Had an amazing lunch with Yanni at #IARS24 !

He is planning amazing things in cardio obstetrics people!! 💫

#OBAnes

What dose of intrathecal fentanyl do you use for cesarean delivery at your hospital?

We use 15 mcg at Mayo Clinic Department of Anesthesiology

Michael Hofkamp, MD, FASA ‘s institution found in patients who had 15 mcg vs 10 mcg were 33% less likely to need rescue analgesia for CD

#OBAnes

We found that 29.6% of pts in the 10 mcg cohort needed a rescue intervention compared to 21.9% in the 15 mcg cohort. The OR for a pt in 15 mcg cohort needing an intervention was 0.668 (95% CI 0.507, 0.880; p=0.004)

There is no such thing as a “free lunch”. More fentanyl = more pruritus. We used administration of diphenhydramine and hydroxyzine during intraoperative or Phase I recovery periods as a surrogate marker of pruritus.

Practically speaking, 15 mcg is much easier to measure/administer. While my pts incurred more administration of diphenhydramine/hydroxyzine, I believe the improved analgesia outweighed the nuisance of apparent pruritis. 15 mcg of IT fentanyl appears to be the optimum dose for us

Published TODAY in BUMC Proceedings: “Effect of an increased dose of intrathecal fentanyl on cesarean delivery anesthesia at a Texas level IV maternal care center” 🧵

#OBAnes Emily Sharpe, MD, FASA Simon Ash @ropivacaine Susan Burton

tandfonline.com/doi/full/10.10…

Are we closer to an optimal IT fentanyl dose in #OBAnes for cesarean delivery?

Congrats Brendan Carvalho, MD, FRCA 🇺🇸🇿🇦🇵🇹 on this huge achievement! We’re so proud of you!!!

Similarly, Susan Burton spoke at #SOAPAM2024 and said that pts who underwent painful egg retrievals at Yale were also told that having a successful implantation and subsequent delivery were all that “mattered.” #OBAnes Emily Sharpe, MD, FASA Simon Ash

🧠 💉 🤕 I include the possibility of chronic #headache after post-dural puncture headache, in my informed consent conversations surrounding neuraxial #anesthesia
#obanes

Emily Sharpe, MD, FASA Samer Narouze,MD,PhD,MMM Dr. Vishal Uppal MBBS, FRCA 🇨🇦🇮🇳🏴󠁧󠁢󠁳󠁣󠁴󠁿 ASRA Pain Medicine SOAP Lisa Marie Leffert Allison Lee Nuala Lucas

Love this article from Dawn Baker MD, MS on finding balance with social media use!

kevinmd.com/2024/05/social…

This week is #maternalsepsisweek . Sepsis remains a leading cause of preventable maternal mortality. Please watch April’s story (our valued research team member) highlighting missed opportunities and educational resources. Please share: m.youtube.com/watch?v=BLRAHp…

Birth Trauma Inquiry: Report calls for overhaul of maternity care - BBC News. Many of these themes were discussed at #OAA24ASM bbc.co.uk/news/articles/…

Simon Ash Yavor Metodiev 🏳️‍🌈🏴󠁧󠁢󠁷󠁬󠁳󠁿🇧🇬 *For clarity that was 40% across multiple deliveries in paper cited earlier. We research CS as if it’s a one off but for many it isn’t.

I agree with Simon Ash - patient choice is central, and for that we need patients to be well informed beforehand.

Now I agree at least partly with Yavor Metodiev 🏳️‍🌈🏴󠁧󠁢󠁷󠁬󠁳󠁿🇧🇬 that it’d be nice to know why people chose GA. BUT the most important part was that they were 1. given a choice and 2. it was respected. No matter where you sit on the “when in doubt put them out” debate, patient choice is central. It

OAA and #OAA24ASM salutes the phenomenal Simon Ash for your indefatigable commitment to keeping the global #OBAnes community informed. Take a well-deserved bow. 👏👏👏 We look forward to welcoming you back to #OAA3DC24

Imagine if #anesthesia manuscript rejections came with this message!

Kudos to Emily Sharpe, MD, FASA for an excellent #SOAPAM2024 meeting
✅Thanks Xandra Schyns Lisa Leffert for the outstanding #PDPH Panel featuring שרון זינגר WouterSchievink
✅Inspiring #Ostheimer lecturer @MelissaEBauer
✅Pleasure catching up with friends
✅C u soon at #CASAM2024 #ANES24

The complete #SOAPAM2024 #Ostheimer lecture from Melissa E Bauer, D.O., FASA on “What’s new in #OBAnes ?” 🧵… so begins a whirlwind year of speaking for Melissa E Bauer, D.O., FASA and the countdown for Emily Sharpe, MD, FASA when she takes the reigns at #SOAPAM2025 .

Thanks so much for doing this!! You were missed at #SOAPAM2024 !