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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Nitrous Oxide as a Treatment for Severe Depression: Insights from Anesthesiology 2025
11/17/2025
Nitrous Oxide as a Treatment for Severe Depression: Insights from Anesthesiology 2025
Andy Cumpstey and Kate Leslie at the American Society of Anesthesiologists (ASA) Annual Meeting 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.
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Insights on the Future of Anesthesia Quality Improvement with AQI
11/10/2025
Insights on the Future of Anesthesia Quality Improvement with AQI
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.
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Innovations and Achievements at the Center for Perioperative Care (CPOC)
11/03/2025
Innovations and Achievements at the Center for Perioperative Care (CPOC)
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.
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Perioperative Profiles - Kate Leslie
10/27/2025
Perioperative Profiles - Kate Leslie
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.
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Understanding Anesthesia Information Management Systems with Dr. David Kennedy
10/22/2025
Understanding Anesthesia Information Management Systems with Dr. David Kennedy
Anesthesiology 2025, the annual meeting of the American Society of Anesthesiologists, 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.
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Transforming Pain Medicine: An Insight into the Pain Medicine Coalition
10/21/2025
Transforming Pain Medicine: An Insight into the Pain Medicine Coalition
Andy Cumpstey and Kate Leslie take us to Anesthesiology 2025, the annual meeting of the American Society of Anesthesiologists (ASA), 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.
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Insights from the ASA Presidents at Anesthesiology 2025
10/20/2025
Insights from the ASA Presidents at Anesthesiology 2025
Desiree Chappell and Mike Grocott at the American Society of Anesthesiologists (ASA) Annual Meeting 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.
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Clinical Readiness and Training Affiliation in Army Anesthesiology
10/17/2025
Clinical Readiness and Training Affiliation in Army Anesthesiology
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, the annual meeting of the American Society of Anesthesiologists (ASA) conference 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.
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Navigating Governance in Anesthesiology Groups: Insights from ASA 2025
10/16/2025
Navigating Governance in Anesthesiology Groups: Insights from ASA 2025
Anesthesiology 2025, the annual meeting of the American Society of Anesthesiologists. The TopMedTalk team were there and this piece sees Mike Grocott speaking with Sheena Scott, Founder of Scott Healthcare Consulting and Jason Greenberg, Strategic Advisor, Anesthesia, Ventra Health. They discuss common governance mistakes in anesthesiology groups, the importance of effective governance structures, and strategies for improvement. The conversation highlights the challenges of democratic decision-making in larger groups, the need for emotional intelligence in leadership, and methods to address detractors and conflicts. They also emphasize the importance of bylaws, outside consultation, and continued professional development through resources like the ASA's Advance meeting.
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Anesthesiology Economics: Current Trends and Future Directions
10/14/2025
Anesthesiology Economics: Current Trends and Future Directions
Anesthesiology 2025, the annual meeting of the American Society of Anesthesiologists (ASA), Desiree Chappell and Sol Aronson discuss the evolving economics of anesthesiology with guests Jonathan Gal, MD, Professor of Anesthesiology, Department of Anesthesiology, Perioperative and Pain Medicine, Icahn School of Medicine at Mount Sinai, System Medical Director- Facility Revenue Integrity & Optimization; System Medical Director- Offsite ASC Anesthesia; ASA Director from New York for the Board of Directors and Chair of the Committee on Economics and Gordon Morewood, MD, Anesthesiologist-in-Chief of Temple University Health System, Chair and Professor of Clinical Anesthesiology at Lewis Katz School of Medicine at Temple University and Chief of Anesthesia at Piedmont Health (Piedmont Healthcare System, Georgia). The conversation spans various models of payment, including CPT codes, fee-for-service, and alternative payment models. They delve into the nuances of navigating different payer systems like Medicare, Medicaid, and private insurers, highlighting recent trends and challenges. Specific topics include the erosion of physician payments, the impact of the No Surprises Act, and the ASA's ongoing advocacy efforts. The episode underscores the importance of proper economic strategies to ensure the sustainability and optimization of anesthesiology practices.
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The Center for Anesthesia Workforce Studies at the ASA 2025
10/14/2025
The Center for Anesthesia Workforce Studies at the ASA 2025
Presented by Desiree Chappell and Sol Aronson with their guests, Mary Dale Peterson, Executive VP and COO, Driscoll Children's Health System, serving as chair of the ASA’s Workforce Summits, chair of the Ad Hoc Taskforce on Physician Workforce and chair of the Ad Hoc Committee on Anesthesia Workforce Research and a member of the ASA Charitable Foundation’s board of directors, and Thomas Miller, Director of Analytics and Research Services (ARS) and the Center for Anesthesia Workforce Studies (CAWS). The conversation covers topics such as the increasing supply of anesthesiology professionals, the impact of COVID-19, and the growing demand for non-operating room anesthesia services. Dr. Peterson shares insights from her experience managing pediatric anesthesiology and suggests innovative solutions for workforce management. The panel also addresses the challenges of maintaining efficient operations amidst changing practice patterns and the importance of adapting to the new workforce's needs and preferences. More on the ASA’s CAWS here: As we mention Mary has appeared previously on TopMedTalk here:
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Pediatric Airway Management Advances: Insights from Annery Garcia-Marcinkiewicz
10/13/2025
Pediatric Airway Management Advances: Insights from Annery Garcia-Marcinkiewicz
Our coverage of Anesthesiology 2025 begins, presented by Desiree Chappell and Andy Cumpstey with their guest Annery Garcia-Marcinkiewicz MD MSCE, Care Medicine at the Children’s Hospital of Philadelphia, University of Pennsylvania. The discussion highlights the unique challenges and anatomical differences in pediatric patients, elaborates on the evolution of airway management tools and the impact of the Pediatric Difficult Intubation Registry. We underscore the benefits of video laryngoscopy over direct laryngoscopy in improving first-attempt success rates and reducing complications, especially in small, vulnerable infants. The episode concludes with practical advice for clinicians and the importance of advanced equipment in enhancing patient safety and efficiency in pediatric anesthesiology.
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Dingle Conference - the year in review
10/06/2025
Dingle Conference - the year in review
The full team gather together to reflect on the last 12 months of TopMedTalk at this year’s Evidence Based Perioperative Medicine (EBPOM) Dingle conference. Desiree Chappell, Sol Aronson, Andy Cumpstey, Mike Grocott, Kate Leslie and Monty Mythen select highlights from the archives for our new listeners. Here are the podcasts they mention, start your TopMedTalk journey with any of these. The PREPARE Trial “some great insights in the frailty, rehabilitation field and .. some really smart work … probably the top of my list” Mike Grocott. This excellent podcast: -- Gender Disparities in Surgical Efficiency and Outcomes "We had a great meeting with a medical student of Professor Matthias Eikermann in New York who talked about the different experiences of male and female practitioners. And that was really very powerful … she spoke really well…someone to watch out for, for the future.” Kate Leslie -- Perioperative medicine, the challenges, the rewards and the future “We had Ramani Moonesinghe visiting Australia from the uk, who obviously great friend of TopMedTalk and we know well, which she did a really, really fascinating conversation with us.” Andy Cumpstey -- Improving sustainability and reducing operating room waste “She says the same thing every time and, and every time I feel I'm a little bit closer to being a good citizen with respect to sustainability. And, you know, we all sort of focus on things like recycling and disposables and things like that, but she, she sort of focuses on a much bigger picture of the supply chain and, um, how we really need to reinvent all the processes” Kate Leslie -- Exploring cerebral autoregulation “Her research, which is published in the public domain, recognizing the fact that there isn't a magic number of, for blood pressure. It's very individual and so it's a great podcast. Please do listen to it. There's a scary bit towards the end, which recognized that, in critical critically ill patients, you know, they quite often, we let their blood pressures drop. They have high right sided pressures and we often sit them up 'cause we think it's good for them. So listen to that bit because, you know, scary.” Monty Mythen “He just crystallized so well, it was like a sort of a primary exam. A capsule of information about this new idea, which I don't think I can actually properly explain either, but it's got to do with blood pressure, diabetes, and hypercholesterolemia, and how a combination of things can put you in this metabolic risk category.” Kate Leslie -- Periperative Profiles, Paul Myles “A really interesting conversation with Professor Paul Myles, which started off a new series for us, which I'm really enjoying. We've called that the Perioperative Profile series and, I guess the aim of that series, if you like, is to speak to some of the key thought leaders in our space” Andy Cumpstey
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Perioperative Profiles, Ramani Moonesinghe
09/28/2025
Perioperative Profiles, Ramani Moonesinghe
At this year’s Evidence Based Perioperative Medicine (EBPOM) World Congress we sat down with Ramani Moonesinghe OBE, and had a conversation about her remarkable journey from her immigrant roots to her influential roles in perioperative and critical care. Hear about her contributions to Britain’s National Health Service, her groundbreaking research, and her personal life balancing a demanding career with family. Gain insights into the future of perioperative care, health inequalities, and her thoughts on the nation’s COVID-19 preparedness. Presented by Andy Cumpstey with Ramani Moonesinghe OBE, Professor of Perioperative Medicine, UCL, and Honorary Consultant in Anaesthesia and Perioperative Medicine, UCLH, London, UK.
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Advances in Perioperative Medicine and Postoperative Monitoring
09/21/2025
Advances in Perioperative Medicine and Postoperative Monitoring
Recorded at this year’s Evidence Based Perioperative Medicine (EBPOM) World Congress held in London, this episode of TopMedTalk features Andy Cumpstey with his guests TJ Gan, Professor and Division Head, Anesthesiology, Critical Care and Pain Medicine, UT Texas MD Anderson Cancer Center, Houston, TX, USA, and Tim Miller, Professor of Anesthesiology at Duke University Medical Center, Durham, NC, USA. The conversation provides insights on the key themes and developments from the conference. They discuss the critical importance of postoperative monitoring and interventions, including haemodynamic management, advanced monitoring systems, and the integration of new technologies such as AI and wearables. They emphasize evolution in surgical practices, particularly the shift towards outpatient procedures facilitated by robotic surgery. The conversation then highlights the global need for enhanced postoperative care standards and the potential future directions in perioperative medicine.
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Dreaming Toolkit: Improving Patient Recovery through Drinking, Eating, and Mobilizing
09/15/2025
Dreaming Toolkit: Improving Patient Recovery through Drinking, Eating, and Mobilizing
Andy Cumpstey is joined by three experts from NHS England; Mindy Dawes, Deputy Divisional Director of Nursing for Surgery at Walsall Healthcare NHS Trust; Maria Oyston, Head of Nursing Service Transformation & Resilience at NHS England; and Jane Murkin, Deputy Director for Safety & Improvement - Nursing at NHS England, to discuss the Dreaming Project and Toolkit. The conversation delves into the origins and implementation of the Dreaming Collaborative, which aims to prevent patient deconditioning post-surgery by promoting early drinking, eating, and mobilizing. They discuss the contributions of various stakeholders, the importance of a multi-disciplinary approach, and the toolkit which was designed to help healthcare providers implement these strategies effectively. The episode highlights the significant improvements in patient outcomes and reduced length of stay achieved through this project, as well as the importance of engaging patients and healthcare staff at all levels. Further reading: We mention this paper: Our guest, Mindy Dawes, provides this paper:
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Advancements in Surgery Schools: Insights from EBPOM World Congress
09/08/2025
Advancements in Surgery Schools: Insights from EBPOM World Congress
Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this piece sees Andy Cumpstey speaking with Imogen Fecher-Jones, Lead Nurse Perioperative Services, University Hospital Southampton, and Andrew Davies, Consultant in upper gastro-intestinal surgery at Guy's and St Thomas' NHS Hospital Trust, in the UK. We discuss the concept and benefits of surgery schools, their development in the UK, and a newly created toolkit aimed at standardizing and implementing these programs more effectively. Discover how surgery schools are impacting patient outcomes and the importance of evidence-based approaches in modern medicine. This episode also delves into the multidisciplinary efforts and various stakeholders involved in creating the surgery school toolkit, with insights on its applicability both nationally and internationally. Tune in to learn more about this pivotal initiative from leading experts in the field. We mention our previous podcast on the topic of The Perioperative Quality Initiative (POQI), which you can hear here:
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The Future of Continuous Blood Pressure Monitoring
09/01/2025
The Future of Continuous Blood Pressure Monitoring
Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London, Andy Cumpstey is joined by Simon Davies, Consultant Anaesthetist York Teaching Hospitals NHS Foundation Trust. We discuss Simon’s work at the intersection of university research, NHS practice, and industry consulting. Hear about his recent experiences and insights from a meeting on Capitol Hill where a bipartisan group is pushing for increased continuous blood pressure monitoring. Key topics include technological advancements, patient safety, and the significant implications for maternal and general surgical care. The episode also touches upon the global and future impact of these initiatives as well as upcoming research projects in the field.
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Perioperative Profiles, Paul Myles
08/25/2025
Perioperative Profiles, Paul Myles
Perioperative Profiles is a new series from TopMedTalk which looks at both the professional and personal journey taken by some of the world’s most innovative and successful perioperative practitioners and researchers. In this, the first of the series, Andy Cumpstey interviews Professor Paul Myles, Director of Research in the Department of Anaesthesiology and Perioperative Medicine at the Alfred Hospital in Melbourne, and Head of Department at Monash University, Australia. Recorded during the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this year, hear how Paul was inspired by his mother with ambitions to become a country GP and then took a trip to the United Kingdom where he was inspired by a new vision; anesthesiologists leading practice changing research. Paul Myles discusses his early years, his initial medical training at Monash University, and the pivotal experience in the UK that steered him towards anesthesiology. Hear about his transition into research, the challenges he faced, and his significant contributions, including the establishment of multi-center trials and the ANZCA Clinical Trials Network. The discussion also touches on the balance between career and family, and the future of clinical trials with adaptive designs. The episode underscores the importance of collaboration, mentorship, and persistence in achieving success in medical research.
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Perioperative Medicine and Promoting Diversity in Healthcare
08/18/2025
Perioperative Medicine and Promoting Diversity in Healthcare
Perioperative Medicine and Promoting Diversity in Healthcare, A Deep Dive with David Story, Professor and Foundation Chair of Anaesthesia at the University of Melbourne; Head of the University Department of Critical Care, and President of the Australian and New Zealand College of Anesthetists (ANZCA). In this piece we discuss the evolution of perioperative medicine and the importance of diversity and inclusion within healthcare, focusing particularly on the challenges and advancements involving First Nations people in Australia and Aotearoa New Zealand. Hear insights into the efforts to support Aboriginal and Torres Strait Islander peoples, and Māori, in medical education and practice, emphasizing the role of trust and cultural sensitivity. We also touch on gender equity in the medical field and the progress made towards a fairer, more inclusive environment in both Australia and Aotearoa New Zealand. Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London and presented by Andy Cumpstey. For more information on EBPOM please visit
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Enhanced Recovery Pathways in Ambulatory Surgical Care | EBPOM 25
08/11/2025
Enhanced Recovery Pathways in Ambulatory Surgical Care | EBPOM 25
Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress 2025 in London, this piece focuses upon pioneering work in ambulatory surgical care and enhanced recovery pathways. Presented by Andy Cumpstey with his guest Dr. Anoushka Afonso, Associate Professor of Clinical Anesthesiology at Memorial Sloan Kettering Cancer Center (MSK), where she is the Director of Enhanced Recovery Program. Hear how standardized care protocols, non-opioid analgesia, and real-time locating systems help to provide a higher standard for patients. Also, we look at the future of personalized care and the critical importance of 'Returning to Intended Oncological Therapy' (RIOT) for cancer patients.
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Metabolic flexibility
08/04/2025
Metabolic flexibility
Recorded at the Evidence Based Perioperative Medicine (EBPOM) World Congress in London this piece dives into the importance of metabolic flexibility in perioperative care. We discuss the prevalence of metabolic inflexibility in patients undergoing surgery and its impact on postoperative complications alongside insights from recent studies and potential future interventions, emphasizing the importance of recognizing metabolic inflexibility as an important factor in clinical practice. The conversation concludes with a look at how this concept extends beyond perioperative care to overall health and wellness. Presented by Andy Cumpstey with his guest John Whittle, consultant in anaesthesia, critical care and perioperative medicine at University College Hospitals and an honorary associate professor at University College London, UK. The data mentioned is here:
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International Perspectives on Perioperative Medicine
07/28/2025
International Perspectives on Perioperative Medicine
Broadcasting from the Evidence-based Perioperative Medicine World Congress in London, UK, TopMedTalk takes you behind the scenes to the conference conversations that matter. This episode delves into the importance of diversity in perioperative medicine, the patient-centred approach, the challenges of integrating multidisciplinary care, and the future of healthcare across different countries. Our guests share their experiences, challenges and strategies in implementing holistic, patient-focused care and the significance of leveraging technology and communication in improving patient outcomes. Presented by Andy Cumpstey with his guests, David Selwyn, appointed as the inaugural Director of the Centre for Perioperative Care (CPOC) in May 2019 and tasked with establishing and developing CPOC as a truly cross-organisational, multidisciplinary initiative led by the Royal College of Anaesthetists (RCoA), facilitating cross-organisational working on perioperative care for patient benefit. He remains an active clinician, dealing with the competing demands of anaesthesia and adult critical care; Vanessa Beavis, Past President of ANZCA, a specialist anaesthetist at Auckland City Hospital, New Zealand and also an Honorary Senior Lecturer at the Department of Anaesthesiology at the University of Auckland; and Maxime Cannesson, Department Chair, Anesthesiology and Professor of Anesthesiology at UCLA, California, USA and the Director, Centre for Perioperative Medicine (CPMed), American Society of Anesthesiology.
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Monitoring, the revolution is here
07/21/2025
Monitoring, the revolution is here
TopMedTalk's Andy Cumpstey continues our coverage of the hugely successful Evidence-Based Perioperative Medicine (EPBOM) World Congress in London. Here we dive deep into the realm of patient monitoring, exploring the use of wearable sensors and advanced algorithms for early detection and preventive care in hospital environments. Learn about ongoing research, innovation challenges, and prospective trials aiming to enhance patient care and safety. A comprehensive discussion on the future of healthcare technology and its implications on clinical practice. Presented by Andy Cumpstey with his guests, Sadia Khan, Consultant Cardiologist at West Middlesex University Hospital, Meera Joshi, Specialist registrar at Ashford and St Peter's Hospital NHS Foundation Trust and clinical research fellow in the department of surgery cancer at Imperial College London and Jasjit Syan, Senior Clinical Fellow in Cardiology and a PhD candidate in Digital Health at Chelsea and Westminster NHS Foundation Trust.
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Perioperative Pain Management - panel discussion | EBPOM
07/14/2025
Perioperative Pain Management - panel discussion | EBPOM
The final instalment of our series “Perioperative Pain Management” is a panel discussion where we answer the question: What are the various challenges and strategies in managing perioperative pain, particularly with regard to opioid use? The discussion covers the complexities of opioid de-escalation in preoperative periods, the benefits and risks of opioid-free anesthesia, and the use of multimodal approaches. We also touch on the coordination of patient care across multiple specialties and the impact of intraoperative practices on postoperative pain management and long-term opioid use. The session emphasizes the importance of patient education, consistent communication, and empowered collaboration among healthcare providers. The speakers on the panel are; Tim Miller, Professor of Anesthesiology at Duke University Medical Center, Fauzia Hasnie, Consultant Lead, Opioid Multidisciplinary Pain Management Clinic, Joint Lead, Combined Sickle-Opioid Virtual Multidisciplinary Clinic Guy’s & St Thomas’ NHS Foundation Trust, and Esteban Salas Rezola, Specialist in Anaesthesiology, Resuscitation and Pain Therapy at Hospital General Alicante. Chaired by John Whittle, Clinical Academic working in Perioperative Translational Medicine at UCL and Honorary Consultant in Perioperative Medicine, Anaesthesia and Critical Care at University College Hospitals London. The three presentations which accompany this piece are here:
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Healthcare demographics, tackling an age old problem | EBPOM 2025
07/10/2025
Healthcare demographics, tackling an age old problem | EBPOM 2025
Recorded at this year's annual Evidence Based Perioperative Medicine (EBPOM) World Congress in London, this conversation deals with a crisis that modern practitioners will recognise; how do we adapt to the needs of a collectively older population? We begin by focusing upon the Australian Intergenerational Report's alarming projections about an aging population and its impact on healthcare expenditure. It's a problem mirrored by many other Western nations. The conversation covers the ARC model, a solution that shows promise in improving postoperative outcomes by offering advanced recovery room care. We also discuss the importance of addressing blood pressure, fluid management, and potential cost-effective healthcare strategies to manage the increasing elderly population requiring surgery. We conclude by emphasizing the need for comprehensive measures beyond the ARC model to tackle the emerging healthcare challenges globally. Presented by Andy Cumpstey with Guy Ludbrook, Professor of Anaesthesia at the University of Adelaide and Royal Adelaide Hospital and Esrom Leaman is a specialty trainee in anaesthetics at the Royal Adelaide Hospital and Research Fellow at the Centre for Perioperative Health Economics & Policy.
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Perioperative Pain Management; the Opioid Epidemic and opioid reduction strategies
07/07/2025
Perioperative Pain Management; the Opioid Epidemic and opioid reduction strategies
This series of talks hits upon one of the longstanding themes of TopMedTalk, opioids and opioid reduction in a perioperative setting. We discuss the opioid epidemic, the issue of persistent opioid use after surgery, and strategies for opioid reduction. Topics include historical usage, the dangers of high-dose opioids, and alternative pain management techniques such as opioid-free anesthesia and multimodal analgesia. The discussion also highlights the importance of ongoing research, patient education, and evidence-based practices to minimize the side effects of opioids while ensuring effective pain management. Presented by Tim Miller, Professor of Anesthesiology at Duke University Medical Center. Tim completed his training in Nottingham, UK followed by a fellowship in cardiothoracic anaesthesia at Glenfield Hospital, Leicester, UK. He is a fellow of the Royal College of Anaesthetists.
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Perioperative Pain Management; opioid reduction service
06/30/2025
Perioperative Pain Management; opioid reduction service
In this piece we look at the opioid crisis in the UK and how it has translated into clinical practice. Hear about the history and data behind opioid prescription trends, specifically highlighting the high-risk patient demographics and mortality figures associated with opioid use. Learn how a multidisciplinary approach, taken by the opioid reduction service at Guy’s & St. Thomas', helps showcase early outcome data and the strategies employed in opioid weaning. Emphasizing the importance of patient engagement and personalized care we detail the clinic’s processes, preparations, and long-term strategies for opioid tapering. The episode concludes with a compelling patient testimonial video reflecting the positive outcomes of the service. Fauzia Hasnie, Consultant Lead, Opioid Multidisciplinary Pain Management Clinic, Joint Lead, Combined Sickle-Opioid Virtual Multidisciplinary Clinic Guy’s & St Thomas’ NHS Foundation Trust. Resources: UK National Institute for Health Care Excellence (NICE) guidelines: US Centers for Disease Control and Prevention (CDC):
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Perioperative Pain Management; Opioid Sparing Analgesia strategies guided by NOL index
06/23/2025
Perioperative Pain Management; Opioid Sparing Analgesia strategies guided by NOL index
This piece focuses on strategies for opioid-sparing anesthesia guided by the NOL Index, emphasizing the variability in patient responses to opioids. The importance of monitoring nociception, using advanced devices and techniques to customize opioid dosing, reduce side effects, and confirm the effectiveness of regional anesthesia. Our presenter shares personal experiences from their professional life and case studies, illustrating the benefits and challenges of implementing multimodal and opioid-free anesthesia approaches. The talk highlights the need for individualized treatment strategies in critical care and anesthesia. Presented by Esteban Salas Rezola, Specialist in Anaesthesiology, Resuscitation and Pain Therapy at Hospital General Alicante.
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Diversity at Euroanaesthesia 2025
06/16/2025
Diversity at Euroanaesthesia 2025
Euroanaesthesia 2025: the annual meeting of the European Society of Anaesthesiology and Intensive Care, in Lisbon, Portugal. TopMedTalk were there, check out our coverage on our podcast timeline. We’ve released many bonus episodes over the last few weeks! In this piece Kate Leslie and Nick Margerrison speak with their guests Sarah Saxena, course director and professor of anaesthesiology at the University of Mons, Belgium and Mia Gisselbaek, an anaesthesiologist and PhD student in medical education at University of Geneva Hospital, Switzerland. Drs Saxena and Gisselbaek were members of the working group for the ESAIC Mellin-Olsen Declaration on Diversity, Equity and Inclusion, which was signed at the opening ceremony of Euroanaesthesia 2025 in Lisbon, Portugal. The declaration can be found here: . doi: 10.1097/EJA.0000000000002186 A link to the machine learning algorithm for delirium developed by Drs Saxena and Gisselbaek can be found here
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