Cheery Littlebottom

New: Guidelines for anaesthesia and sedation in patients who are breastfeeding

Anaesthetic, sedative & analgesic medicines are transferred to breastmilk in only very small amounts. Patients should be advised that discarding of breastmilk after anaesthesia is not necessary

Download: buff.ly/KNnL8gR

Semaglutide, fasting and gastric ultrasound

Nearly 50% of patients receiving semaglutide treatment had a full stomach on pre-operative gastric ultrasound, regardless of dose, duration, route of administration or withholding time.

#AnSky

doi.org/10.1111/anae...

In this study, the presence of regional anaesthesia emerged as the strongest determinant of improved postop recovery.

#AnSky

doi.org/10.1111/anae...

Graph of maternal mortality rate against year for the UK. Rate bounces until and down around 500 deaths per 100,000 births until about 1940, when it falls sharply. It’s been very low (~1–3 per 100,000) ever since.

This graph is astonishing. The people that bang on about “natural birth” and “women have been doing this forever without help” need to be forced to stare at this until their eyes water.

Regional if possible. No clonidine. Opioid sparing (fentanyl in preference to longer acting). Discharge home if well.

Worry more about undiagnosed OSA or those who refuse CPAP

What was the overall feeling in the room about TIVA RSI?

Your peak inspiratory flow rate will be higher than your FGF through the CGO, so you'll be giving air at an unpredictable rate.

You could get the same effect with higher FGF through a circle can't you? I know there was an article saying 6L/min, but if O2 and air are cheaper run them fast?

I've played around with gen AI, about that it has made some tasks easier, but I don't believe it will achieve all that it's hyped to do (e.g. putting us out of work, especially doctors), and don't believe the altruistic goals (capitalism will stop that)

AI companies will fail. We can salvage something from the wreckage | Cory Doctorow AI is asbestos in the walls of our tech society, stuffed there by monopolists run amok. A serious fight against it must strike at its roots

Cory Doctorow summarises why I'm an AI sceptic. It's a long read but worth the effort

www.theguardian.com/us-news/ng-i...

Yes exactly this.

Labour suites I got used to interpreting ECGs because the obstetricians weren't confident but being told I had to perform them too was a shock to me a few years ago but has just got worse (fewer midwives now have a nursing backgrounds)

It's just painful. Everyone loses.

We deskill and frustrate the nurses
We increase the workload on the doctors who end up doing it
The patients end up with delays

It's madness

It does when I've tried it on top of cottage pies.

Freezing is a good call if you have space. Turn them into part cooked potato wedges and then freeze works very well (cute into wedges, parboil or steam, cover in oil, part roast then cool and freeze)

I'm impressed your institution is running so low, well done.

I try to run 500ml for maintenance with 6-8L on induction, but a lot of my colleagues are running 15L on induction and 1-2 L for maintenance ("for safety margin").

I think you're doing a brilliant job and wish we could match

But with the GA, do you need a fully functioning epidural too? A spinal where the local is wearing off by the end you can turn the remi up (or other IV opioid), and the spinal still has the diamorphine for poat-op

Probably very similar to you but with spinal instead of epidural.

Much less clonidine and magnesium intraop and more opioids then?

I have updated my Serratus Anterior Plane Block Video

Full Link Here: youtu.be/_Bv8UL9jdWI?...

#RAsky #AnSky #MesSky

Latest video on Infraclavicular block on my channel now!

youtu.be/GmwpyQqeVxs?...

#AnSky #RAsky #MedSky #RegionalAnaesthesia #RegionalAnesthesia

'Tis the season for some festive science songs.

If you've ever wanted to hear someone sing about a dimunitive tyranosaur then now is your chance

Hooray, welcome back xx

This is the sort of recipe I've come across and my colleagues who use it report it works well. The 20mcg/ml of remi in this paper is more than I've seen used so far

This seems like a huge dose of remifentanil in this study.

50ml of 1%propofol mixed with 1mg of remi is way more than I've seen colleagues use.

Is vasopressor use in this method really comparable to other methods as claimed?

How many had a 28.9% pay rise!

ANSWER - EVERYONE WHO DIDN’T HAVE SUCH A BIG CUT

If you hadn’t had the cut your haven’t needed the rise!

It really is that simple - shouldn’t be this hard

Unless you’re a history graduate Wes Streeting or bad at maths

The answer below

Worldwide Anaesthetic Conferences 2026 Discover all worldwide anaesthetic conferences in 2026. An easy to use list for planning your year. Made by an Anaesthetist’s wife.

Useful list of anaesthetic conferences 2026… #ansky

anaestheticgroup.com.au/worldwide-an...

“When participants used ChatGPT to draft essays, brain scans revealed a 47% drop in neural connectivity across regions associated with memory, language, & critical reasoning.

Their brains worked less, but they felt just as engaged—a kind of metacognitive mirage.”🧪

YouTube video by Dr Amit Pawa New Rectus Sheath Block Video with Actual Block Included!

Updated Video on Rectus Sheath Block (including actual block) just released! Please check it out!

#RAsky #AnSky #MedSky
#RegionalAnaesthesia #RegionalAnesthesia

youtu.be/MMsHci7kzIo?...

LEDs are so useful at all their different levels. At middle grade level their institutional experience makes on call and workforce planning so much better. They are criminally under recognised and their expansion with good candidates would help hospitals immeasurably

Agree on both points.

The #medskydebate thing was great and I learned some cool stuff and had fun with it. It seemed like hard work for @maffygirl.medsky.social though and it was sad but unsurprising that it has faded away

The following are associated with a reduced incidence of postoperative neurocognitive complications: dexmedetomidine; esketamine; remimazolam; acupuncture; cerebral monitoring; sleep interventions; corticosteroids; antipsychotics; & peripheral nerve blocks.

#AnSky #MedSky

doi.org/10.1111/anae...

Thank you for all the hard work, hope to see you back xx