5 Questions Anesthesiologists Asked This Month

NYSORA's Anesthesia Assistant App processes thousands of questions from anesthesiologists every month. The article presents five frequently asked questions that are clinically relevant and often require reconsideration even by experienced clinicians. The first question concerns neuraxial anesthesia in an 82-year-old patient taking apixaban with a hip fracture, where the primary concern is spinal or epidural hematoma. The second question addresses hemodynamic goals during urgent surgery for a patient with severe aortic stenosis, emphasizing maintaining preload, afterload, and sinus rhythm. The third question warns against using succinylcholine in a 19-year-old patient with Duchenne muscular dystrophy due to the risk of hyperkalemia and rhabdomyolysis. The fourth question identifies Local Anesthetic Systemic Toxicity (LAST) as an immediate diagnosis for profound hypotension and bradycardia shortly after local anesthetic administration. The final question suggests methylene blue as an adjunctive treatment for refractory vasoplegic syndrome.