeakable.

If you enjoy these true glitch in the matrix stories, feel free to click FOLLOW before you jump universes. If you have a story you want to submit, email it to DarekWeberSubmissions@gmail.com

It begins with the “stupidest song ever written,” as Robert Altman called it, and ends with a self-referential jab at the very idea of finding comic relief in the tragedy of war. But it is equally unserious, the film “M.A.S.H” seem to suggest, to take seriously the authority of war-making institutions, and their pretense to putting violence in service of an ideal. And so morality succumbs to mockery, love to hedonism, and military rank to the form of authority immanent in the power to save lives. Yet suicide is not in fact painless, if it means robbing others of our presence, or ridding ourselves of the capacities for grief and earnestness. Wes & Erin discuss the 1970 classic “M.A.S.H,” and whether irony ought always to be our anesthetic, when confronted with traumas that are otherwise unspeakable.

Dr. Beckman's International Veterinary Dentistry Institute offers courses in all areas of vet dentistry.    Online & Live Courses for Vets and Techs https://veterinarydentistry.net/    To request an invitation to the VDP Program: https://ivdi.org/    In this episode of The Vet Dental Show, Dr. Brett Beckman, a board-certified veterinary dentist, and Annie Mills, LVT, Dental Technician Specialist (VTS), share tips on preventing hypothermia in patients, managing anesthesia during full mouth extractions, and the role of veterinary technicians in dental charting. This episode also discusses post-op care, the importance of nerve blocks, and using sedation for anxious pets.   Podcast Details Host: Dr. Brett Beckman, DVM, FAVD, DAVDC, DAAPM

New drones inspired by birds that jump for take-off. It's Weird Wednesday and Reggie has orcas that are wearing salmon for hats, the Merriam-Webster's word of the year, and the winner of the Spanish Scrabble Championship who doesn't speak Spanish. Plus, on This Day in History, Dr. Horace Wells and the first use of anesthetic in dentistry. Bird-inspired drone can jump for take-off | ScienceDaily For Orcas, Dead Salmon Hats Are Back in Fashion | Scientific American No, Orcas Probably Aren't Reviving the 'Dead Salmon Hat' Trend, Despite a Viral Photo, Experts Say. Here's Why | Smithsonian There's something fishy about a recent sighting of an orca in a salmon ‘hat' | CNN ‘Polarization' is Merriam-Webster's 2024 word of the year | AP News He won the Spanish Scrabble championships, yet he doesn't speak Spanish | CNN Horace Wells | Biography, Anesthesia, & Facts | Britannica Sponsored by Factor - use promo code coolstuff50 to get 50% off your first box plus free shipping Factormeals.com/50coolstuff Contact the show - coolstuffcommute@gmail.com Learn more about your ad choices. Visit megaphone.fm/adchoices

From episode #407 - This is a rather unfortunate (and funny as all hell) story about the side effects of a general anesthetic.  Give us a follow if you haven't already ~ Jay and Dunc. Want to get in touch? Hit us up, here: https://linktr.ee/notforradio  

In this episode of RAPM Focus, Editor-in-Chief Brian Sites, MD, is delighted to be joined by Alexander Stone, MD, and Kamen Vlassakov, MD, following the April 2024 publication of their original research paper, “Anesthesia Start Time Documentation Accuracy where Peripheral Nerve Block is the Primary Anesthetic.” Understanding the intricacies of billing is crucial for anesthesiologists in all practice settings, not just in private practice. Proper billing practices not only ensure fair compensation for services rendered, but also impact patient care, hospital finances, and overall health care delivery. Anesthesiologists who engage with billing gain a better understanding of health care economics, which is essential for navigating the complex landscape of modern health care. Dr. Stone is a regional anesthesiologist at Brigham and Women's Hospital. He is an assistant professor of anesthesia at Harvard Medical School and Associate Editor of RAPM. Dr. Vlassakov is the chief of the division of regional and orthopedic anesthesiology, as well as the program director of the regional anesthesiology and acute pain medicine fellowship at Brigham and Women's Hospital. He is an associate professor of anesthesia at Harvard Medical School and also an Associate Editor of RAPM. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on X @RAPMOnline, Facebook @Regional Anesthesia & Pain Medicine, and Instagram @RAPM_Online.

In the ever-evolving field of anesthesia, new research constantly reshapes how we approach patient care. In this episode, we explore the compelling findings of a recent systematic review and meta-analysis on the impact of propofol-based total intravenous anesthesia (TIVA) on cancer outcomes.   Here's some of what we discuss in this episode: We'll provide an overview of the study and some of the key findings. The biological underpinnings of propofol's benefits. The preservation of immune function could be a key factor in why propofol is associated with better survival outcomes. Dissecting the findings on recurrence-free survival. A deep dive into propofol's role in lung cancer. Clinical implications and practical considerations. The future of anesthesia and cancer research.   Visit us online: https://beyondthemaskpodcast.com/ The 1099 CRNA Institute: https://aana.com/1099 ***Use coupon code BEYOND1999 to get 20% off through November 2024 Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246 Donate to Our Heart Your Hands here: https://www.ourheartsyourhands.org/donate  Support Team Emma Kate: https://grouprev.com/haloswalk2024-shannon-shannon-brekken

How do we avoid the side effects and potential emergency situations that can be associated with both local anesthetics and vasoconstrictors? What can we do to minimize the risk and manage the emergency situation? Our guest is Dr. David Isen, who runs a dental clinic in Toronto, Canada, Sleep For Dentistry. He has given over 400 presentations around the world on topics related to the management of medical emergencies in healthcare settings, local anesthesia for dentistry and the use of sedation in dentistry.

Cryoneurolysis has rapidly evolved and refined itself as a viable technology for postoperative and chronic pain. Its specifications mean greater efficacy for certain scenarios, and active research means its application is about to enter warp-speed. In this episode of Vital Times, we speak with Dr. John Finneran, of UCSD, who is actively conducting research trials with this technique. Get up to date and get inspired.

PDF Notes for Surgery 101 episode on Basic Anesthetic Drugs: Vasopressors and Inotropes

This is the third and final episode of the series focused on basic anesthetic drugs. In this episode, we will explore vasopressors and inotropes.  After listening to this episode, you will be able to: 1. Outline the role of vasopressors 2. List the 5 main vasopressors used in the OR and their indications 3. Describe the mechanism of action for Phenylephrine, Ephedrine, Norepinephrine, Epinephrine, and Vasopressin  

In this episode, Swetha Prakash will be looking at the vital aspect of maintaining anesthesia, particularly through inhaled agents, as well as emergence from anesthesia. After listening to this episode, you will be able to: 1. Define the goals of the maintenance phase of anesthesia. 2. Define Minimum Alveolar Concentration (MAC) and its use in providing an adequate level of anesthesia. 3. Describe the advantages and disadvantages of volatile anesthetics. 4. Name 5 inhalation anesthetics that can be used and provide a brief description of when each one can be used. 5. Describe the key steps of emergence from anesthesia.

In this episode, Professor Temmermand and Dr. Thomas Baribeault discuss opioid free anesthetic technique, it's importance, and keys for successful implementation in the surgical patient. Dr. Baribeault founded the Society for Opioid-Free Anesthesia (SOFA) which is a non-profit organization dedicated to education and research on opioid-free anesthesia and post-operative pain management.[SPECIAL DOWNLOAD]: Non-Opioid Analgesics Cheat Sheet[FREE DOWNLOAD] FOR THE SRNA: GRAB YOUR FREE SEE/NCE STUDY PLAN HERE [FREE DOWNLOAD] FOR THE RN: GRAB YOUR FREE ICU DRUG CHART HEREFollow us on Instagram at: @Atomic_AnesthesiaCheck out our other free resources at AtomicAnesthesia.comSOFA: https://goopioidfree.com/

Swetha Prakash is a medical student at the University of Alberta. In this  three part series, Swetha will discuss the essential components of general anesthesia and discuss the key medications associated with each one. The goal is to enhance your understanding of the basic drugs administered to surgical patients within the framework of a general anesthetic.  After listening to this episode, listeners will be able to: 1. Describe the 4 components of a general anesthetic 2. List the 3 phases of anesthesia 3. List four medications commonly used as amnestic/hypnotic agents in induction 4. Describe how each induction plan is tailored to the specific patient  

In this episode, we are going to shine the spotlight on a species that doesn't always get the limelight on this podcast: the horse! Horses pose a unique challenge for anesthetists, especially when we turn off the vaporizer at the end of anesthesia and ask these rather large animals to stand up while under the influence of medications designed to cause sedation and muscle relaxation. In equine anesthesia, the recovery period is a time of considerable risk and has been the focus of prolific research, with many studies attempting to pinpoint risk factors that increase the risk of adverse events occurring in the recovery period and identify pharmaceutical protocols and recovery techniques that will mitigate these risks. Lucky for us, we have an exceptional guest joining the podcast to delve into this particularly challenging aspect of veterinary anesthesia. Dr. Stuart Clark-Price is a renowned expert in the field, boasting board certifications in both Large Animal Medicine and Anesthesia, and recently ascended to the role of full Professor of Anesthesia at Auburn University College of Veterinary Medicine. Together, with host Dr. Bonnie Gatson, we'll explore why recovery from general anesthesia poses such a significant challenge for the horse, shed light on the various risk factors that can increase the likelihood of undesirable recoveries, and share evidence-based recommendations for interventions that can enhance the quality of recovery for equine patients.If you like what you hear, we have a couple of favors to ask of you: Become a member of NAVAS for access to more anesthesia and analgesia educational and RACE-approved CE content. Spread the word. Share our podcast on your socials or a discussion forum. That would really help us achieve our mission: Reduce mortality and morbidity in veterinary patients undergoing sedation, anesthesia, and analgesia through high-quality, peer-reviewed education.As a reminder, the ACVAA Annual Meeting is happening in Denver, CO from September 25-27 later this year. Registration rates are discounted for NAVAS members. We hope to see you there! Sign up at https://vetvacationce.com/product/acvaa-annual-meeting-denver-co-2024/Thank you to our sponsor, Dechra - learn more about the pharmaceutical products Dechra has to offer veterinary professionals, such as Zenalpha.If you have questions about this episode or want to suggest topics for future episodes, reach out to the producers at education@mynavas.org.All opinions stated by the host and their guests are theirs alone and do not represent the thoughts or opinions of any corporation, university, or other business or governmental entity.

Dr. Amy Thomson joins us to explore non-anesthetic dentistry and client communication, tackling common fears about anesthesia and the importance of clear language in veterinary care. Learn from her expertise as she and Dr. Andy Roark discuss how to effectively manage cases like Nico, a Chihuahua with good teeth but bad breath on this week's episode of the Cone of Shame Veterinary Podcast. Don't miss these crucial insights that could transform your approach and elevate your practice. Let's get started, gang! LINKS American Veterinary Dental College: https://avdc.org/ Veterinary Dental Forum: https://www.veterinarydentalforum.org/ Amy Thomson IG: https://www.instagram.com/toothy.thomson/ Referenced Obi Vet Course: https://obivet.com/product-category/certificates/ VetHive:https://www.vethive.com Amy Thomson website: https://toothythomson.ca ABOUT OUR GUEST Dr. Amy Thomson, often known as "Toothy," is passionate about teeth! However, it was not always this way—she started her career in small animal practice with very minimal dentistry knowledge. She was fortunate to have a great mentor in her first job, where she learned a lot and her desire to learn more grew. Once she attended her first Veterinary Dental Forum in 2013, she KNEW dentistry was her passion—and became affectionately known as “Toothy Thomson.” With time and support from her family, friends, colleagues, and a big ‘shove' from her mentor, she applied for a dentistry and oral surgery residency and was overjoyed when she matched at the University of Wisconsin-Madison. During her residency, her passion grew not only for dentistry but also for teaching. And because life is always full of surprises, Dr. Thomson found herself at a crossroads in 2020 in the early stages of the pandemic—so she started her own mobile dentistry practice! In addition to working alongside small animal general practice teams, she also became very active online, sharing her knowledge. It has always been important for her to share as much as she can, given it took hundreds of hours and thousands of dollars to obtain the knowledge she did while in general practice. Knowledge she wants to see all veterinary teams have!

Psychedelics are a hot topic in psychiatry today.  They're producing dramatic reversals for patients with severe depression, PTSD, and other mental health conditions. But scientists still have fundamental questions about why these drugs are so effective. For example, is the "trip" even necessary? Some think it is not and are working to design drugs with similar brain chemistry but no psychoactive effects — “Taking the trip out of the drug.” Others suspect that many of the benefits of psychedelics can be attributed to hype and expectation: People expect to get better, so they do. Normally scientists control for placebo using a blinded study where patients don't know if they're getting the real treatment or a sugar pill. But how are you going to do this with mind-altering substances? Patients are probably going to figure out pretty quickly whether they got a sugar cube with or without LSD. Today's guest, Stanford anesthesiologist Boris Heifets, has come up with a particularly clever strategy to tease apart the psychedelic experience, biochemistry, hype and placebo. Listen for the whole story!Learn more:The Heifets Lab at Stanford MedicineDepression, ketamine & anesthesia:Randomized trial of ketamine masked by surgical anesthesia in patients with depression (Nature 2023 - paywall)Ketamine's effect on depression may hinge on hope (Stanford Medicine, 2023)Anesthetic dreams and trauma recovery:Case report 1: dreaming & knife attack (A & A Practice, 2022 - paywall)Case report 2: dreaming & PTSD (American Journal of Psychiatry, 2024)Could anesthesia-induced dreams wipe away trauma? (Stanford Medicine, 2024)Video: Mothers with PTSD following their sons' deaths talk about dreaming of their sons under anesthesia (Heifets Lab, 2024 — content advisory)Related episodes:S1 E1: Psychedelics and EmpathyS3 E3: OCD and KetamineEpisode creditsThis episode was produced by Michael Osborne at 14th Street Studios, with production assistance by Morgan Honaker. Our logo is by Aimee Garza. The show is hosted by Nicholas Weiler at Stanford's Wu Tsai Neurosciences Institute. Thanks for listening! If you're enjoying our show, please take a moment to give us a review on your podcast app of choice and share this episode with your friends. That's how we grow as a show and bring the stories of the frontiers of neuroscience to a wider audience. Learn more about the Wu Tsai Neurosciences Institute at Stanford and follow us on Twitter, Facebook, and LinkedIn.

More and more people are doing research surrounding space health and traumatic injury. Halifax anesthesiologist Dr. Jon Bailey is one of them. Information Morning's Feleshia Chandler tells us about work he's doing to help better manage pain in zero gravity.

In this episode, MS4 Tania Mulherkar will review common anesthetic agents, their properties, usage, and side effects. This is an excellent Step 1 and 2 review!

As the duty anaesthetist you are called down to the antenatal clinic by the obstetric team to see a pregnant woman with achondroplasia who is booked to deliver in your hospital. What are the anaesthetic issues which can arise in this condition? What evidence is there in the literature for the optimal anaesthetic techniques? What will you discuss with this woman and how will you counsel her? Join Declan and I as we discuss the anaesthetic issues of this relatively rare but sometimes challenging condition... References Dumitrascu CI, Eneh PN, Keim AA, Kraus MB, Sharpe EE. Anesthetic management of parturients with achondroplasia: a case series. Proc (Bayl Univ Med Cent). 2023 Dec 20;37(1):63-68. doi: 10.1080/08998280.2023.2261084. PMID: 38173994; PMCID: PMC10761160. Lange, E.M.S., Toledo, P., Stariha, J. et al. Anesthetic management for Cesarean delivery in parturients with a diagnosis of dwarfism. Can J Anesth/J Can Anesth 63, 945–951 (2016). https://doi.org/10.1007/s12630-016-0671-5 15 Ways Pregnancy Is Different For Little People - Good Lay Person Website

In this Care Plan episode, the focus is on thoracotomies, both open and video-assisted, commonly performed for thoracic or cardiovascular issues. The discussion goes into preoperative considerations, emphasizing optimizing patients' respiratory health and utilizing double-lumen tubes for one-lung ventilation (OLV). Detailed insights into the challenges posed by patient positioning, the effects of OLV on pulmonary blood flow, and the significance of hypoxic pulmonary vasoconstriction are covered. Anesthetic considerations, including anesthetic choice and ventilation strategies during OLV, are outlined, along with meticulous postoperative care strategies focusing on pain management and chest tube management.To connect with Rhea and Sachi, check them out on Instagram @crna_scientist and @thecrnaclub. Also, be on the lookout for the launch of their new company featuring basic and clinical science education for the nurse anesthesia community.Support the showTo access all of our content, download the CORE Anesthesia App available here on the App Store and here on Google Play. Want to connect? Check out our instagram or email us at info@coreanesthesia.com

Today Garry and Terry will be focusing on the revolutionary benzodiazepine – remimazolam. In this episode, we unravel the intriguing tales from diverse case studies, exploring the unique applications and benefits of remimazolam in different surgical scenarios. From thyroid surgeries to emergency cardiac procedures, remimazolam emerges as a promising ally in ensuring smoother inductions, minimal postoperative complications, and enhanced patient experiences.   Here's some of what we discuss in this episode: Understanding the mechanism of action behind remimazolam. We talk about the context of intravenous benzodiazepines. How remimazolam's versatility makes it a potential candidate for various clinical scenarios, catering to the unique needs of both procedural sedation and general anesthesia. What have the different case studies taught us? How could the landscape evolve as more research is conducted?   Visit us online and get show resources here: https://beyondthemaskpodcast.com/   Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf   Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

Ketamine prescriptions for chronic pain and mental health are increasing, but what is known about the safety and effectiveness for off-label use? And how are doctors prescribing a drug approved as an anesthetic in clinical settings for outpatient use? Dr. Caleb Alexander returns to the podcast to talk with Lindsay Smith Rogers all about ketamine.

Today we want to unravel the intricate relationship between anticoagulants and regional anesthesia. Join Garry and Terry as they navigate through the delicate balance of benefits and risks associated with these practices. We'll dive into the world of anticoagulation reversal agents, discussing FDA-approved options such as Idarucizumab and Andexanet. So join Garry and Terry as they navigate the complexities of anticoagulants and regional anesthesia, emphasizing the critical role guidelines play in ensuring patient safety in the ever-evolving landscape of anesthetic practices.   Here's some of what we discuss in this episode: The evolving perspectives on NSAIDs, COX-2 inhibitors, and aspirin, emphasizing recent data that challenges initial concerns about spinal hematomas. Neuraxial anesthesia, celebrated for positive outcomes, brings its own set of risks, notably bleeding and hematoma formation. Heparin administration, both subcutaneous and intraoperative, prompts nuanced considerations, ensuring safety in the neuraxial procedure. Insights into thrombolytic therapy, urging caution due to limited clinical data.   Visit us online and get show resources here: https://beyondthemaskpodcast.com/   Get the CE Certificate here: https://beyondthemaskpodcast.com/wp-content/uploads/2020/04/Beyond-the-Mask-CE-Cert-FILLABLE.pdf   Help us grow by leaving a review: https://podcasts.apple.com/us/podcast/beyond-the-mask-innovation-opportunities-for-crnas/id1440309246

RAPM Editor-in-Chief Brian Sites, MD, joins Daniela Bravo, MD, and Julián Aliste, MD, two co-authors of “Randomized clinical trial comparing pericapsular nerve group (PENG) block and periarticular local anesthetic infiltration for total hip artholasty,” first published in February 2023. In this episode, they discuss the explosion of fascia PENG blocks in the past decade. Dr. Bravo is an assistant professor in the department of anesthesiology and perioperative medicine at the University of Chile. She is the co-director of the regional anesthesia and acute pain service. Dr. Julien Alaste is an associate professor at department of anesthesiology and perioperative medicine at the University of Chile. He is the director of the regional anesthesia and acute pain fellowship. *The purpose of this podcast is to educate and to inform. The content of this podcast does not constitute medical advice, and it is not intended to function as a substitute for a healthcare practitioner's judgement, patient care, or treatment. The views expressed by contributors are those of the speakers. BMJ does not endorse any views or recommendations discussed or expressed on this podcast. Listeners should also be aware that professionals in the field may have different opinions. By listening to this podcast, listeners agree not to use its content as the basis for their own medical treatment or for the medical treatment of others. Podcast and music produced by Dan Langa. Find us on Twitter @RAPMOnline. #PENGblock #arthoplasty #localanesthetic #regionalanesthesia #chronicpain #anesthesia #pain #painmanagement #MedEd #medicine

DrJustin Talwar, Anesthesiology Resident at the University of Kentucky, discusses pharmacokinetics of volatile anesthetic agents.

Welcome to the next installment of the Anesthesia Patient Safety podcast hosted by Alli Bechtel.  This podcast is an exciting journey towards improved anesthesia patient safety.What is your anesthetic plan for patients presenting for endoscopy to remove food bolus impaction or foreign body ingestion? Tune in today as we discuss important considerations when deciding on location for performing this urgent procedure, need for additional resources, and anesthetic plan including general anesthesia or monitored anesthesia care. This is Part 1 of a two-part series.Additional sound effects from: Zapsplat.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/180-anesthetic-considerations-for-patients-with-food-bolus-impaction/© 2023, The Anesthesia Patient Safety Foundation

Welcome to Living Well with MS. In this episode, we are sharing the highlights from one of our ‘Ask Aaron' webinars, where neurologist, Dr Aaron Boster, answers questions about MS from the community. In this episode, Dr Boster covers a range of topics, including heat intolerance, when to start a DMT and his tips for self-managing MS. You can watch the original webinar here. Keep reading for the key episode takeaways.   Topics and Timestamps: 02:13 Considerations for changing to a less stressful job and stronger DMTs. 05:09 Talking to clinicians about stress. 06:25 Hyperbaric oxygen therapy. 08:11 Stem cell transplants for PPMS. 10:35 Tysabri during pregnancy and breastfeeding. 12:23 MS and Stroke. 13:52 MRI showing brain cysts. 16:57 Betaferon and slow progression. 19:45 Changing from Tysabri to Ocrevus. 21:41 Vertigo. 23:05 Ampyra for walking, spasticity, and nerve pain. 25:50 Types of inflammation. 28:05 Anesthetic or epidural and MS. 30:15 B-cell depletion therapy and allergies. 31:17 Tips for self-managing MS. 37:42 Heat intolerance. 40:30 When to start on a DMT. 41:22 Ocrevus and low lymphocyte levels. 43:40 Diet and MS. 48:50 Nausea as an MS symptom. 51:30 CBD for MS. 52:45 Bursitis and MS. 53:36 Choosing a DMT and considering side effects. 55:16 Invisible illness in an ableist world. Selected Key Takeaways: Exercise as part of your daily lifestyle  34:42 “Exercising as part of a lifestyle means that if you do it, you're not rewarded. There's no reward for doing something as part of your lifestyle and if you don't do it, there's no punishment - you're not sent to the naughty corner. So, for example, I have a lifestyle of brushing my teeth. I don't tweet about it. I don't make YouTube videos about it. I don't even talk about it when I get to work. It's just something I do every morning and if I happen to forget to brush my teeth before I head off to the office, I'll run upstairs and do it. This is part of my lifestyle. So, I need people impacted by MS to exercise as part of their lifestyle.” Plan your day to minimise symptoms like heat intolerance 39:43 “We can conserve energy during those times when it's really hot out. Whereas I would normally encourage a patient to park at the back of the parking lot to get their steps in. If it's the middle of the day, [walking that far is] going to sap all your energy so that when you get to the grocery store you can't shop, that doesn't really work very well, does it? And so that's an example where we would have someone drop us off at the threshold of the grocery store so that you can be successful in your shopping.” Be brave in using mobility aids and seeking accommodations. 57:27 “I tell people who are embarrassed by their cane, ‘Don't you dare be embarrassed by your cane, a cane is a sign of intelligence.' A person with a cane would like to not fall. So, when a little boy is walking with [his] mum, and says, ‘Mummy, why is she using a cane?' That's an opportunity for the mother to say, ‘Well, she doesn't want to fall, she has a problem with her leg and the cane helps her.' It normalises it. So, one of the things that we need to do is to be brave. I'll remind you of the definition of bravery, ‘doing something despite being scared'. The second thing is, I want you to be very selfish. You need to be selfish; you live your life once. You're not living your life so some stranger, you don't know, thinks nice polite things about you.” Want to learn more about living a full and happy life with multiple sclerosis? Sign up to our newsletter to hear our latest tips. More info and links: Watch the original webinar here. Dr Boster was on three previous Living Well with MS episodes: S1E11: Making the Right Medication Choices   S2E17: Lifestyle Choices and Their Impact on MS  S3E43: Let's Talk About Sex (and MS) Check out Dr Boster's popular YouTube channel covering all aspects of MS. New to Overcoming MS? Visit our introductory page  Connect with others following Overcoming MS on the Live Well Hub Visit the Overcoming MS website Follow us on social media: Facebook Instagram YouTube Pinterest Don't miss out:  Subscribe to this podcast and never miss an episode. Listen to our archive of Living Well with MS episodes here. If you like Living Well with MS, please leave a 5-star review. Feel free to share your comments and suggestions for future guests and episode topics by emailing podcast@overcomingms.org. Make sure you sign up to our newsletter to hear our latest tips and news about living a full and happy life with MS. Support us: If you enjoy this podcast and want to support the ongoing work of Overcoming MS, we would really appreciate it if you could leave a donation here. Every donation, however small, helps us to share the podcast with more people on how to live well with MS.

Ether led to painless medical and dental procedures. --- Send in a voice message: https://podcasters.spotify.com/pod/show/rocky-seale7/message

Ketamine is among the most unique pharmaceutical agents on the market. Join us on an exploration of the research on its neuropharmacology and use for depression, and discussion of risks and benefits. References: Article referenced in the beginning: Martinez-Marmol, et al. Hericerin derivatives activates a pan neurotrophic pathway in central hippocampal neurons converging to ERK1/2 signaling enhancing spacial memory. Journal of Neurochemistry. 2023(165);6: 791-808   Ballard E and Zarate C. The role of disassociation in ketamine's anti-depressant effects. Nature Communications. 2020: 6431 Bobo WV, et al. Ketamine for treatment resistant unipolar and bipolar major depression: Critical review and implications for clinical practice. Depression and Anxiety. 6 April 2016. Esketamine [package insert]. Janssen Neuroscience. July 2023. Fava M, et al. Double blind, placebo controlled dose ranging trial of intravenous ketamine as adjunctive therapy in treatment resistant depression (TRD). Molecular Psychiatry. 2020(25): 1592-1603 Gales A, Maxwell S. Ketamine: recent evidence and clinical uses. World Federation of Societies of Anesthesiologists. 12 June 2018. Johnston JN, et al. Ketamine in neuropsychiatric disorders: an update. Neuropsychopharmacology. 2023 Loo CK, et al. Placebo-controlled pilot trial testing dose titration and intravenous, intramuscular, and subcutaneous routes for ketamine in depression. Acta Psychiatria Scandinavica. 30 March 2016. Mandal S, et al. Efficacy of Ketamine therapy in the treatment of depression. Indian Journal of Psychiatry. 2019 Sept-Oct; 61(5). VA/DoD Clinical Practice Guideline. (2022). The Management of Major Depressive Disorder. Washington, DC: U.S. Government Printing Office

Oral surgeon James Ryan, 50, has been found guilty of murder for the death of his 25-year-old girlfriend, Sarah Harris. The verdict was reached on Friday after a three-hour deliberation by the jury.  The case revolved around the death of Sarah Harris, who was discovered lifeless at Ryan's Maryland home in January 2022. An autopsy revealed that Harris had died due to intoxication caused by a mixture of ketamine, propofol, and diazepam - powerful anesthetic drugs. Prosecutors alleged that Ryan displayed "an extreme indifference" to Harris' life by providing her with these dangerous substances despite her deteriorating health and addiction struggles. At the time of her death, Harris weighed a mere 83 pounds.  Court documents and testimony indicated that Ryan had set up an intravenous stand to administer these addictive drugs to Harris. A search of their home uncovered multiple bottles of the controlled substances, along with hypodermic needles, syringes, and related paraphernalia.  Investigators also brought to light text messages between the couple, where Harris explicitly requested various controlled substances from Ryan's dental practice. The text exchanges revealed that Ryan had been facilitating an at-home drug delivery system for Harris, including the provision of IV poles, saline solution, fluids, and needles.  Harris had first crossed paths with Ryan in the fall of 2020 when she sought oral surgery services at his practice. Their relationship evolved as Harris was subsequently employed as a surgical technician due to her prior experience in the field. The prosecution argued that Ryan, being a skilled oral surgeon well-aware of the risks involved, had deliberately supplied Harris with these dangerous substances, contributing to her gradual decline.  Throughout the trial, Ryan's defense maintained that Harris' death was either a result of suicide or an accidental overdose that she administered to herself. Defense attorney Thomas DeGonia pointed to Harris' history of requesting ketamine for relief from depression and the recent death of her brother. DeGonia argued that these factors could have contributed to her tragic end.  Ryan chose not to testify during his trial, and the jury ultimately rejected the defense's arguments, finding him guilty on all counts.  Ryan's sentencing date remains to be determined, and he could potentially face up to 55 years behind bars. Want to listen to ALL of our podcasts AD-FREE? Subscribe through APPLE PODCASTS, and try it for three days free: https://tinyurl.com/ycw626tj Follow Our Other Cases: https://www.truecrimetodaypod.com The latest on Catching the Long Island Serial Killer, Awaiting Admission: BTK's Unconfessed Crimes, Chad & Lori Daybell, The Murder of Ana Walshe, Alex Murdaugh, Bryan Kohberger, Lucy Letby, Kouri Richins, Justice for Harmony Montgomery, The Murder of Stephen Smith, The Murder of Madeline Kingsbury, and much more! Listen at https://www.truecrimetodaypod.com

August 24: Today on TownHall we are looking back at a TownHall episode from May of last year. In this episode, Jake Lancaster, Chief Medical Information Officer at Baptist Memorial Health Care interviewed Priya Ramaswamy, MD, Clinical Informatics Fellow/Anesthesiologist at UCSF. What is sustainable healthcare informatics? Not just in the US but across the globe, healthcare organizations are taking a stance to make a healthier ecosystem for people. Anesthetic gasses have damaging effects on the environment that contribute to global warming. The government is going to start requiring all organizations, including hospitals and healthcare systems to report on their admissions. What technology did UCSF develop within their Epic EHR to help with this? What are the elements needed to develop a clinical decision support alert system to remind anesthesia providers to turn down their fresh gas?As healthcare technology professionals, we're in a seismic shift. Artificial Intelligence is not just a buzzword—it's transforming our field and altering how we deliver healthcare. But with these technological advancements come complex challenges and unique opportunities. Are you ready to navigate this new landscape? Join us, September 7th, 1pm ET for an unmissable journey into the future of healthcare. Register Here. - https://thisweekhealth.com/ai-journey-in-healthcare/Subscribe: This Week HealthTwitter: This Week HealthLinkedIn: Week HealthDonate: Alex's Lemonade Stand: Foundation for Childhood Cancer

Love Veterinary Dentistry?

So, you want to be an anesthesiologist...how are you going to evaluate patients before their surgeries? This episode suggests a 5 questions you may ask yourself to help form the anesthetic plan for any given case.

Acne might just be unmatched as an aesthetic concern for how visible and traumatizing it can be for patients. Yet truly significant improvements in acne treatments have been hard to come by. As Cutera SVP Steve Kreider notes in this interview with Dr. Grant Stevens, "I've been selling acne products for 17 years, and the standard of care hasn't fundamentally changed."Except that Cutera itself has now changed the game with AviClear, a laser treatment that offers a safe, prescription-free solution for acne. In addition to reducing existing acne, clinical trials show that future breakout episodes are shorter, less intense, and more infrequent following the AviClear procedure. Further, acne clearance results continue to improve over time, demonstrating the long-term efficacy of this novel treatment. Join us as Dr. Stevens explores all the details of this groundbreaking laser device, along with breaking news about a recent FDA clearance for AviClear, all on the latest episode of The Technology of Beauty.Show Notes:00:00 Intro00:27 Background06:53 Arrival at Cutera08:50 Treating acne with light-based technology09:47 Breaking news!11:54 Monotherapy vs. multi-factoral treatments13:24 Procedure description, patient comfort, recovery16:07 Off-face? Anesthetic? Cost?18:17 Discussion of the Cutera xeo, lasers, other devices23:10 The future of aestheticsAny statements or views expressed on this podcast are the opinion of the host and guest(s) respectively. The technologies and commercial products discussed herein, and any claims made in relation to these, have not been evaluated by the Technology of Beauty, its host, or producers. AviClear results may vary.» Apple Podcasts | https://podcasts.apple.com/us/podcast/technology-of-beauty/id1510898426» Spotify | https://open.spotify.com/show/0hEIiwccpZUUHuMhlyCOAm» Recent episodes | https://www.influxmarketing.com/technology-of-beauty/» Instagram | https://www.instagram.com/thetechnologyofbeauty/» LinkedIn | https://www.linkedin.com/company/the-technology-of-beauty/The Technology of Beauty is produced by Influx Marketing, The Digital Agency for Aesthetic Practices. https://www.influxmarketing.com/Want more aesthetic insights? Subscribe to Next Level Practices, the show where we discuss the ever-changing world of digital marketing and patient acquisition and bring you the latest ideas, strategies, and tactics to help you take your practice to the next level. https://www.influxmarketing.com/next-level-practices/

Dr. Shannon Westin, Dr. Rajendra Badwe, and Dr. Alastair Thompson discuss the JCO paper "Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer." TRANSCRIPT The guests on this podcast episode have no disclosures to declare.  Dr. Shannon Westin: Hello, and welcome to another episode of JCO After Hours, the podcast where we get in-depth on manuscripts that are published in the Journal of Clinical Oncology. I am your host, Shannon Westin, gynecological oncologist by trade, but serve as our JCO Social Media Editor. And I'm super excited to talk to you about a paper that was just published online, April 6, 2023, entitled “The Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer.”   Before we start, I just note that our guests have no conflicts of interest.   And so I'm accompanied by two greats in the field. First is the principal investigator on this trial, Dr. Rajendra Badwe, who is the Director and Head of Surgical Oncology Division at the Tata Memorial Center in Mumbai.  Welcome. Dr. Rajendra Badwe: Thank you. Dr. Shannon Westin: And then, of course, I'm joined by Dr. Alastair Thompson, Co-Director of the Lester and Sue Smith Breast Center and the Section Chief for Breast Surgery at Baylor College of Medicine here in Houston, Texas. We should have met in person. Dr. Alastair Thompson: Great to be with you today, both of you. Thank you. Dr. Shannon Westin: So this is an exciting topic, and of course, as a surgeon, I'm super intrigued. So let's get started. First, I would love for you all to tell me about the rationale for modulating events at the time of surgery to improve survival in any cancer, but specifically in breast cancer as it was in this study. Dr. Rajendra Badwe: So we have been working on events at the time of surgery for quite some time. And for the first time, when I walked through the gynae OPD in Guy's Hospital, there was this cartoon of the cell being extruded for ovulation, and I felt a cell moving from one organ to the other is actually metastasis. And that's how we started working on it. And in the past few years, we have been—a decade or so, we have been publishing changes induced by event of surgery.   So what we did earlier before beginning this trial is picking up a core biopsy before I start surgery. So it's normoxic, well-ventilated as well as well-nutrition-provided tumor, and I do a core biopsy and send it for expression profile on next-generation sequencing. Then, when 50% of the tumor surface is denuded from the opposite side, which is not denuded, I do other core biopsy. And the third core biopsy is when the tumor is in my hand in breast conservation surgery.  So first was normoxic, second was hypoxic, and the last was completely anoxic tumor. And we found that the middle sample, which has never been studied, all our understanding of biology of breast cancer is based on the first core biopsy or the whole tumor sample post-surgery. The middle sample had approximately 800 genes going up and down on the next-generation sequencing mRNA, and majority of these were epithelial-mesenchymal transition, proliferation, invasion, motility. You name the hallmark of metastases, and they were up in the middle of surgery at least in 30% of the tumor. Now, if the cell surface on one side in a three-centimeter tumor ring to the cell at the other end of the tumor as to some invasion has happened, how quickly can it happen? The difference between the two biopsies was just about five minutes.  Obviously, it was some kind of an electrical stimulus that went across the tumor. That's what our assumption was. And if it was to happen through the voltage-gated channels, the downstream effect of voltage-gated channel being depolarized was the same channels that I mentioned, the hallmarks of metastases that I mentioned. And if we were to block it, it was easiest possible by local anesthetic. So that's how this trial was originated. And we did in 1600 patients local anesthetic, half of them randomly allocated to receive lidocaine 0.5% versus not. Dr. Shannon Westin: That is so intriguing. I have to look up this work. I definitely agree with you. We do a lot of pre-biopsies and post-biopsies, but the intra-tumor biopsy is so novel with being able to study the anoxic tissue. I'm so interested. And you kind of started to get into this. Can you dig in a little bit more around that role or how the mechanism of action of this peritumoral anesthetic infiltration might work in preventing metastasis and preventing some of the changes that you were able to see? Dr. Rajendra Badwe: So if adequate amount of local anesthetic injected would paralyze or block the voltage-gated channels, sodium channels, and if the sodium is not allowed to get inside the cell as a gush, the first depolarization does not happen. And the downstream effect of such voltage-gated channels being stimulated is induction of proliferation, induction of invasion, and increased motility of the cell, everything that is necessary for metastases to set in. In fact, somewhere close to about 200 genes that belong to the pathway that allows a cell to express epithelial-mesenchymal transition were upregulated during this hypoxic episode. And hypoxia also is known to produce these changes. So we now, out of these 1583 patients, in about 100 patients, we also have the middle sample. And that's being looked at on the third-generation—next-generation expression profile to see whether the effects that I mentioned just now, are they abrogated by local anesthetic as the underlying mechanism of reducing the metastatic potential or upregulating pro-metastatic pathways in cancer cells. Dr. Shannon Westin: It's so intriguing. I guess I wonder if you or Dr. Thompson can speak a little bit about the results of any studies looking at peritumoral anesthetic infiltration prior to the work that we're going to discuss today. Were there smaller studies that looked at this? Dr. Alastair Thompson: There have been a number of studies over the years, particularly some small studies from the Republic of Ireland, which have suggested that the use of local anesthetic in breast surgery might be beneficial. And then there have been some other larger studies really more thinking about the block of the surgical stimulus to the surgical site, for example, using paravertebral blocks. And we are aware that what is given as an anesthetic, whether it's an agent, intravenous agent, like propofol, or a gaseous agent, may also have some effect on the metabolic response to the trauma of surgery. So there's quite a building logical background to this particular trial. But to my knowledge, this is a unique trial which a group of surgeons have been able to implement a fairly simple technique, taking a very short period of time, but with almost as much impact as some of the major drug trials in terms of disease freedom and overall survival.  Dr. Shannon Westin: Great. So, yeah, let's get into—do you want to take us through the design of the study, Dr. Badwe? Dr. Rajendra Badwe: Yes, thank you. We had 1583 patients who were randomly allocated. These are women with early breast cancer, so essentially, T1, T2 breast cancer with or without lymphadenopathy in the armpit, and metastatic, disease-wise, M0. And these individuals, these patients, were randomly allocated on table to receive local anesthetic versus not. 796 women received local anesthetic, and 804 women did not receive local anesthetic. The adequacy of this local anesthetic was 0.5% of lidocaine being injected on all surfaces of the tumor as if from one pole of the tumor, I would open an umbrella, a needle going in all directions all around the tumor from one side and then from the other side. And if the tumor was larger than being covered by these injections, additional points of injections were done on all surfaces of the primary tumor. The adequacy was tested by inability of the surgeon to use electrical diathermy for dissection. So the surgeon had to use knife to get the tumor out. Because of so much of water content in the tissues, the diathermy would not work. And if it worked, that would mean the amount of local anesthetic injected was inadequate. So that was the quality control parameter.  Postoperatively, patients received standard treatment. We had assessment of the hormone receptors, HER2 receptors. And postoperatively, they received standard chemotherapy, which is—in great majority, was epirubicin or Adriamycin with cyclophosphamide, four cycles, followed by 12 weekly paclitaxel injections. And those who were hormone receptor-positive, premenopausal received tamoxifen, and postmenopausals received either letrozole or Arimidex. All patients who were more than four centimeter positive in tumor size or had lymph nodes positive received postoperative radiotherapy, irrespective of whether they had conservation or mastectomy. And all individuals who had conservation received postoperative radiation, which was the standard protocol.  Talking about those with HER2 positive or triple-negative or ER/PR positive, their distribution on either side was identical, very, very close, no different at all. 35% of those who were HER2 3+ or FISH positive received trastuzumab for a year on either side, but two-thirds of them did not receive trastuzumab because of the cost constraints in India. But the distribution of those who received versus not was identical on both sides. So that's the kind of general demographics of the women who were on the study. Dr. Shannon Westin: Great. I think now—I think everyone's ready for the good news. So how did the infiltration impact outcomes in these patients? Dr. Rajendra Badwe: The primary endpoint was disease-free survival. There were a total of 255 events, 109 events in local anesthetic arm and 146 events in the no local anesthesia arms. That gave us a 26% reduction, a relative reduction of 26%, which reached statistical significance at P 0.01. And at the same time, for overall survival, which was the secondary endpoint, there was a 29% relative reduction in deaths related to breast cancer, and majority of the patients who died died of breast cancer. The other cause of mortality was very little—to be precise, less than 1.5%, and that was also equally distributed on—identically distributed on both sides. So approximately 4% reduction in disease-free survival absolute and a similar 4% reduction in overall survival and the number of deaths. So this was the first trial that looked at preventing metastases than treating micrometastases. Dr. Shannon Westin: Yeah, and I think I would just call on Dr. Thompson here because I think you already started saying this. I mean, when you look at the simplicity of the intervention and the low-cost nature of the intervention and the impact as opposed to some of our “incremental benefits” that we see with different very expensive targeted therapies and immunotherapies, I'd love just to get your thoughts on that. Dr. Alastair Thompson: So, of course. I think this is an extraordinarily well-designed, very balanced trial. Yes, you can say that not all patients are treated the same way around the world. But there's been a rigor about this which is very attractive, and I think it's one of the reasons the Journal of Clinical Oncology has published it.  What is perhaps astonishing is that if we try to first do no harm, we're actually doing a very simple intervention, low cost, relatively easy. The patient is asleep, so it's not painful in any way. It's not toxic at the sort of levels of local anesthetic being administered. And yet we're managing that for every 25 patients who have this addition to their procedure, one of them is going to be disease free and one of them is going to be alive as a consequence in the relatively short term. So, in terms of balancing the issues of trying to implement something versus the benefits to a patient population, the balance is very much in favor of this really quite minor change in practice to give us quite a major, by modern standards, difference in outcomes.  Dr. Shannon Westin: Yeah, I think it's incredibly exciting, and I think, to your point around is it applicable, is it generalizable, I'd love to hear what you all think. I mean, is this something that we should be implementing across the globe? Dr. Alastair Thompson: Well, I think sometimes, we don't always do in our own practices what has been led and demonstrated to be effective elsewhere. And we need to really pause and, I would suggest, think hard whether such a simple intervention could be implemented on our next working day.  Now, many of us do use local anesthesia in the setting of breast surgery, whether it's mastectomy, axillary lymph node surgery, or lumpectomy. But the difference might be that instead of putting this local anesthesia towards the end of the operation, thinking about doing things up front and maybe, therefore, having an even bigger impact than simply good quality pain control and good quality patient care.  Dr. Shannon Westin: I would love also, just as we're kind of coming to a close here, to get both of your thoughts about how we might implement this. And again, this is coming from a somewhat selfish standpoint. How could we implement this in other solid tumors? So is there a way to replicate? Obviously, breast has a very local disease spread pattern. Is there a way to potentially replicate this in other cancer types?  Dr. Rajendra Badwe: So we have begun a similar study in my hospital for squamous cell carcinoma, as well as lung cancer. And I'm sure there will be efforts to replicate in many other cancers where it is possible to inject local anesthetic all around before we start the resectional procedure. But at the same time, we need studies to confirm that this is actually happening. If I were to take a step further and wait for the expression profile of those who have received local anesthetic versus not in this trial, and if it shows that the abrogation of effects related to the downstream stimulation of VGSC, the voltage-gated sodium channels, then it might just be a good idea to use something else. Because if local anesthetic is effective to the extent, say, about x amount, cannabis has about 200x effect on stabilization of voltage-gated channels. So that could be another intervention that can be explored in trials in any site. Dr. Alastair Thompson: So that's a good point. Where do we go from here? And I would suggest that perhaps thinking about which local anesthetic to inject—would a longer-acting local anesthetic be just as effective from a prevention of shedding of metastatic cells, would that give longer additional pain relief? Would it be possible to think about other tumor sites where we're doing a local reception, for example, in the gastrointestinal tract, elsewhere in the body, including lung, for resections? There's just a huge amount of potential which this landmark, practice-changing trial has really pointed us to. And I would envisage that in future podcasts, Shannon, you're probably going to have a lot of people talking with you about other trials that have followed on from this. Dr. Shannon Westin: I hope so because that will mean we're impacting our patients in a positive way. I'm just so thrilled to have the two of you here. This was such a fascinating discussion. It went by so fast, and I hate to bring it to a close. But I encourage our listeners to definitely read this incredibly important manuscript and communicate with us online on how we can move this forward.   Again, this has been JCO After Hours, and we've been discussing “The Effect of Peritumoral Infiltration of Local Anesthetic Before Surgery on Survival in Early Breast Cancer,” published online April 6, 2023. I'm so thrilled that you joined us today on the podcast, and I hope you'll check out our other podcast offerings. Have a wonderful day. The purpose of this podcast is to educate and to inform. This is not a substitute for professional medical care and is not intended for use in the diagnosis or treatment of individual conditions.   Guests on this podcast express their own opinions, experience, and conclusions. Guest statements on the podcast do not express the opinions of ASCO. The mention of any product, service, organization, activity, or therapy should not be construed as an ASCO endorsement.      

1. Anesthesia (noun): a loss of sensation or awareness, brought on by the administration of drugs or other agents. Etymological definition: derived from the Greek root “-thesia” meaning “sensation” or “feeling”. 2. Anesthetic (adjective): relating to a lack of sensation or awareness. Etymological definition: derived from the Greek root “-thesia” meaning “sensation” or “feeling”. 3. Paresthesia (noun): abnormal or altered sensation such as tingling, burning, or prickling. Etymological definition: derived from the Greek root “-thesia” meaning “sensation” or “feeling”. 4. Euthesia (noun): a healthy or normal sensation. Etymological definition: derived from the Greek root “-thesia” meaning “sensation” or “feeling”. 5. Hypoesthesia (noun): diminished sensation in an area of the body. Etymological definition: derived from the Greek root “-thesia” meaning “sensation” or “feeling”. 6. Hyperesthesia (noun): an abnormally increased sensitivity to an external stimulus. Etymological definition: derived from the Greek root “-thesia” meaning “sensation” or “feeling”. 7. Aisthesis (noun): a feeling or awareness of the environment through physical sensation, such as smell, taste, touch, and sight; Etymology: From the Greek root aisthēsis, “sensation, perception”. 8. Aisthetikos (adjective): relating to or characterized by sensory perception; Etymology: From the Greek root aisthēsis, “sensation, perception”. 9. Aisthetikē (adverb): in a way that relies on sensory perception; Etymology: From the Greek root aisthēsis, “sensation, perception”. 10. Aisthētikos (noun): a person who is sensitive to or has a keen sense of aesthetics; Etymology: From the Greek root aisthēsis, “sensation, perception”. 11. Aisthētic (adjective): relating to the appreciation of beauty; Etymology: From the Greek root aisthēsis, “sensation, perception”. 7. Aisthesiometer (noun): an instrument used to measure sensitivity to touch or other physical sensation; Etymology: From the Greek root aisthēsis, “sensation, perception”. --- Support this podcast: https://podcasters.spotify.com/pod/show/liam-connerly/support

Dr. Ibironke Desalu, Professor of Anaesthesia at the University of Lagos in Lagos, Nigeria, and Open Anesthesia Editor Elizabeth Igaga discuss Dr. Desalu's experiences and the lessons she has learned providing, advocating for and improving anesthetic care in Nigeria. Dr. Desalu highlights coping with burnout, her relentless advocacy for improved pediatric anesthesia care in Africa and her approach to systems change. Further reading discussed in the interview can be found at the following links: WFSA Global Workforce Survey: https://pubmed.ncbi.nlm.nih.gov/28753173/ Global Surgery 2030: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60160-X/fulltext International Standards for a Safe Practice of Anesthesia: https://pubmed.ncbi.nlm.nih.gov/29736769/ Pediatric Anesthesia Training in Africa (PATA) Fellowship: Nigeria: https://wfsahq.org/news/latest-news/applications-open-paediatric-anaesthesia-training-in-africa- pata-fellowship-nigeria/ Uganda: https://wfsahq.org/news/latest-news/applications-open-2023-paediatric-anaesthesia-training-in-a frica-pata-fellowship-uganda/ Zambia: https://wfsahq.org/news/latest-news/applications-open-2023-paediatric-anaesthesia-training-afri ca-pata-fellowship-zambia/

In this episode, Dr Caroline Gardiner, an anaesthetist, explains what happens on the day, the different forms of anaesthetic available during the procedure as well as pain relief following the operation. She also addresses issues such as gas pain, the catheter that many women fear and the importance of staying on top of the pain.

174 Hz Solfeggio Sleep Music | Natural Anaesthetic for Pain Relief | Deep Sleep Meditation Music BENEFITS of 174 Hz Solfeggio Frequency Includes : ✔ Acts as Natural Anaesthetic ✔ Reduces pain physically and energetically ✔ Encourages organs and cells to do their best ✔ Establishes conscious communication between different organs and cells and helps them to return to their optimal state. Solfeggio frequencies are nine tones derived from numerology were used centuries ago. These frequencies are believed to create positive shifts to those in proximity to them. SUBSCRIBE NOW

Dental Nerves of Steel: Passing My Anesthetic Certification Exam By Corina Hartley, RDH Original article published on Today's RDH: https://www.todaysrdh.com/dental-nerves-steel-passing-anesthetic-certification-exam/ Need CE? Start earning CE credits today at https://rdh.tv/ce Get daily dental hygiene articles at https://www.todaysrdh.com Follow Today's RDH on Facebook: https://www.facebook.com/TodaysRDH/ Follow Kara RDH on Facebook: https://www.facebook.com/DentalHygieneKaraRDH/ Follow Kara RDH on Instagram: https://www.instagram.com/kara_rdh/

One area of emphasis on more recent USMLE exams are anesthesia/perioperative related complications. This short podcast goes over a lot of the HY ones you need to know and understand as you prepare for the USMLE Step 2CK and Step 3 exams. Do not ignore this stuff. Audio Download