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PODCAST

Depth of Anesthesia

Depth of Anesthesia is a podcast that critically explores dogmatic practices (we call them claims) in anesthesiology. Join us as we explore the literature around the latest clinical controversies!

education medicine

All Episodes

38:33

21: Should smaller endotracheal tubes be used for...

Depth of Anesthesia ·

2021/02/16

In this episode, we explore the evidence on whether smaller endotracheal tubes are... 1. Less likely to maintain a secure patent airway 2. Less reliable in facilitating positive pressure ventilation 3. Less able to seal the trachea and protect the lungs from aspiration We also discuss the potential harms associated with larger endotracheal tubes. Our guests are Dr. Shamir Karmali and Dr. Peter Rose from the Department of Anesthesiology at Vancouver General Hospital. Thanks for listening! If you

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39:14

20: Do lower intraoperative tidal volumes reduce...

Depth of Anesthesia ·

2020/12/11

In this episode, we explore the evidence on whether lower intraoperative tidal volumes (e.g., 6 vs. 9 cc/kg) reduce postoperative pulmonary complications. Our guest is Dr. Avery Tung. Dr. Tung is Professor of Anesthesia & Critical Care at the University of Chicago and Section Editor for Critical Care & Resuscitation for Anesthesia & Analgesia. Thanks for listening! If you enjoy our content, consider donating to our Patreon at https://bit.ly/3n0sklh. — Follow us on Instagram @DepthofAnesthesia and on

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25:18

19: Is hydrocortisone, ascorbic acid (Vitamin C), and...

Depth of Anesthesia ·

2020/11/11

In this episode, we discuss the role of hydrocortisone, ascorbic acid (Vitamin C) and thiamine (HAT therapy) in the treatment of patients with septic shock. We discuss biological plausibility and comprehensively review the latest evidence. Our guest is Dr. Jonathan Charnin. Dr. Charnin is an assistant professor of anesthesiology in the Divisions of Multi-specialty Anesthesia and Critical Care Medicine at the Mayo Clinic Connect with us @DepthAnesthesia on Twitter or email us at

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28:30

18: Is mixing in lidocaine effective for preventing...

Depth of Anesthesia ·

2020/10/07

In this episode, we discuss the mechanisms of burning with propofol infusion and explore the evidence behind strategies like mixing lidocaine with propofol. Our guest today is Dr. Stu Forman, Professor of Anesthesiology at Massachusetts General Hospital. He is an investigator on several NIH-sponsored basic research grants and co-director of the Harvard Anesthesia Research Training Fellowship. Connect with us @DepthAnesthesia on Twitter or email us at depthofanesthesia@gmail.com. Thanks for

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41:04

17: Is it important to reverse to a train-of-four...

Depth of Anesthesia ·

2020/09/09

In this part II or II series on neuromuscular blockade, we investigate the claim that a train-of-four target of 90% is important to achieve prior to extubation. Our guest today is Dr. Daniel Saddawi-Konefka, residency program director at Mass General. Connect with us @DepthAnesthesia on Twitter or email us at depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References Naguib M, Kopman AF, Lien CA, Hunter

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23:12

16: Is emergence from sevoflurane substantially...

Depth of Anesthesia ·

2020/08/03

We investigate the claim that emergence from sevoflurane is substantially faster than from isoflurane. We explore rationales and discuss cost. Our guest today is Dr. Keith Baker, Vice Chair of Education at Massachusetts General Hospital. Connect with us @DepthAnesthesia on Twitter or email us at depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. __ References Seitsonen ER, Yli-Hankala AM, Korttila KT. Similar

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26:43

15: Is dural puncture epidural (DPE) the optimal...

Depth of Anesthesia ·

2020/07/03

In 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

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25:41

14: What is the approach to post-extubation stridor...

Depth of Anesthesia ·

2020/05/07

In this episode, we explore the evidence for various strategies to manage post-extubation stridor and the applications to COVID-19 patients. Our guest today is Dr. Tiara Calhoun (@tiaraforsyth), an internal medicine resident at the Massachusetts General Hospital. She is an active contributor to FLARE (Fast Literature Assessment and Review), a newsletter that appraises the rapidly evolving literature on SARS-CoV-2. Check FLARE out here:

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40:02

13: Does COVID-19 cause ARDS?

Depth of Anesthesia ·

2020/04/29

Our guest today is Dr. Charles Hardin of the Division of Pulmonary and Critical Care Medicine at Massachusetts General Hospital. He is an active contributor to FLARE (Fast Literature Assessment and Review), a collaborative effort within the Pulmonary and Critical Care Division and the Department of Medicine. The mission of FLARE is to appraise rapidly evolving literature on SARS-CoV-2. Check FLARE out here: https://www.massgeneral.org/news/coronavirus/treatment-guidance/fast-literature-updates

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01:00:12

12: Is COVID-19 spread by aerosols and...

Depth of Anesthesia ·

2020/04/11

Our guest today is Dr. Justin Morgenstern (@First10EM). His website (First10EM) provides critical appraisals of important emergency medicine and critical care topics. Connect with us @DepthAnesthesia on Twitter or email us at depthofanesthesia@gmail.com Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. __ References Justin Morgenstern, "Aerosol generating procedures", First10EM blog, April 6, 2020. Available

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35:33

11: Does cricoid pressure reduce the risk of...

Depth of Anesthesia ·

2020/01/03

For our first episode of 2020, we investigate claims related to the application of cricoid pressure. Claim 1. Cricoid pressure reduces the risk of pulmonary aspiration. Claim 2. Landmark technique is able to accurately identify the cricoid cartilage. Claim 3. Cricoid pressure should be routinely applied in all rapid-sequence intubations. Our guest today is Dr. Jerome Crowley, an adult cardiothoracic anesthesiologist and intensivist at the Massachusetts General Hospital. Connect with us

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28:50

10: Is a subjective assessment of functional capacity...

Depth of Anesthesia ·

2019/11/22

We investigate the claim that a subjective assessment is an accurate way to measure functional capacity. We also explore whether self-reported ability to climb two flights of stairs is the best subjective method to assess functional capacity and whether exercise tolerance greater than or equal to 4 metabolic equivalents predicts the risk of perioperative complications in any major non-cardiac surgery. Our guests today are Dr. Elisa Walsh and Dr. Laurie Shapiro of the Massachusetts General Hospital.

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45:39

9: Is it safe to peripherally administer norepinephrine?

Depth of Anesthesia ·

2019/10/11

We investigate the claim that norepinephrine is not safe for peripheral administration. Our guests today are Dr. Katarina Ruscic and Dr. Jamie Sparling of the Critical Care Division of the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com. Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References Cardenas‐Garcia J, Schaub

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35:03

8: Does ketorolac increase the risk of bleeding?

Depth of Anesthesia ·

2019/09/20

We investigate the claim that administering ketorolac (Toradol) increases bleeding and should be avoided in surgeries for which there is concern for bleeding. Claim 1. Administration of intraoperative ketorolac increases the bleeding time due to platelet inhibition Claim 2. Increased bleeding time translates to higher rate of surgical bleeding Claim 3. The magnitude of bleeding propensity attributable to ketorolac is clinically relevant Our guest today is Dr. Jamie Sparling of the Critical Care

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30:21

7: How do you reverse neuromuscular blockade? - Part...

Depth of Anesthesia ·

2019/08/19

We investigate claims about reversal of neuromuscular blockade. Claim 1. Location of train-of-four assessment matters Claim 2. Train-of-four is unnecessary with "sufficient" time from the last dose Claim 3. Fade can be discriminated by tactile assessment Our guest today is Dr. Daniel Saddawi-Konefka of the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com. Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please

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30:56

6: Is the sniffing position optimal for viewing the...

Depth of Anesthesia ·

2019/07/29

We investigate the claim that the sniffing position aligns the "axes" and is the optimal position for viewing the glottic opening. Our guest is Dr. Keith Baker, Vice Chair for Education and a thoracic anesthesiologist at the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com. Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. --

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32:20

5: Do preoperative anxiolytics improve patient...

Depth of Anesthesia ·

2019/07/24

We investigate pro and con positions on preoperative anxiolytics. Pro claim: Preoperative anxiolytics improve patient satisfaction. Con claim: Preoperative anxiolytics delay recovery and discharge. My guest is Dr. Matthew Vanneman, an attending cardiothoracic anesthesiologist at the Massachusetts General Hospital. Full show notes available at depthofanesthesia.com. Recommend a guest or topic at depthofanesthesia@gmail.com or tweet us @DepthAnesthesia. Rate us on iTunes. -- References C

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54:31

4: Is it safe to administer cefazolin in...

Depth of Anesthesia ·

2019/06/04

We investigate the claim that an alternative antibiotic to cephalosporins (e.g., cefazolin) should be selected for penicillin-allergic patients in the perioperative setting. Claim 1. Alternative antibiotics may be as efficacious in preventing surgical site infections Claim 2. Cephalosporins (e.g., cefazolin) may be unsafe due to cross-reactivity. Claim 3. Administering cephalosporins (e.g., cefazolin) may be against the standard of care. My guest this week is Dr. Matthew Vanneman, an attending

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24:25

3: Does morphine cause more nausea than hydromorphone?

Depth of Anesthesia ·

2019/05/16

We investigate the claim that morphine causes more nausea than hydromorphone. My guest is Dr. Daniel Saddawi-Konefka, program director of the Anesthesia Residency Program at Massachusetts General Hospital. Full show notes available at depthofanesthesia.com. Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References Felden L, Walter C, Harder S, Treede RD,

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35:45

2: Is it necessary to confirm mask ventilation before...

Depth of Anesthesia ·

2019/05/02

We investigate the claim that mask ventilation should be "checked" or "confirmed" before administering paralytics. My guest is Dr. Daniel Saddawi-Konefka, program director of the Anesthesia Residency Program at Massachusetts General Hospital. Full show notes available at depthofanesthesia.com. Connect with us @DepthAnesthesia on Twitter or depthofanesthesia@gmail.com. Thanks for listening! Please rate us on iTunes and share with your colleagues. Music by Stephen Campbell, MD. -- References

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41 results

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