“Negotiating a Regional Anesthesia Service”

The American Society of Regional Anesthesia has announced it will be hosting a novel video guided session moderated by Dr Brian Harrington with presenters Eugene Viscusi MD, Edward Mariano MD, and Santhanam Suresh MD.  It will feature submitted videos by ASRA members and a Panel Discussion and an Open Forum.

Night of the Machines hosted by Dr Mike Olympio at Wake Forest University School of Medicine

Internal compartment of the Mindray A7 anesthesia machine

I am grateful for the opportunity to have attended the Anesthesia Machine Workshop “Night of the Machines” put on by Dr Mike Olympio who has done so for about every other year at Wake Forest University School of Medicine. This year’s was held  in the Center for Applied Learning and was well attended by anesthesiology residents, the institution’s anesthesia technicians, several student nurse anesthetists, and a few visitors like myself.  The 13 hour program was built on break-out sessions of small groups reading and analyzing schematics and diagrams on older machines, presenting their findings, and followed by expert lectures tying classic design to current machine principals. Representatives from anesthesia machine companies such as Mindray and Drager were on hand who presented their companies newest machines–the Mindray A7 and the Perseus A500.  The Mindray’s internal components are pictured above. The Perseus has a ventilator powered by a turbine the size of an Oreo cookie that spins at 55,000 rpm.  The two day event concluded with a hands-on Datex Aestiva machine pre-anesthesia safety check-out in the simulation laboratory. Participants were challenged to uncover 9 problems laid before them by the author of this course. Dr Olympio provided home baked goods while catered lunch and dinner was enjoyed by all.

Two Common Misconceptions about Anesthesia

John Charles Gerancher previously served as professor in the department of anesthesiology at the Wake Forest University School of Medicine. In addition, JC Gerancher oversaw the construction and implementation of a regional anesthesia section at Wake Forest Baptist Health.

One commonly held misconception about anesthetic drugs is that they put the body into deep sleep. In reality, it would be impossible to perform a highly invasive procedure on a sleeping patient. Anesthetic actually sends the body into a highly controlled, comatose state that doctors can reverse.

Many individuals are also under the impression that anesthesia is a chemical or medicine, when it is actually the state the body enters after anesthetic has been administered. Propofol is an anesthetic that puts the brain into a state of excitement before enacting the more traditional comatose, pain-free state.

Patients should always consult with their physicians and discuss the type of anesthetic being administered and its possible side effects.

39th Annual Regional Anesthesiology and Acute Pain Medicine Meeting is previewed in ASRA’s February Newsletter


The upcoming 39th Annual Regional Anesthesiology and Acute Pain Medicine Meeting is being put together by program chair Sandra L. Kopp, M.D. of the Mayo clinic.  The program will be held in Chicago and is now online.

Study Explores Anesthesia and Nerve Blocks

Dr. John Charles Gerancher is a former professor of anesthesiology at the Wake Forest University School of Medicine. A paper co-authored by Dr. John Charles Gerancher examines whether the overall drug dosage or the local anesthetic concentration acts as the main cause of continuous infraclavicular nerve blocks.

In carrying out the study, researchers inserted an infraclavicular catheter into individuals undergoing orthopedic surgery. They randomly separated the participants into two groups: those who received a 0.2 percent infusion of perineural ropivacaine and those who received a 0.4 percent infusion. Overall, both groups were given 16 milligrams of ropivacaine per hour. Further, patients could self-administer an additional eight milligrams every half hour.

The study’s results indicate that insensate limbs appear more often in those patients who received relatively concentrated ropivacaine at smaller volumes. The authors concluded that the interplay of local anesthetic volume and concentration is influenced by complex factors like the location of catheters.

The research appeared as “The Effects of Local Anesthetic Concentration and Dosage on Continuous Infraclavicular Nerve Blocks: A Multicenter, Randomized, Observer-masked, Controlled Study” in the journal Anesthesia and Analgesia.