15: Is dural puncture epidural (DPE) the optimal labor analgesia technique?
Release Date: 07/03/2020
Depth of Anesthesia
Dr. Jess Hawkins joins the show to discuss the literature pertaining to remifentanil and opioid-induced hyperalgesia. Dr. Hawkins is an anesthesia resident at the Massachusetts General Hospital. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your colleagues. — Follow us on Instagram @DepthofAnesthesia and on Twitter (X) @DepthAnesthesia for podcast and literature updates. Email us at [email protected] with episode ideas or if you'd...
info_outline 37: Should intraoperative dexamethasone be avoided in patients with diabetes mellitus?Depth of Anesthesia
Dr. Caroline Andrew and Dr. David Nathan join the show to discuss the literature pertaining to intraoperative administration of dexamethasone. Dr. Caroline Andrew is an anesthesia resident at the Massachusetts General Hospital. Dr. David Nathan is the Director of the Diabetes Center at Massachusetts General Hospital and Professor of Medicine at Harvard Medical School. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your colleagues. — Follow...
info_outline 36. Does tranexamic acid increase the risk of thromboembolism?Depth of Anesthesia
Dr. Zach Cost and Dr. Tem Bendapudi join the show to discuss the literature pertaining to tranexamic acid and thromboembolic risk. Dr. Zach Cost is an anesthesia resident at the Massachusetts General Hospital. Dr. Pavan (“Tem”) Bendapudi holds a joint faculty appointment in the Division of Hematology and Blood Transfusion Service and is assistant professor of medicine at Harvard Medical School. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your...
info_outline 35. Does spinal anesthesia decrease the risk of postoperative delirium?Depth of Anesthesia
Dr. Mark Neuman and Dr. Sam Falkson join the show to discuss the literature around risks of regional versus general anesthesia for postoperative delirium. Dr. Neuman is the founding Director of the Center for Perioperative Outcomes Research and Transformation and Professor of Anesthesiology at Penn Medicine. Dr. Sam Falkson is an anesthesia resident at the Massachusetts General Hospital. This podcast was recorded as part of the Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your...
info_outline 34. Are double lumen endotracheal tubes superior to bronchial blockers?Depth of Anesthesia
Dr. Nick Kumar and Dr. Andy Siemens from the Massachusetts General Hospital anesthesia residency join the show to discuss the literature comparing double lumen endotracheal tubes and bronchial blockers. Dr. Dan Saddawi-Konefka joins as our faculty expert - special thanks to Dan for supporting the ongoing Depth of Anesthesia podcast elective. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your colleagues. — Follow us on Instagram @DepthofAnesthesia and on Twitter @DepthAnesthesia for podcast and literature updates. Email us...
info_outline 33. Do perioperative gabapentinoids decrease postoperative pain?Depth of Anesthesia
It's our first solo episode! We review the evidence around perioperative use of gabapentinoids (gabapentin and pregabalin) and discuss interesting concepts including trial sequential analysis and minimally important difference. If you enjoy our content, leave a 5-star review on Apple Podcasts and share our content with your colleagues. — Follow us on Instagram @DepthofAnesthesia and on Twitter @DepthAnesthesia for podcast and literature updates. Email us at [email protected] with episode ideas or if you’d like to join our team. Music by Stephen Campbell, MD. — References...
info_outline 32: Do LMAs increase the risk of aspiration compared to ETTs? - Part II of IIDepth of Anesthesia
Dr. Chris Di Capua and Dr. Bryan Glezerson (@BryanGlezerson) join the show to discuss the literature around the risk of aspiration with LMAs compared to ETTs. This is an episode produced from the Depth of Anesthesia Podcast Elective that’s available to MGH anesthesia residents. Special thanks to Dr. Saddawi-Konefka for supporting the initiative. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts. — Follow us on Instagram @DepthofAnesthesia and on Twitter @DepthAnesthesia for podcast and literature updates. Email us at [email protected] with...
info_outline 31: Do LMAs increase the risk of aspiration compared to ETTs? - Part I of IIDepth of Anesthesia
Dr. Chris Di Capua and Dr. Bryan Glezerson (@BryanGlezerson) join the show to discuss the literature around the risk of aspiration with LMAs compared to ETTs. This is part I of a two-part series on LMAs. In part II, we discuss the safety of LMAs in specific patient populations including patients receiving positive pressure ventilation, patients undergoing laparoscopic surgery, obese patients, and pregnant patients. This is an episode produced from the Depth of Anesthesia Podcast Elective that’s available to MGH anesthesia residents. Special thanks to Dr. Saddawi-Konefka for supporting the...
info_outline 30: Live from the IARS Annual Meeting - Part II of IIDepth of Anesthesia
In this special two-part series, we record a live episode at the International Anesthesia Research Society meeting. Dr. Dan Saddawi-Konefka and I revisit a question from our very first Depth of Anesthesia episode: is it necessary to confirm mask ventilation before paralyzing? Supporting graphics are available at and on our Instagram @DepthofAnesthesia. Special thanks to Dr. Seun Johnson-Akeju, Dr. Keith Baker, and Dr. Dan Leisman for their guidance and support. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and consider helping us...
info_outline 29: Live from the IARS Annual Meeting - Part I of IIDepth of Anesthesia
In this special two-part series, we record a live episode at the International Anesthesia Research Society meeting. Dr. Dan Saddawi-Konefka and I revisit a question from our very first Depth of Anesthesia episode: is it necessary to confirm mask ventilation before paralyzing? Supporting graphics are available at and on our Instagram @DepthofAnesthesia. Special thanks to Dr. Seun Johnson-Akeju, Dr. Keith Baker, and Dr. Dan Leisman for their guidance and support. Thanks for listening! If you enjoy our content, leave a 5-star review on Apple Podcasts and consider helping us offset the...
info_outlineIn this episode, we investigate the following claims related to DPE:
1. Dural puncture epidural (DPE) technique improves analgesic quality versus traditional epidural
2. DPE technique has faster onset of analgesia versus traditional epidural
3. DPE has less adverse effects compared with combined spinal-epidural (CSE)
Our guest today is Dr. Ronald George (@Ron_George), Professor and Chief of Obstetric Anesthesia at UCSF.
Connect with us @DepthAnesthesia on Twitter or email us at [email protected]
Thanks for listening! Please rate us on iTunes and share with your colleagues.
Music by Stephen Campbell, MD.
--
References
Heesen M, Rijs K, Rossaint R, Klimek M. Dural puncture epidural versus conventional epidural block for labor analgesia: a systematic review of randomized controlled trials. Int J Obstet Anesth. 2019;40:24-31. doi:10.1016/j.ijoa.2019.05.007
Thomas JA, Pan PH, Harris LC, Owen MD, D'Angelo R. Dural puncture with a 27-gauge Whitacre needle as part of a combined spinal-epidural technique does not improve labor epidural catheter function. Anesthesiology. 2005;103(5):1046-1051. doi:10.1097/00000542-200511000-00019
Wilson SH, Wolf BJ, Bingham K, et al. Labor Analgesia Onset With Dural Puncture Epidural Versus Traditional Epidural Using a 26-Gauge Whitacre Needle and 0.125% Bupivacaine Bolus: A Randomized Clinical Trial. Anesth Analg. 2018;126(2):545-551. doi:10.1213/ANE.0000000000002129
Cappiello E, O'Rourke N, Segal S, Tsen LC. A randomized trial of dural puncture epidural technique compared with the standard epidural technique for labor analgesia. Anesth Analg. 2008;107(5):1646-1651. doi:10.1213/ane.0b013e318184ec14
Chau A, Bibbo C, Huang CC, et al. Dural Puncture Epidural Technique Improves Labor Analgesia Quality With Fewer Side Effects Compared With Epidural and Combined Spinal Epidural Techniques: A Randomized Clinical Trial. Anesth Analg. 2017;124(2):560-569. doi:10.1213/ANE.0000000000001798
__
By listening to this podcast, you agree not to use information as medical advice to treat any medical condition in either yourself or others, including but not limited to patients that you are treating. Opinions expressed are solely those of the host and guests and do not express the views or opinions of Massachusetts General Hospital.