TopMedTalk

Obstetrics might seem the natural place for Enhanced Recovery After Surgery (ERAS). Which components of Enhanced Recovery apply the most to a procedure such as a Caesarian section (C-section)? Differences between obstetrics in the UK and the US are discussed. The addictive qualities of oxycodone are discussed in detail. This leads to a discussion about what tablets patients should be leaving the hospital with. Presented by Monty Mythen and Desiree Chappell with their guest Brendan Carvalho, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University Medical Center.

Obstetrics might seem the natural place for Enhanced Recovery After Surgery (ERAS). Which components of Enhanced Recovery apply the most to a procedure such as a Caesarian section (C-section)?   Differences between obstetrics in the UK and the US are discussed. The addictive qualities of oxycodone are discussed in detail. This leads to a discussion about what tablets patients should be leaving the hospital with.   Presented by Monty Mythen and Desiree Chappell with their guest Brendan Carvalho, Professor of Anesthesiology, Perioperative and Pain Medicine at Stanford University Medical Center.

This piece is a deep dive into regional anaesthesia for Enhancing Recovery. Hear how paravertebral nerve blocks can be used in breast cancer surgery, how does this effect long term outcomes for patients? There is then further discussion regarding regional anaesthesia for Ambulatory Surgery.

There is also a long form discussion of electromyographic (EMG) objective monitoring on a neuromuscular blockade. How can this help reduce and discover potential poor outcomes?

Further questions from the online audience are addressed such as "can you send knee surgery patients home on the day of surgery, how do you manage pain?"

Presented by Desiree Chappell and Monty Mythen with their guest Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

This piece is a deep dive into regional anaesthesia for Enhancing Recovery. Hear how paravertebral nerve blocks can be used in breast cancer surgery, how does this effect long term outcomes for patients? There is then further discussion regarding regional anaesthesia for Ambulatory Surgery.

There is also a long form discussion of electromyographic (EMG) objective monitoring on a neuromuscular blockade. How can this help reduce and discover potential poor outcomes?

Further questions from the online audience are addressed such as "can you send knee surgery patients home on the day of surgery, how do you manage pain?"

Presented by Desiree Chappell and Monty Mythen with their guest Professor Stuart Grant, MB ChB, FRCA Director, Medical Student Education, Duke University School of medicine.

Enhanced Recovery After Surgery (ERAS) is the focus for the TopMedTalk team at this year's ASA. This piece features discussion regarding; what to do about pre-operative frailty, smoking cessation, patient-centric care and how to manage pre and post operative expectations.

How do we ensure the conversations we have before surgery both reflect the needs of the patient and the realities of an operation? Moving beyond that how do we use patient reported outcomes to improve the process overall?

We also have contributions from the audience; "What role does the General Practitioner have in promoting smoking cessation, is the pre-operative clinic too late to get the ball rolling?" and "Is perioperative medicine to be understood as a generic provider / management system or as a specific branch of practice?"

Desiree Chappell and Monty Mythen speak with their guest Dr Angela Edwards, Head of Perioperative Medicine at Wake Forest University School of Medicine.

Enhanced Recovery After Surgery (ERAS) is the focus for the TopMedTalk team at this year's ASA. This piece features discussion regarding; what to do about pre-operative frailty, smoking cessation, patient-centric care and how to manage pre and post operative expectations.

How do we ensure the conversations we have before surgery both reflect the needs of the patient and the realities of an operation? Moving beyond that how do we use patient reported outcomes to improve the process overall?

We also have contributions from the audience; "What role does the General Practitioner have in promoting smoking cessation, is the pre-operative clinic too late to get the ball rolling?" and "Is perioperative medicine to be understood as a generic provider / management system or as a specific branch of practice?"

Desiree Chappell and Monty Mythen speak with their guest Dr Angela Edwards, Head of Perioperative Medicine at Wake Forest University School of Medicine.

This piece is about optimizing the perioperative patient for Enhanced Recovery (ER). Hear from one of the pioneers of ER for laparoscopic colorectal surgery in the UK, over 15 years ago he was sending patients home in less than 24 hours having had laparoscopic right hemicolectomys!

This is the story of one of the roots of Enhanced Recovery adoption in the NHS. We also cover issues such as, the importance of pre-operative nutrition, gabapentinoids and, in a similar vein, low dose ketamine. Do such treatments require a frailty adjustment and what is the bigger picture as regards delirium?

Questions are taken from the audience; what is the value of lidocaine infusions? How does opioid minimisation fit into this picture? How practical are alternating dosages when it comes to analgesics in the US healthcare system?

Finally, there is an indepth discussion about anemia in the perioperative process.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University

This piece is about optimizing the perioperative patient for Enhanced Recovery (ER). Hear from one of the pioneers of ER for laparoscopic colorectal surgery in the UK, over 15 years ago he was sending patients home in less than 24 hours having had laparoscopic right hemicolectomys!

This is the story of one of the roots of Enhanced Recovery adoption in the NHS. We also cover issues such as, the importance of pre-operative nutrition, gabapentinoids and, in a similar vein, low dose ketamine. Do such treatments require a frailty adjustment and what is the bigger picture as regards delirium?

Questions are taken from the audience; what is the value of lidocaine infusions? How does opioid minimisation fit into this picture? How practical are alternating dosages when it comes to analgesics in the US healthcare system?

Finally, there is an indepth discussion about anemia in the perioperative process.

Presented by Desiree Chappell and Monty Mythen with their guest Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University

How do new technologies impact the postoperative elements of Enhanced Recovery? We discuss ward monitoring 3.0 and the technology available, or in the pipeline, to improve outcomes. How do we best use this information and these innovations?

There is also a refreshing conversation about Artificial Intelligence (AI) alongside discussion about "bed sensors" and "facial recognition". Some dementia units are using new technology to monitor patient movement both in and out of their beds, how does this tie into the issue of early mobilisation? Furthermore - what will the consequences be when facial recognition and monitoring is ubiquitous within institutions?

The website mentioned in the podcast is here: https://www.michardconsulting.com/

Presented by Desiree Chappell with Monty Mythen and their guest Frederic Michard of MiCo Consulting.

This fascinating conversation revolves around the experience and need for good teachers in the field of Anaesthesia. How do we encourage professionals and students to pursue this vital and rewarding discipline? Dr Joff Lacey presents with his guest Dr Rob Stephens, Consultant in Anaesthesia, UCLH, Hon Senior Lecturer in Anaesthesia, UCL.