Gastric POCUS, 3-Part Episode
April 2024 OA-POCUS Case of the Month
Anesthesia Services in Tanzania and Kenya
OA-Global Health Equity Ask the Experts - April 2024
REPOST: October 2021 – Pediatric Tracheal Extubations
April 2024 OA-SPA Ask the Expert
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Question of the Day
A 61-year-old morbidly obese man with history of hypertension and a STOP-BANG score of 5 presents to an outpatient surgery center for an open rotator cuff repair. Which of the following is MOST correct regarding the perioperative management of this patient?
Explanation
This is a challenging question that few people answer correctly! Most anesthesiologists are not familiar with the Society for Ambulatory Anesthesia consensus statement on preoperative selection of adult patients with obstructive sleep apnea scheduled for ambulatory surgery. A STOP-BANG score of 5 or greater carries a 35% risk of the patient having severe obstructive sleep apnea. Patients with obstructive sleep apnea have an increased risk of difficult intubation, postoperative mechanical ventilation, and adverse cardiopulmonary events. Thus, patients should be screened preoperatively for obstructive sleep apnea. If a patient scores greater than or equal to 5 on the STOP-BANG score, it is recommended that the anesthesiologist treat the patient as though they have been diagnosed with obstructive sleep apnea (e.g. limit opioids). Patients with obstructive sleep apnea are at much higher risk for adverse perioperative events if significant opioid analgesia is administered. There is no clear data at this point to suggest that performing a formal sleep study and being prescribed continuous positive airway pressure (CPAP) actually reduces the morbidity and mortality of these patients. Additionally, it is unknown how long a patient should comply with their CPAP prior to elective surgery in order to minimize perioperative risk.
References:
Joshi GP, Ankichetty SP, Gan TJ, Chung F. Society for Ambulatory Anesthesia consensus statement on preoperative selection of adult patients with obstructive sleep apnea scheduled for ambulatory surgery. Anesth Analg. 2012;115(5):1060-1068. doi:10.1213/ANE.0b013e318269cfd7 Pediatric Obstructive Sleep ApneaOA Series: April 2024
Vodcast
06:08
OA-POCUS Case of the Month
Gastric POCUS, Part 1 of 3Eric R. Heinz, MD, PhD, George Washington University, Yuriy Bronshteyn, MD, FASE, Duke University Health System
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Vodcast
17:46
OA-POCUS Case of the Month
Gastric POCUS, Part 2 of 3Eric R. Heinz, MD, PhD, George Washington University, Yuriy Bronshteyn, MD, FASE, Duke University Health System
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Vodcast
04:43
OA-POCUS Case of the Month
Gastric POCUS, Part 3 of 3Eric R. Heinz, MD, PhD, George Washington University, Yuriy Bronshteyn, MD, FASE, Duke University Health System
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Podcast
41:04
OA Global Health Equity Ask the Expert
Anesthesia Services in Tanzania and KenyaSamuel Percy, MD, Children's Hospital Colorado
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Podcast
16:40
OA-SPA Ask the Expert
REPOST: October 2021 – Pediatric Tracheal ExtubationsDebnath Chatterjee, MD, FAAP, Children’s Hospital Colorado
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