Anesthesiology and Perioperative Science

🦠“Dirty” OR ≠ higher infection risk! High CFU ≠ Staphylococcus aureus transmission ❗ 👉Contamination ≠ transmission ≠ infection 👉Quantity ≠ risk 📊CFU = cleanliness score, not an alarm 💡 link.springer.com/article/10.100… #PatientSafety #InfectionControl

Ketamine ❌ POD? Not so fast…🤔 📊 One huge study may skew results 💉 “Ketamine” ≠ same exposure ⏱️ Early ≠ late delirium ⚠️ Small bias may flip outcomes 👉 Evidence still shaky—need better RCTs! 🔬 🧐link.springer.com/article/10.100… #Anesthesia #Delirium #Ketamine #EBM

🧠Can RIC really protect the brain? New meta-analysis just dropped! 📊15 RCTs, ~3000 patients: ❌No reduction in POD ❌No reduction in POCD ⚠️Slight improvement in global cognition (MMSE/MoCA ↑) 🤔 Neuroprotection ≠ clinical benefit? link.springer.com/article/10.100… #POCD #Delirium

💡 TLIP block = precise spine analgesia! 🎯 Targets dorsal rami 💊 ↓ opioids, ↑ recovery 🔥 M-TLIP: easier & safer ⚖️ TLIP ≈ ESPB, but more focused 🚀 Future role in chronic back pain? link.springer.com/article/10.100… #Anesthesia #RegionalAnesthesia

🚨Laryngospasm? Don’t panic! Try this simple combo👇 💨 Positive pressure ventilation ➕ 🫁 External chest compression 👉 PPV opens the airway 👉 Chest compression ↑ intrathoracic pressure 👉 Helps “break” the closed vocal cords ⚡ Small move, big impact in anesthesia!

👃💉Small path, big relief! SPG block = a smart, minimally invasive way to treat headaches. A soft catheter passes through the nose to reach a key pain hub🧠 🎯Target: SPG ⚡Effect: blocks pain + resets signals 💡Use: migraine, cluster headache #Anesthesia

🚨Shock = body “power failure” 6 common types: 🩸Hypovolemic – blood loss ❤️Cardiogenic – heart pump failure 🦠Septic – severe infection 🐝Anaphylactic – allergic reaction 🧠Neurogenic – nerve control loss 🚧Obstructive – blood flow blocked Result: ↓BP + tissue hypoxia ⚠️ #Shock

SPG neurostimulation ⚡ is changing headache therapy! 🧠✨New study： Fast relief for cluster headache. Pain ↓ in ~15 min. Attacks ↓ over time. 🧐link.springer.com/article/10.100… #ClusterHeadache #SPG

🧠 SPG Block Approaches in one glance! Three ways to reach the Sphenopalatine Ganglion: ➡️ Lateral ➡️ Foramen Ovale ➡️ Transnasal Different paths, same target — pain relief. A small nerve hub with a big role in headache treatment. Which approach do you prefer? 👀 #SPGBlock

@skmuppasani Thank you for pointing this out. The reverse Trendelenburg position and Trendelenburg position are written backwards.

@journal_aps Wrongly labeled Trendelenberg

🛌 Surgical position ≠ posture Position → venous return → CO → ventilation. 🔻 Trendelenburg: ↑ICP ↑IOP ↓compliance 🔺 Reverse: ↓preload ↑ventilation 🦵 Lithotomy: ⚠ peroneal nerve ⬇️ Prone: ⚠ airway ⚠ vision loss ↔️ Lateral: V/Q mismatch 🪑 Fowler: ⚠ air embolism

⚡Defibrillation isn’t just “shock harder.” It’s shock smarter. Standard (anterolateral) = default. AP (vector change) = better LV coverage. DSED = dual vectors. Rapid sequential shocks. Refractory VF? 👉Vector matters. Energy × direction × impedance = success. #Resuscitation

😏Think heart exams are just "pressed against the chest"? 📡Transesophageal echocardiography (TEE) 🎬The probe enters through the mouth, taking a large-scale image of the heart 👀The image is clearer, blood clots have nowhere to hide 💥Valve problems are detected at a glance

🫃💤 Truly fasted? #GastricUltrasound knows. ➡ Right lateral ➡ Find liver + aorta ➡ Scan the antrum 👀 Measure CSA 📏 Liquid? Solid? Empty? 60-sec aspiration check ⚠️ Safer anesthesia. Smarter calls. #POCUS #Anesthesiology

Chronic postsurgical pain isn’t just “more pain” ⚡—it’s brain rewiring. 🧠✨ After thoracoscopic surgery, patients who developed CPSP showed early changes in the Nucleus accumbens: ⬇️ fALFF ⬇️ Gray matter density 🔌 Shell–core disconnection link.springer.com/article/10.100… #CPSP #Pain

🧠💉 Epidural in 30 seconds: Needle stops in the epidural space — not CSF. Local anesthetic spreads ⬆️⬇️ around nerve roots. Level depends on: 💧 Volume | 🚀 Speed | 🛏️ Position Segmental. Adjustable. Sometimes unilateral. Anatomy = precision. 🎯 #Epidural #RegionalAnesthesia

💉 Dental sedation just got smarter. In a 13-center RCT (n=612), remimazolam proved non-inferior to midazolam for extraction success (99% vs 96%). ✅ ⏱ Faster recovery. 🚪 Earlier discharge. 🛡 Fewer 24h AEs. 🔗link.springer.com/article/10.100… #Anesthesia #DentalSedation

🧠Spinal cord injury—it's a storm of 🔥inflammation, ⚡ROS, and apoptosis. 💊Dexmedetomidine (DEX) goes beyond sedation. It fights NLRP3, oxidative stress, ER stress & cell death. DEX × Hydrogels = from anesthetic to neurorepair tool 🚀 link.springer.com/article/10.100… #SpinalCordInjury

Cardiac anesthesia isn’t just about BP & HR. It’s about the brain. 🔍 BIS tracks anesthetic depth 🩸 NIRS reveals cerebral oxygenation Used together 👉 📉 Less awareness ⚡ Faster extubation 🧩 Fewer cognitive complications link.springer.com/article/10.100… #CardiacAnesthesia #BIS #NIRS

🧠⚡ PDN isn’t just nerve damage—it’s brain rewiring. 🔥 Chronic pain reshapes key brain regions 🔁 Peripheral injury → central remodeling → persistent pain 🎯 Target the brain, not just the nerves 🧐link.springer.com/article/10.100… #PDN #Diabetes #NeuropathicPain #BrainPlasticity