TopMedTalk

Join Andy Cumpstey and Kate Leslie in this broadcast from the ANESTHESIOLOGY® 2025 meeting. They welcome guests Stacie G. Deiner, an anesthesiologist, professor and vice-chair for research at Dartmouth Hitchcock Medical Center and Mark D. Neuman, anesthesiologist and Horatio C. Wood Professor of Anesthesiology at the Perelman School of Medicine at the University of Pennsylvania.

We discuss the new ASA guidelines for older adults. The episode delves into the development, significant recommendations, and implementation of these guidelines, emphasizing the importance of preoperative evaluation and the choice of anesthesia technique. Mark and Stacie also highlight ongoing research and the future of perioperative care for older adults. This conversation underscores the role of shared decision-making and proactive health measures in improving surgical outcomes.

The ASA guideline can be found here:

https://www.asahq.org/standards-and-practice-parameters/practice-advisory-perioperative-care-of-older-adults-scheduled-for-inpatient-surgery

The REGAIN study can be found here: https://www.nejm.org/doi/full/10.1056/NEJMoa2113514

Andy Cumpstey and Kate Leslie welcome Professor Monty Mythen to his Perioperative Profile. Recorded at the 2025 Evidence Based Perioperative Medicine (EBPOM) meeting in Dingle, Ireland.

Monty discusses his fascinating career, from his childhood in London to becoming Professor of Anaesthesia and Intensive Care at University College London. He notes his involvement in founding EBPOM and his role at BD Advanced Patient Monitoring. The conversation covers Monty's groundbreaking research on gut perfusion and multiple organ failure, his high-altitude research expeditions to Mount Everest, and his transition to a role in the healthcare industry. He shares insights on the intricate process of medical device approval. The episode is a deep dive into the experiences and achievements of a leading medical mind.

Andy Cumpstey and Kate Leslie at ANESTHESIOLOGY® 2025 in San Antonio, Texas.

They interview Peter Nagele, professor of anesthesiology at the University of Chicago, about his groundbreaking trial on the use of nitrous oxide as a treatment for severe depression. The trial aimed to assess the efficacy of nitrous oxide compared to a placebo and explored different doses (25% vs. 50%). They discusses the study's promising results, the neurobiology of depression, and the potential for a phase three international multicenter trial.

This episode also highlights the need for novel treatments for treatment-resistant depression and the importance of collaborative research in advancing medical knowledge.

ANESTHESIOLOGY® 2025 Desiree Chappell and Mike Grocott discuss the latest advancements and key topics in the field of anesthesiology with special guests Sheila Barnett, Chair of the Department of Anesthesiology at Dartmouth Hitchcock Medical Center, Professor of Anesthesiology at Geisel School of Medicine at Dartmouth and Patrick Guffey, Professor of Clinical Practice, Anesthesiology-Pediatric Anesthesiology at the University of Colorado Anschutz Medical Campus.

The conversation centers around the Anesthesia Quality Institute (AQI) and its various initiatives, including the National Anesthesia Clinical Outcomes Registry (NACO) and the importance of integrating electronic health records for improved data collection and quality of care. The guests highlight the challenges and opportunities of using clinical data to drive quality improvements and the future potential of collaborating with electronic health record systems like Epic. The episode underscores the importance of quality data in anesthesia and highlights efforts to enhance patient outcomes and healthcare value.

TopMedTalk's Andy Cumpstey recorded this piece recently for us at the Royal College of Anaesthetists' Centre for Perioperative Care's (CPOC) annual meeting in London.

The conversation features key figures from CPOC, including: David Selwyn, Acting Chief Executive at Sherwood Forest Hospitals NHS Foundation Trust, appointed as the inaugural Director of CPOC in May 2019, Denny Levett, Professor in Perioperative Medicine and Critical Care at the University of Southampton and a Consultant in Perioperative Medicine at Southampton University Hospital NHS Foundation trust (UHS), Scarlett McNally, Consultant Orthopaedic Surgeon in Eastbourne DGH, UK since 2002, Deputy Director at the COPC (2020-26) and an honorary clinical professor at Brighton and Sussex Medical School, Jugdeep Dhesi, Deputy Director for CPOC, Clinical lead for the innovative and award winning POPS (Perioperative medicine for Older People undergoing Surgery) service, Honorary Reader at King's College London and Associate Professor at University College London, and Lawrence Mudford, who transitioned from a healthcare professional to a patient, following a cancer diagnosis. Following his successful treatment, he took up his current role as a patient representative for CPOC.

The panel explore the creation and evolution of CPOC since its inception in 2019, highlighting the collaborative efforts to improve surgical pathways by integrating patient and multidisciplinary voices. They discuss various initiatives, guidelines, and successful practices aimed at enhancing patient-centered care, managing conditions like frailty, diabetes, and anaemia, and promoting shared decision-making. The episode also delves into future goals, such as addressing the implementation gap, fostering digital transformation, and operationalizing educational curricula for healthcare professionals to further support perioperative care.

Andy Cumpstey interviews internationally renowned anaesthetist and researcher, Kate Leslie, Head of Research in the Department of Anaesthesia and Pain Management at the Royal Melbourne Hospital and Honorary Professor at the University of Melbourne.

Kate shares insights into her journey from growing up in Melbourne to leading groundbreaking research and clinical trials. We discuss her professional milestones, including her work with the Australian and New Zealand College of Anaesthetists (ANZCA) Clinical Trials Network and the global impact of their studies. Additionally, Kate reflects on the challenges and triumphs as a woman in medicine, emphasizing the importance of resilience and personal growth. The episode also highlights Kate's recent accolades, such as the ASA Excellence in Research Award and her work as an editor for major anaesthesia publications.

ANESTHESIOLOGY® 2025, Desiree Chappell speaks with her guest, David Kennedy, Emeritus Professor at the University of Pennsylvania.

They discuss the complexities of value-based care models and the essential role of Anesthesia Information Management Systems (AIMS). Dr. Kennedy, with his extensive experience in both private practice and large anesthesia groups, explains the benefits and functionality of AIMS. He highlights how AIMS can optimize data access, improve patient care through real-time analytics, and enhance operational efficiency. Additionally, the conversation covers the integration of AI in these systems, its potential to transform standard care practices, and the need to address data security and clinician skill retention. The episode concludes with the importance of portable AIMS platforms for practitioners working in diverse medical environments.

Andy Cumpstey and Kate Leslie take us to ANESTHESIOLOGY® 2025, where they spoke with Samer Narouze, Chairman of the Center for Pain Medicine at Western Reserve Hospital and Chair of the Pain Committee for the ASA.

Samer introduces the newly formed Pain Medicine Coalition, which aims to improve patient access to pain care and advocate for pain specialists. The coalition, an alliance between prestigious organizations, focuses on reducing barriers to non-opioid pain treatments and legislative advocacy for better coverage. He also discusses the importance of comprehensive, evidence-based pain management and the recent launch of a Certificate of Innovation and Leadership in Pain Medicine to support newly graduated pain fellows. The discussion highlights the coalition's efforts to rebrand and advance the field of pain medicine toward a more patient-centric and multidisciplinary approach.

Desiree Chappell and Mike Grocott at ANESTHESIOLOGY® 2025 have our traditional conversation with the incoming and outgoing Presidents of the organisation.

Incoming President Dr. Patrick Giam and outgoing President Dr. Don Arnold to discuss their careers, initiatives, and the future of anesthesiology. Topics include advancements in perioperative medicine, the importance of mentorship, strategies for increasing member engagement, and the integration of new technologies like artificial intelligence. Both leaders share their visions for the ASA, emphasizing leadership development, professional growth, and improving patient care.

Desiree Chappell and Lieutenant Colonel Daniel P. Raboin, MD, PharmD, U.S. Army anesthesiologist and pharmacist who serves as the Deputy Anesthesiology Consultant to the Army Surgeon General, Lieutenant Colonel Jordan Lane, MD, U.S. Army anesthesiologist at Tripler Army Medical Center in Hawaii and Colonel Michael S. Patzkowski, MD, MHA, Army Anesthesiology Consultant to the Surgeon General.

Recorded at ANESTHESIOLOGY® 2025 in San Antonio, we discuss clinical readiness and training programs within Army anesthesiology, cover the importance of maintaining clinical readiness through specialized training, partnership agreements with civilian trauma centers, and how these programs help in preparing anesthesiologists for deployment situations. The discussion also highlights the logistical and administrative challenges of such programs and the solutions implemented to overcome them.