TopMedTalk

Joff and his guests visit the hallowed turf that is the Boston Ether Dome, in the Bulfinch Building, Massachusetts General Hospital. How have times moved on since those early pioneering days when the relatively young profession of Anaesthesia was born? Back then the word wasn't as widely used and the gentlemen in question described their activities as "rendering people insensible using sulphuric ether for the conduct of surgery".

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Recorded last year this piece has Dr Joff Lacey paying tribute to the birthplace of Anaesthesia. Joined by Dr Liam Brennan, President of The Royal College of Anaesthetists (RCoA) and Dr Andy Bailey, Addenbrooke's Hospital, Cambridge.

On the morning of the first day of the 2018, annual conference, of the American Society of Anesthesiologists (ASA) Monty Mythen and Desiree Chappell were lucky enough to get an exclusive interview with Professor Henrik Kehlet.

Henrik Kehlet is a gastrointestinal surgeon and former professor of surgery, Copenhagen University, and now professor of perioperative therapy and Head of Section of Surgical Pathophysiology, Rigshospitalet, Copenhagen University.

He has published more than 650 articles within perioperative pathophysiology, pain relief and surgical outcome summarized into the concept of 'fast-track surgery', which also includes a focus on perioperative fluid management.

This piece is a reflection upon and celebration of conversations that were made possible by both The American Society of Anesthesiologists and Edwards Life Sciences, a key sponsor for TopMedTalk.

If you would like to hear these conversations in full please follow the links below:

Greg Fischer, Chairman, Department of Anesthesiology & Critical Care Medicine at Memorial Sloan Kettering Cancer Center:

https://www.topmedtalk.com/anes19-greg-fischer/

Tim Miller, Associate Professor of Anesthesiology from Duke University Medical Centre:

https://www.topmedtalk.com/anes19-tim-miller/

The Perioperative Quality Initiative (POQI) is here: https://thepoqi.org/

Michael Scott, Professor and Division Director, Critical Care Anesthesiology- Virginia Commonwealth University:

https://www.topmedtalk.com/anes19-michael-scott/

Also - congratulations to the American Society of Anesthesiologists on the success of this year's online proposition, find out more at www.asahq.org

And don't forget Evidence Based Perioperative Medicine are continuing the momentum of the hugely successful Chicago and London, online meetings - check out www.ebpom.org for more details.

Recorded at the American Society of Anesthesiologists' Annual General Meeting in 2019; "The Power of The Interdisciplinary Team"; introducing the Enhanced Recovery team from Keck Medical Center at The University of Southern California (USC).

Our guests kindly share an email address you can contact them on: [email protected]

Presented by Desiree Chappell and Monty Mythen with their guests Professor Carol Peden, Robin Cresner, CCRN, Dr Shane Dickinson, anesthesiologist and Snow Shoo Son; The Enhanced Recovery Team from Keck Medical Center at USC.

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Like this, want more?

There's a fascinating conversation with Carol Peden here: https://www.topmedtalk.com/talks-to-carol-peden/

A discussion about oxygen and the Xtreme Everest research studies into human adaptation to hypoxia. How does the human body adapt to extreme conditions? We assume it will inevitably cause damage but this is not always the case. How do people who have inherited a tolerance for low levels of oxygen manage?

Monty Mythen, Mike Grocott and Joff Lacey are joined by special guest Dr Dan Martin OBE, Consultant in Intensive Care and Everest summiteer.

Where is perioperative medicine as a specialty in the US? How do frail patients benefit from the perioperative process? Age and physical fitness are important factors when deciding if you're going to put a patient through major surgery, how do these factors allow us to differentiate between those who are likely to have a poor outcome? How common is cardiopulmonary exercise testing (CPET) in the US?

Presented by Desiree Chappell and Monty Mythen with their guest Bobbie Jean Sweitzer, Director of Perioperative Medicine at Northwestern.

Our guest's excellent book is here: https://www.amazon.co.uk/Preoperative-Assessment-Management-BobbieJean-Sweitzer-ebook/dp/B07DWLNW8Y

"We need to work together more, it needs to be multidisciplinary"

A fascinating and still essential discussion - from a truly global perspective - featuring guest presenter Dr Liam Brennan, President of the Royal College of Anaesthetists and his guests; Dr Gonzalo Barreiro, President of the World Federation of Societies of Anaesthesiologists (WFSA), Julian Gore-Booth, CEO of WFSA and Dr Paul Clyburn, President of the Association of Anaesthetists of Great Britain and Ireland, to discuss the unmet global need for safe and accessible anaesthesia.

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 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?"

Since this piece was recorded it's worth nothing that these important studies were subsequently finished and published:

"Recurrence of breast cancer after regional or general anaesthesia: a randomised controlled trial " https://pubmed.ncbi.nlm.nih.gov/31645288/

"Influence of perioperative anaesthetic and analgesic interventions on oncological outcomes: a narrative review " https://pubmed.ncbi.nlm.nih.gov/3125529/

"How Anesthetic, Analgesic and Other Non-Surgical Techniques During Cancer Surgery Might Affect Postoperative Oncologic Outcomes: A Summary of Current State of Evidence"

https://pubmed.ncbi.nlm.nih.gov/31035321/

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 look at the very beginnings of your favorite medical podcast. Today we celebrate the American Society of Anesthesiologists (ASA) and their annual general meetings, which we have covered every year since 2017. Find out how TopMedTalk pioneered its first live transmissions from that meeting in Boston and began providing free medical information for an ever growing online audience.

This piece features a timeless conversation about the profession of Anesthesia, from its inception to the diverse and exciting role we find today. Are we right to say that its a role which is rightly evolving toward a broader focus on perioperative medicine? Can we be sure that those in this profession are right to take a leadership role as evidence of the life saving benefits of the perioperative method become recognised internationally?

Presented by Monty Mythen, Smiths Medical Professor of Anaesthesia and Critical Care at University College London and TopMedTalk's Editor in Chief, with, Mike Grocott, Professor of Anaesthesia and Critical Care Medicine at the University of Southampton, Joff Lacey, now a Consultant Anaesthetist at St George's Hospital in South West London and Sol Aronson, tenured Professor at Duke University.

Please check out the ASA's website here: www.asahq.org

The fuller conversations from this podcast are available here:

Podcast 1: Live from Boston ASA 2017 – Anaesthesia and the Perioperative Medicine movement

https://www.topmedtalk.com/podcast-1-live-from-boston-asa-2017-anaesthesia-and-the-perioperative-medicine-movement/

Live from Boston ASA 2017 - Perioperative Medicine in USA

https://www.topmedtalk.com/live-from-boston-asa-2017-perioperative-medicine-in-the-usa/