ASA 2018 San Francisco | Smith’s Medical Symposium on Enhanced Recovery part 3

Recorded before a live audience this piece continues the question and answer session from parts one and two. Epidurals versus plane blocks, what do you choose and why? Is there a potential for decrease in fasting times for clear fluids to further enhance recovery? Where can Enhanced Recovery (ER) protocol templates be found on line?…

ASA 2018 San Francisco | Smith’s Medical Symposium on Enhanced Recovery part 2

What is the balance of risks and benefits related to regional anaesthesia? Does the short term use of opioids really contribute to the opioid crisis? What are the benefits of “opioid sparing” when held against “opioid free”? When it comes to regional anaesthesia, what kind of benefits should we expect beyond pain control and opioid…

ASA 2018 San Francisco | Smith’s Medical Symposium on Enhanced Recovery part 1

Recorded before a live audience this Q&A session was recorded at the annual meeting of the American Society of Anesthesiologists (ASA) at a specially hosted dinner where both those in attendance and the online audience could submit questions. This discussion is about Enhanced Recovery (ER) and lowering tolerance of poor outcomes after surgery. How do…

ASA 2018 San Francisco | Frailty and the perioperative patient – enhancing recovery.

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…

ASA 2018 San Francisco | Considerations for the obstetric patient; ERAS for C-section.

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…

ASA 2018 San Francisco | Regional anaesthesia associated with improved cancer survival – new data.

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…

ASA 2018 San Francisco | Improving outcomes for the perioperative patient

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…

ASA 2018 San Francisco | Optimising the perioperative patient

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…

ASA 2018 San Francisco | The practical applications of innovation.

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”.…