TopMedTalk
TopMedTalk for the latest medical news surrounding Anaesthesia, Perioperative Care and Enhanced Recovery. Live updates from conferences; Journal Club; Techno Talk and Hot-Topic podcasts. Continuing Medical Education (CME) on the go
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TopMedTalk Classic: COVID-19 from the frontlines in Italy
11/02/2026
TopMedTalk Classic: COVID-19 from the frontlines in Italy
This moving piece was originally released Mar 23, 2020 with the title: Epidemiology revisited - a case for virtual meetings | COVID 19 It’s taken from TopMedTalk’s extensive archive and represented here as an encouragement for you to explore our FREE back catalogue of medical conversations. Hear the team’s reaction to the outbreak of the disease from the perspective of healthcare workers in Italy. Focusing on the community health approach to controlling this pandemic, our guest emphasizes the importance of understanding the epidemiology of COVID- 19. Mirco Nacoti, Department of Anesthesia and Intensive Care, Pediatric Intensive Care Unit, Papa Giovanni XXIII Hospital, Bergamo, Italy, was subsequently featured in the New England Journal of Medicine where he along with Andrea Ciocca and Maurizio Cereda wrote this excellent article: Presented by Monty Mythen and Desiree Chappell. This podcast was originally released as part of a longer podcast which you can listen to here:
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ANESTHESIOLOGY® 2026: Preventing Maternal Deaths
10/29/2026
ANESTHESIOLOGY® 2026: Preventing Maternal Deaths
ANESTHESIOLOGY® 2026 meeting in San Diego, TopMedTalk hosts Kate Leslie and Andy Cumpstey interview Mike Scott (University of Rochester; Lifebox co-founder) and LaToya Mason (University of Mississippi; SOAP state representative) about a maternal health forum held alongside the United Nations General Assembly. They discuss worsening global maternal mortality, missed WHO 2030 targets, and that many deaths are preventable, with contributors including rising cesarean rates, older maternal age, and increasing comorbidities; Brazil’s cesarean rate and complications like accreta and concealed hemorrhage are highlighted. Mason shares her personal experience of postpartum peripartum cardiomyopathy detected via smartwatch data, underscoring the need for patient education, listening to patients, and earlier recognition. The panel advanced a mandate that no woman should die during childbirth, emphasizing country-specific approaches, government buy-in, training, scalable monitoring (pulse oximetry, continuous blood pressure), low-fidelity risk tools, and engaging technology and industry to improve outcomes globally and in the US. The Global Surgery Foundation is here:
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ANESTHESIOLOGY® 2026: WFSA President Carolina Haylock-Loor on Global Advocacy for Anesthesiologists
10/28/2026
ANESTHESIOLOGY® 2026: WFSA President Carolina Haylock-Loor on Global Advocacy for Anesthesiologists
ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Andy Cumpstey and James Bowness interview Carolina Haylock-Loor, the president of the World Federation of Societies of Anesthesiologists (WFSA). She explains the WFSA’s role as a global organization with 151 member societies from 158 countries and its strategic priorities of advocacy, collaboration, and education. Noting its status as a WHO non-state actor since 1984 and as the voice for about half a million anesthesiologists to promote safe, affordable, timely anesthesia across the continuum of care. They discuss the need for stronger recognition of anesthesiology and physician-led practice, highlight global health challenges and rural care, and preview the WFSA’s flagship World Congress of Anaesthesiology in Vancouver, May 7–10, 2028, featuring 20+ tracks with global health embedded throughout.
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ANESTHESIOLOGY® 2026: No Surprises Act, IDR, and Out-of-Network Spending
10/27/2026
ANESTHESIOLOGY® 2026: No Surprises Act, IDR, and Out-of-Network Spending
Recorded at ASA Anesthesiology 2026 in San Diego, hosts Andy Cumpstey and Harriet Hopf speak with Patrick Velliky, Chief External Affairs Officer and Senior Vice President for Government Affairs at HaloMD, about misconceptions around the No Surprises Act (NSA) independent dispute resolution (IDR) process and its cost impact. Velliky argues many studies cite total arbitration awards without a pre-NSA baseline, and his emergency medicine analysis comparing like-for-like out-of-network (OON) claims found OON spending is 13%–50% lower post-NSA, with modeled savings depending on assumptions about payments for the ~90% of eligible claims not going to IDR. He discusses the qualifying payment amount (QPA), recent litigation finding unlawful QPA manipulation, and concerns about third-party administrators (TPAs), including lack of transparency, shared-savings fees, and a reported ~35% nonpayment rate of binding IDR awards. The conversation links these issues to anesthesia, subsidies, consolidation, employer oversight, and pending bipartisan legislation to penalize nonpayment and improve accountability.
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Perioperative Profile: Mike Scott
10/26/2026
Perioperative Profile: Mike Scott
At the EBPOM World Congress in London, Andy Cumpstey interviews Professor Michael Scott, Chair of the Department of Anesthesiology and Perioperative Medicine, University of Rochester Medical Center (URMC) in Rochester, New York for TopMedTalk’s Perioperative Profile series. Scott, recounts growing up in Bath in the UK, studying medicine at Birmingham, and funding medical school through award-winning travel photography that later informed medical teaching resources and WHO’s LifeBox work. He describes extensive travel, including China, Nepal, Peru, Gaza, and Myanmar, and how experiences shifted him toward medicine and then anesthesia after time in emergency medicine. Scott outlines his UK training, family moves, and relocation to the US, including work at VCU and Penn during COVID, where he helped build tele-ICU capabilities amid PPE and ventilator shortages. He highlights pride in LifeBox, enhanced recovery/complication reduction, and opioid-sparing initiatives, and advises resilience and supportive partnerships.
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ANESTHESIOLOGY® 2026: Opioid Overdose Prevention and Treatment
10/25/2026
ANESTHESIOLOGY® 2026: Opioid Overdose Prevention and Treatment
ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Kate Leslie and Andy Cumpstey speak with Bonnie Milas, clinical professor of anesthesiology and critical care medicine at the University of Pennsylvania and American Society of Anesthesiologists (ASA) President Patrick Giam. The discussion covers addiction, overdose prevention, and pain management. Milas, who lost two adult sons to accidental fentanyl poisonings, advocates putting naloxone and basic response training in the hands of families and communities. She explains overdose signs (unresponsiveness, pinpoint pupils, slow/shallow breathing, cyanosis), calling 911, rescue breathing/CPR, and that naloxone is an easy, safe nasal spray now available over the counter. Giam discusses anesthesiology’s role in opioid-sparing multimodal analgesia, individualized prescribing, education at discharge, and advocacy for reimbursement and fewer prior authorization barriers. Milas highlights ASA’s REVIVEme initiative to reduce opioid and drug related mortality, an educational campaign to reduce risks from adulterated drug supplies, and the need to remove stigma, educate youth, and make naloxone as available as AEDs. More here:
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ANESTHESIOLOGY® 2026: Army Anesthesiology Leadership, Global Health Engagement, and Readiness
10/24/2026
ANESTHESIOLOGY® 2026: Army Anesthesiology Leadership, Global Health Engagement, and Readiness
This edition of TopMedTalk at Anesthesiology 2026 in San Diego, features Kate Leslie and Sol Aronson interviewing Major Zachary Affrin, a pediatric anesthesiologist at Tripler Army Medical Center in Hawaii, and Captain Joy Ferré, a PGY3 anesthesiology resident at Brooke Army Medical Center/SAUHEC. They discuss paths into military medicine and anesthesiology, including HPSP and Uniformed Services University, and emphasize early leadership opportunities, subspecialty development supported by the Army (including Affrin’s fellowship at Children’s Hospital of Philadelphia), and work-life balance with unique military experiences. Ferré describes Global Health Engagement mission trips, highlighting a Panama trip that delivered 80 cataract, corneal transplant, and glaucoma surgeries for civilian patients. Affrin also notes military innovation efforts such as renewed use of whole blood for trauma care at geographically isolated facilities. Disclaimer: “The views expressed in this recording are those of the authors and do not necessarily reflect the official policy or position of the Defense Health Agency, Department of War, nor the U.S. Government.”
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ANESTHESIOLOGY® 2026: End-tidal Control, Safety and Sustainability
10/23/2026
ANESTHESIOLOGY® 2026: End-tidal Control, Safety and Sustainability
ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Andy Cumpstey and Harriet Hopf interview Shahid Ali, Assistant Professor of Anesthesiology and the Director of Cardiac Anesthesia at the Michael E. DeBakey Veterans Affairs Medical Center in Houston, Texas, about automated anesthesia technologies. Ali contrasts automated inhaled delivery via end-tidal control (now available in the US) with target-controlled infusions (common outside the US but not FDA-approved), explains anesthesia goals and workflows, and describes how clinicians set age-adjusted MAC targets while the system adjusts vapor concentration and fresh gas flow, including a “purge” function to hasten wake-up. He highlights safety features that disengage automation when parameters are unsafe, teaching advantages from real-time visualization of flows, MAC, and cost, and sustainability benefits from low-flow automation, citing large reductions in emissions.
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ANESTHESIOLOGY® 2026: CPMed’s Vision for Coordinated Perioperative Care
10/22/2026
ANESTHESIOLOGY® 2026: CPMed’s Vision for Coordinated Perioperative Care
ANESTHESIOLOGY® 2026 in San Diego, TopMedTalk hosts Kate Leslie and Sol Aronson speak with David L. Hepner, MD, MPH. Associate Professor of Anaesthesia at Harvard Medical School and Bradley R. Cohn, MD, Regional Medical Director and the Chair of Perioperative Medicine for Kaiser Permanente Northern California (KPNC) / The Permanente Medical Group about the American Society of anesthesiologists (ASA) Center for Perioperative Medicine (CPMed) and its push to move perioperative care from fragmented episodes to a coordinated continuum. They describe CPMed’s origins in October 2022, its multidisciplinary and international “big tent” approach, and efforts in education and training, including adding perioperative medicine to ABA topic areas and expanding ACGME training. The discussion highlights patient-first risk framing, care coordination and communication, scarce resource stewardship, learning from UK and other international models (e.g., prehab, anemia/frailty treatment), and the TEAM payment model’s implications for pre-op optimization. They emphasize measuring outcomes, reducing cancellations, and closing gaps at care transitions. More on the ASA’s CPMed here:
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ANESTHESIOLOGY® 2026: Welcome, Meeting Highlights and Upcoming Interviews
10/21/2026
ANESTHESIOLOGY® 2026: Welcome, Meeting Highlights and Upcoming Interviews
TopMedTalk’s coverage of ANESTHESIOLOGY® 2026 (the annual meeting of the American Society of Anesthesiologists) in San Diego begins, with Kate Leslie and Andy Cumpstey introducing this year’s hosting team. Hosts including Mike Grocott, Sol Aronson, James Bowness and new team member Harriet Hopf discuss meeting highlights such as the Emery A. Rovenstine Memorial Lecture from Anesthesiology editor-in-chief James Rathmell and the keynote by Will Flannery (Dr. Glaucomflecken). They emphasize perioperative medicine momentum, networking opportunities, and plans for upcoming TopMedTalk interviews on AI (including Mission Control UCSD and large language models) and perioperative profiles with Carol Peden, Ellen O’Sullivan, James Rathmell and Hugh Hemmings, while thanking the American Society of Anesthesiologists and sponsors BD Advanced Patient Monitoring and GE Healthcare.
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TopMedTalk AI: AI, Augmented Reality and Simulation in Regional Anaesthesia
10/19/2026
TopMedTalk AI: AI, Augmented Reality and Simulation in Regional Anaesthesia
Host James Bowness and co-host Andy Cumpstey introduce another TopMedTalk AI series recorded at St Andrews University with Alasdair Taylor, a Consultant Anaesthetist at NHS Tayside who runs an exam-focused anatomy course (“Anatomy for the FRCA”) and now leads a two-day regional anaesthesia “Regional Anesthesia: Plan A blocks” course aimed mainly at stage two registrars. Supported by NHS Education for Scotland and technology funding, the course is oversubscribed, attracts delegates internationally, has expanded to ICU and emergency medicine applications, and has trained nearly 200 delegates—about 10% of Scotland’s anaesthetists. The course combines cadaveric anatomy teaching from in-house anatomists with live ultrasound scanning augmented by AI anatomy overlays (ScanNav) and a Needle Trainer simulator that projects a retractable-needle path, provides objective metrics like percentage time the needle tip is in view, and supports deliberate practice. Faculty are aligned using ESRA-endorsed block guides while allowing time for tips and debate.
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EBPOM London: Cancer Care, Surgical Robotics and Pain Management
10/15/2026
EBPOM London: Cancer Care, Surgical Robotics and Pain Management
At the Evidence Based Perioperative Medicine (EBPOM) World Congress, and the first World Congress of Enhanced Post-Operative Care (EPOC), Andy Cumpstey interviews Deena Harji, Consultant Robotic and Colorectal Surgeon at the Manchester University NHS Foundation Trust (MFT) and the Professor of Robotics and Digital Healthcare Technologies, alongside Cathy Price, Consultant in Pain Medicine at Southampton NHS Foundation Trust. Harji covers the rapid UK adoption of surgical robotics, noting potential benefits such as lower systemic inflammatory response, less pain, faster recovery, and earlier discharge, while acknowledging implementation has outpaced evidence on clinical and cost effectiveness. Price argues pain management should be treated as a whole perioperative journey, addressing multiple cancer-surgery pain mechanisms and biopsychosocial factors, using multimodal analgesia, ERAS principles, tailored approaches for chronic pain, psychosocial interventions, and functional outcomes rather than “pain tick” metrics. They emphasize teamwork, patient selection for robotics (frail, elderly, obese, complex cases), anesthetic considerations (lower pneumoperitoneum), and sensible limits including early conversion. Find out more about
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Enabling the next generation of research leaders.
10/12/2026
Enabling the next generation of research leaders.
At the Annual Scientific Meeting of the Australian and New Zealand College of Anaesthetists (ANZCA) and Faculty of Pain Medicine (FPM) held in Auckland, New Zealand, Kate Leslie and Andy Cumpstey interview ANZCA president David Story and the ASM New Zealand Visitor Tim Walsh about what inspired them to pursue a career in research and how they support emerging research leaders. David Story is Professor and Chair, Department of Critical Care, University of Melbourne, Australia, and Consultant Anaesthetist at the Austin Hospital, Australia. Tim Walsh is Professor of Critical Care at the University of Edinburgh and Honorary Consultant in Critical Care at Edinburgh Royal Infirmary, Scotland. Find out more about ANZCA here:
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GLP-1 Receptor Agonists and Anaesthesia: Aspiration Risk in a UK Multicentre Study
10/08/2026
GLP-1 Receptor Agonists and Anaesthesia: Aspiration Risk in a UK Multicentre Study
Recorded in Prato, Italy at the 8th Collaborative Clinical Trials in Anesthesiology meeting. Desiree Chappell and guest co-host Mark Priestley interview Professor Kariem El-Boghdadly, Consultant Anaesthetist and Clinical Lead for Theatres, Anaesthesia, and Peri-operative Medicine at Guy's and St Thomas' NHS Foundation Trust, as well as an Honorary Reader at King's College London about the perioperative implications of GLP-1 receptor agonists. El-Boghdadly explains expanding GLP-1 use, delayed gastric emptying, and why early “hold for a week” guidance may be impractical. He describes a UK trainee research network observational study across ~130 hospitals collecting ~47,000 cases, including ~1,300 GLP-1 patients, and reports an unadjusted ~11-fold higher aspiration/regurgitation rate in GLP-1 users (about 1 in 70) versus non-users (about 1 in 800), with about half occurring on emergence/extubation. The discussion emphasizes risk assessment, extubation planning, low uptake of gastric ultrasound, and the need for future randomized trials. The paper being discussed is here: Checkout for more information and early bird tickets to our conferences now.
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TopMedTalk Classic: Detecting and managing frailty
10/05/2026
TopMedTalk Classic: Detecting and managing frailty
This month’s TopMedTalk Classic was originally aired in 2019 but remains very relevant today. Presented by Dr Jugdeep Dhesi, Clinical Lead, POPS and Consultant Geriatrician, Guys and St Thomas' NHS Trust, and an expert on frailty. This talk explores how our understanding and discussion has improved regarding a condition that is still yet to have a clear, universally accepted, definition. How do we build a patient's physical reserve? What is the best way to conceptualise frailty? Are there any universal treatments available? TopMedTalk’s back catalogue contains over 2000 episodes covering all aspects of perioperative medicine. We’d love you to go back and listen to some of our other classic episodes.
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EBPOM Ireland 2026: Pre-Hospital Care in Mountain Rescue and at Sporting Events
10/01/2026
EBPOM Ireland 2026: Pre-Hospital Care in Mountain Rescue and at Sporting Events
Recording from TopMedTalk at EBPOM in Dingle, Ireland, Kate Leslie and Imogen Fecher-Jones interview Oliver Pratt, Consultant Anaesthetist at Salford Royal Hospital, Chair of the Primary FRCA Structured Oral Examinations for the Royal College of Anaesthetists, and a Medical Officer for the Kinder Mountain Rescue Team and Joe Cosgrove, a Consultant in Anaesthesia and Intensive Care Medicine at the Newcastle upon Tyne Hospitals NHS Foundation Trust, a Primary FRCA Examiner for the Royal College of Anaesthetists, and the Critical Care Outreach Lead specializing in advance care planning. He is also Events Medicine Doctor for Durham County Cricket Club and Newcastle United FC plus adviser to the England and Wales Cricket Board on medical contingency and major incident planning for international cricket matches. The discussion is about contributing to pre-hospital care in mountain rescue and event healthcare. Oliver describes joining Kinder Mountain Rescue as a volunteer; emphasising that organisational, teaching, and communication skills are often more useful than advanced procedures. He also notes increasing call-outs for poorly prepared walkers alongside serious cases such as major haemorrhage from a femoral artery laceration. Joe discusses stadium medicine at Newcastle United, where cardiac arrests occur about once per season, including a 19-year-old with Wolff-Parkinson White (WPW) syndrome and cocaine who survived after prolonged CPR amid derby-day security. Both outline structured debriefing practices, and Cosgrove mentions new mandatory event healthcare requirements and forthcoming government guidance, while Pratt directs listeners to Mountain Rescue England and Wales for involvement or donations. More on that here:
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Perioperative Profiles: Duminda Wijeysundera
09/28/2026
Perioperative Profiles: Duminda Wijeysundera
This month’s Perioperative Profile features Duminda Wijeysundera, Professor in the Department of Anesthesiology and Pain Medicine and IHPME at the University of Toronto, and a Staff Physician at St. Michael's Hospital, who holds the Endowed Chair in Translational Anesthesiology Research, serves as Head of Science at SPHERE, acts as a Senior Adjunct Scientist at ICES, and is a Trustee for the International Anesthesia Research Society (IARS). He describes growing up across Sri Lanka, the US, Singapore, and Canada, and how adaptability and cultural sensitivity shaped him; he entered medicine for scientific interest and stability, switched from internal medicine to anesthesiology, and pursued research training using Ontario administrative data, including work on epidural outcomes. He explains the METS study comparing clinicians’ judgment, CPET, the Duke Activity Status Index, and NT-proBNP, and discusses follow-on FAST WALK and FIT After Surgery findings on postoperative disability, frailty, and the impact of poor social supports.
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EBPOM London 2026: Enhanced Postoperative Care Units (EPOCs)
09/24/2026
EBPOM London 2026: Enhanced Postoperative Care Units (EPOCs)
Recorded at the Evidence Based Perioperative Medicine (EPBOM) World Congress in London, this TopMedTalk episode, presented by Andy Cumpstey, features Guy Ludbrook, Professor of Anaesthesia and Head of Acute Care Medicine at the University of Adelaide and resident Georgia Cadzow, discussing the Perioperative Quality Initiative (POQI) POQI is a not-for-profit that uses a formal Delphi process to distill evidence and expert consensus into publishable clinical recommendations on topics such as perioperative hypotension, acute kidney injury, delirium, health economics, and fluid therapy. Georgia describes the iterative POQI meeting format, including pre-reading, small-group drafting, plenary workshopping, and final voting requiring 85% agreement. The conversation focuses on recent POQI work on Enhanced Postoperative Care (EPOC) units—protocolized, short-stay (24–48 hour) care for medium-risk postoperative patients—covering benefits and harms, economic impacts, and quality indicators, alongside plans for shared core datasets, the EPOC Network, and a 2027 second EPOC World Congress.
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Regulating AI in Perioperative Medicine: Data, Trust, and Evidence
09/21/2026
Regulating AI in Perioperative Medicine: Data, Trust, and Evidence
Today’s TopMedTalk AI podcast was recorded at the Association of Anaesthetists of Great Britain and Ireland in London. It features Andy Cumpstey and Desiree Chappell and their guests, John Whittle, honorary associate professor of Perioperative medicine at University College London and Duncan McPherson, Head of the clinical team at QMD Services and Anesthesiologist and Honorary Professor at University College London. We discuss how early AI research shares core requirements with other research—especially data safety and governance—while medical device regulation applies the same legal principles to AI as to other devices: safety and performance, alongside separate data protection laws. Patient concerns focus on data use, trust, and whether AI use in care should require consent. The panel addresses “black box” models, evolving software, bias and generalisability. The conversation contrasts regulated medical devices with unregulated scientific publishing, noting risks from AI-generated fraudulent papers and limits of relying on peer-reviewed literature, while emphasizing critical appraisal and appropriate clinical implementation.
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SOAP: Caesarean Pain, Patient Voice and System Change
09/17/2026
SOAP: Caesarean Pain, Patient Voice and System Change
At the 58th Society for Obstetric Anesthesia and Perinatology (SOAP) meeting in Montreal, TopMedTalk hosts Mike Grocott and Desiree Chappell interview Heather Nixon, SOAP immediate past president and Section Chief for Obstetric Anesthesiology; Section Chief for Simulation, Education, and Training Department of Anesthesiology University of Illinois, about SOAP’s educational mission, governance, outreach, and special interest groups. Nixon describes her focus on intraoperative pain during caesarean delivery after a sentinel event and how listening to patient narratives, including The Retrievals (Season 2), highlighted issues such as dismissal of pain, communication failures, and cultural bias. She outlines SOAP’s toolkit response and UIC system changes: intraoperative pain scoring every 15 minutes in Epic, empowerment to speak up, workflow education, and quicker conversion to general anesthesia to prevent prolonged severe pain, and notes SOAP’s patient-facing Painless Push website. Link to the The Retrievals:
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ANZCA ASM: Neuroscience, neuroimaging and practice in pain medicine
09/14/2026
ANZCA ASM: Neuroscience, neuroimaging and practice in pain medicine
Recorded at ANZCA and the Faculty of Pain Medicine’s Annual Scientific Meeting in Auckland, TopMedTalk hosts Andy Cumstey and Kate Leslie interview visiting pain research leaders, Professor Irene Tracey, the Vice-Chancellor of the University of Oxford and Professor Lesley Colvin, the Chair of Pain Medicine at the University of Dundee and an Honorary Consultant in Anaesthesia and Pain Medicine at NHS Tayside. They discuss how thinking has shifted from chronic pain as a simple transition from acute pain, to a distinct disease with separate mechanisms and early “pre-vulnerability” factors including stress-axis disruption and reduced endogenous inhibition. Colvin outlines epidemiological and neuroimaging evidence linking adverse childhood experiences, including repeated medical procedures, to higher risks of chronic pain and other long-term conditions, with reward-system blunting also seen in depression and more severe pain. Tracey explains the “Bayesian brain,” where dominant priors can sustain pain, influencing treatment and trial design, while both highlight brain plasticity, emerging neurotech such as VR-based training, and behavior-change approaches to increase physical activity. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to
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EBPOM London: The National Clinical Audit for Major Elective Surgery
09/10/2026
EBPOM London: The National Clinical Audit for Major Elective Surgery
At EBPOM 2026 live from the British Library in London, Joff Lacy and Imogen Fecher-Jones speak with Malcolm West and Tim Baker, clinical co-leads for the National Clinical Audit of Perioperative Care (NCAPC), an NHS England mandated and HQIP-funded initiative managed by the Royal College of Anaesthetists to audit major elective surgery in England and publicly funded Jersey. They outline the audit’s denominator (major surgery with anaesthetist involvement and >24-hour stay), year-one focus cohorts (thoracic, major gynaecology, major hip/knee orthopaedics, and lower GI/colorectal surgery), and aims to improve data quality and reduce unwarranted variation. The team describes a rapid modified Delphi process involving 200+ professionals and 70+ patients to define core metrics, highlights plans to automate data collection via hospital electronic records, and explains local roles, an organisational survey, and the goal of ongoing expansion and long-term delivery. FOR MORE ON EBPOM IRELAND GO HERE:
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TopMedTalk Classic: Managing Perioperative Risk in Frail Patients
09/07/2026
TopMedTalk Classic: Managing Perioperative Risk in Frail Patients
This month’s TopMedTalk Classic has been digitally remastered for you and we’ve added the Q&A which wasn’t part of the original podcast. We’re featuring a talk first broadcast in 2018, featuring BobbieJean Sweitzer, Systems Director, Preoperative Medicine, Inova Health, Falls Church, Virginia, and Professor of Medical Education, University of Virginia. BobbieJean discusses whether perioperative risk in frail patients can be managed, emphasizing that current risk tools underweight frailty and functional outcomes. Using cases and data from U.S. nursing home residents, she highlights high postoperative mortality and functional decline after procedures such as colectomy and breast surgery, arguing for multidisciplinary, patient-inclusive decision-making that considers nonoperative and palliative options. Sweitzer describes Northwestern’s implementation of quick frailty and cognitive screening, plus interventions including anemia treatment, nutritional optimization, and elements of prehabilitation, noting evidence that screening can trigger goal clarification and more palliative care consults. In the Q&A, speakers debate frailty-tool consensus, motivating patient engagement, funding prehab services, interpretation of mortality reductions after screening, and strategies to influence surgeons’ decision-making. Original podcasts:
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SMART trial designs, perioperative data ecosystems, and collaboration
09/03/2026
SMART trial designs, perioperative data ecosystems, and collaboration
At the Collaborative Clinical Trials meeting in Prato, Italy, Mike Grocott and co-host Mark Priestley speak with Sachin Kheterpal, University of Michigan Medical School’s Associate Dean for Research Information Technology and the Robert B Sweet Professor and Kelley M. Kidwell, Chair of the Department of Anesthesiology and Professor of Biostatistics at the University of Michigan School of Public Health and Senior Associate Dean for Faculty Affairs . Kidwell explains sequential multiple assignment randomized trials (SMART) as multi-stage designs that randomize at key decision points to evaluate treatment sequences, distinguishing them from adaptive trials and addressing misconceptions about sample size. Kheterpal describes the University of Michigan–led Multi-Center Perioperative Outcomes Group (MPOG), contrasting EHR-based automated extraction and individual provider feedback with manually collected programs like NSQIP, and discussing alignment with AQI/NACOR and inspiration from UK National Audit Projects to improve documentation for future inference. They note emerging use of large language models to extract outcomes from free-text notes, discuss pragmatic trial designs including THRIVE, and emphasize the value of close statistician–clinician collaboration and scientific humility, highlighting a BMJ talk on countering misinformation. For more information on EBPOM Dingle, go here now:
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Perioperative Profile: Dan Sessler
08/31/2026
Perioperative Profile: Dan Sessler
In this TopMedTalk perioperative profile, host Andy Cumpstey interviews Professor Dan Sessler, Vice President for Clinical and Outcomes Research and Professor of Anesthesiology and Biostatistics at UTHealth Houston (McGovern Medical School), about his career as a perioperative trialist with over 1,000 publications. Sessler describes his scientific family background, early inspiration from clinical trials through Henry Kaplan’s Hodgkin’s work, and a shift from planned pediatric oncology to anesthesiology. He recounts building a research career starting with perioperative thermoregulation at UCLA and UCSF, then expanding into broad outcomes research, ultimately founding a large Department of Outcomes Research at the Cleveland Clinic and advocating for large multicenter trials. He emphasizes mentorship, philanthropy, and his current focus on reducing postoperative mortality through better ward monitoring and prevention beyond “failure to rescue.” - The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to
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IARS 2026: Foundation for Anesthesia Education and Research (FAER)
08/27/2026
IARS 2026: Foundation for Anesthesia Education and Research (FAER)
At The International Anesthesia Research Society (IARS) and Society of Critical Care Anesthesiologists (SOCCA) meeting in Montreal, TopMedTalk hosts Mike Grocott and former editor-in-chief Desiree Chappell speak with FAER board members Dr. Rebecca A. Aslakson, Chair and Professor with Tenure, Department of Anesthesiology, University of Vermont Health Network and Dr. Michael Gropper, Professor and Chair of the UCSF Department of Anesthesia and Perioperative Care, about the Foundation for Anesthesia Education and Research (FAER). We describe how FAER’s early-career support—especially the Mentored Research Training Grant—helped launch our guest’s own research trajectories and facilitates transition to larger funding, with about 60% of MRTG recipients later obtaining NIH funding. They outline FAER’s origins (founded in 1986 in partnership with the ASA), funding mechanisms spanning medical students to early faculty, partnerships with multiple specialty organizations, and career development resources including networking, mock study sections, and a National Academy of Medicine collaboration, emphasizing mentorship and community as central to long-term research success. -- Find out more about EBPOM Dingle now:
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TopMedTalk AI: AI-Augmented Ultrasound for Regional Anaesthesia
08/24/2026
TopMedTalk AI: AI-Augmented Ultrasound for Regional Anaesthesia
In Scotland at St Andrews, TopMedTalk AI hosts Andy Cumpstey and James Bowness discuss AI in regional anaesthesia with Bernard Victor Delvaux, staff anesthesiologist at the Centre Hospitalier Privé Claude Galien in Quincy-sous-Sénart, France. Bowness describes a regional anaesthesia course using AI-augmented ultrasound imaging, augmented reality simulated needling, and cadaveric ultrasound with real needle insertion. Delvaux discusses his research in AI-assisted nerve recognition, explains supervised model development through large-scale ultrasound image annotation for GE Healthcare’s C-NERF, and they explore how to evaluate AI beyond pixel-based metrics toward clinically oriented utility and safety, including differences in usefulness for trainees versus experts. They discuss model design across anatomical sites, the need for diverse training and external validation data, risks from poor image acquisition, and barriers such as trust and autonomy. Delvaux outlines priorities for ESRA’s AI working group, focusing on AI literacy and faster, reliable evaluation guidance. -- The 2026 International Practicum on Cardiopulmonary Exercise Testing will be held at the Balmer Lawn Hotel in Brockenhurst, UK, from September 16th to 18th this year. It is organised by iPOETTS , the international perioperative testing and training society. Come and join us at this premier educational event designed for clinicians, scientists, and healthcare professionals interested in sport, exercise, and perioperative medicine. This is an International Perioperative Testing and Training Society accredited event so when you attend you can get your iPOETTS accreditation, showing that you are a practitioner who has reached a high, standardized level of competence in performing and interpreting Cardiopulmonary Exercise Testing (CPET) for patients preparing for major surgery. Go now to
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Breaking Trials: ITACS Trial on Preoperative IV Iron for Anaemia Before Cardiac Surgery
08/20/2026
Breaking Trials: ITACS Trial on Preoperative IV Iron for Anaemia Before Cardiac Surgery
Recorded at the excellent ANESTHESIOLOGY® 2025 in San Antonio. Hear Andy Cumpstey and Mike Grocott interview Paul Myles, a Professor of Anaesthesiology and Perioperative Medicine at Monash University in Melbourne, Australia. Here we focus upon his group’s approach to large pragmatic, multicenter international trials and the process of selecting and developing study questions within a clinical trials network. Myles presents the ITACS trial (intravenous iron treatment for anaemia before cardiac surgery), designed because anaemia is common (~30%) in elective cardiac surgery and is associated with increased complications, longer hospital stay, mortality, and greater transfusion requirements, while prior randomized evidence supporting routine preoperative IV iron clinics has been weak despite observational associations. The two-arm randomized controlled trial enrolled about 1,000 patients scheduled for cardiac surgery 1–26 weeks ahead across 33 hospitals in 10 countries; patients with anaemia due to causes unlikely to benefit from iron (e.g., megaloblastic anemia, certain iron storage diseases) were excluded, while non–iron deficiency anaemia was included. Participants received a single 1 g dose of IV iron in the weeks preoperatively, with a primary endpoint of days alive and at home at 90 days to capture patient-centered recovery and the functional impact of complications. Results included a statistically significant one-day improvement in days alive and at home, modestly higher preoperative haemoglobin, markedly improved iron indices, and a marked reduction in red cell transfusions intraoperatively and through 30 days and 3 months; the team estimated saving 44 units of red cells per 100 patients treated. The one-day benefit was mainly driven by fewer readmission days, and a formal cost-effectiveness analysis (with Australian resource-use data) is underway with planned publication within six months. The discussion highlights why mild anaemia matters in major surgery due to postoperative blood loss and recovery, and notes that while extrapolation to other major surgeries with expected blood loss >500 mL may be considered, the hosts and Myles emphasize ongoing equipoise and the need for additional large randomized trials outside cardiac surgery. -- We strongly suggest you investigate our forthcoming EBPOM Ireland conference, being held in the beautiful location of Dingle. World leading experts in perioperative medicine presenting the latest cutting edge research in periperative medicine and enhanced recorvery after surgery. Find more information at
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EBPOM London 2026: European Postoperative Care Pathways
08/17/2026
EBPOM London 2026: European Postoperative Care Pathways
This presentation was recorded at the Evidence Based Perioperative Medicine (EBPOM) 2026 Annual Global Meeting. It features Nicolai Bang-Foss, Consultant, head of GI and orthopaedic anaesthesia, Hvidovre University Hospital, Denmark His main research field is the perioperative care of the elderly emergency patient. Specific areas of research have been regional analgesia, transfusion thresholds, outreach programs and perioperative logistics as well as perioperative haemodynamics. He describes wide European variation in postoperative pathways driven largely by ICU bed capacity, with Scandinavian countries running lean systems that push PACUs toward 24-hour, higher-acuity perioperative units and preoperative optimization for emergency laparotomy and hip fracture care. He outlines nonstandardized PACU/IMC structures, variable nursing education, and Danish strategies such as bypassing PACU for uncomplicated spinal anesthetic hip/knee replacements to free capacity for high-risk cases. He also reports research suggesting PACU nurses’ clinical judgment outperforms discharge scores and highlights deteriorating surgical ward staffing and post-COVID pressures affecting triage and outcomes. If you’d like to hear presentations of this standard - before anyone else - we suggest you investigate our forthcoming EBPOM Ireland conference, being held in the beautiful location of Dingle. World leading experts in perioperative medicine presenting the latest cutting edge research in periperative medicine and enhanced recorvery after surgery. Find more information at
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Breaking Trials: The VITAL trial on TIVA, volatiles and outcome
08/13/2026
Breaking Trials: The VITAL trial on TIVA, volatiles and outcome
Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this episode of TopMedTalk sees Andy Cumpstey speaking with a panel of experts about the VITAL trial: a pragmatic randomised controlled trial about volatile vs total intravenous anaesthesia (TIVA) for major non-cardiac surgery in adult patients. The primary outcome was days alive and out of hospital at 30 days. Despite finding no significant differences in the primary outcome, the trial reveals that patients receiving TIVA anesthesia experience better recovery, with less postoperative nausea and other side effects. The conversation also touches on the trial mechanics, related ongoing studies, and implications for future research and clinical practice. Our guests include Professor Joyce Yeung, Director, Perioperative Medicine Clinical Trials Network, Associate Clinical Professor at University of Warwick and Honorary Consultant in critical care; Dr Shaman Jhanji, Consultant in Anaesthetics and Intensive Care Medicine at the Royal Marsden Hospital, London and Professor Bernhard Riedel, Director, Department of Anaesthetics, Perioperative Medicine, and Pain Medicine, Peter MacCallum Cancer Centre, Melbourne, Australia The paper is here: For more about EBPOM check out
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